The Enhanced Gonococcal Surveillance Programme, Cambodia

The AGSP data are presented quarterly in tabulated form, as well as in the AGSP annual report. This report presents national gonococcal antimicrobial resistance surveillance data from 1 July, to 30 September, 2016.

The Australian National Neisseria Network (NNN) comprises reference laboratories in each state and territory that report data on antimicrobial susceptibility testing to an agreed group of antimicrobial agents for the Australian Gonococcal Surveillance Programme (AGSP). The AGSP data are presented quarterly in tabulated form, as well as in the AGSP annual report. This report presents national gonococcal antimicrobial resistance surveillance data from 1 October to 31 December 2023.

The Australian National Neisseria Network (NNN) comprises reference laboratories in each state and territory that report data on antimicrobial susceptibility testing to an agreed group of antimicrobial agents for the Australian Gonococcal Surveillance Programme (AGSP). The AGSP data are presented quarterly in tabulated form, as well as in the AGSP annual report. This report presents national gonococcal antimicrobial resistance surveillance data from 1 April to 30 June 2023.

The reference laboratories of the Australian Meningococcal Surveillance Programme (AMSP) report data on the number of cases of invasive meningococcal disease (IMD) confirmed by laboratory testing using culture and by non-culture based techniques. Data contained in quar-terly reports are restricted to a description of the number of cases of IMD by jurisdiction and serogroup, where known. A full analysis of laboratory confirmed cases of IMD in each calen-dar year is contained in the AMSP annual reports.

Highlights for August 2000 (typhoid, vaccine preventable diseases, malaria, legionellosis, meningococcal infections, influenza);National Notifiable Diseases Surveillance System tables, 1 to 31 August 2000;Laboratory Serology and Virology Reporting Scheme tables, 1 to 31 August 2000;Australian Sentinel Practice Research Network report tables, weeks 31 to 34, 2000;Gonococcal surveillance, reporting period 1 April to 30 June 2000;Australian encephalitis: chicken surveillance program, reporting period July and August 2000;HIV and AIDS surveillance, reporting period 1 to 30 April 2000, assessed as at 31 July 2000.

Data from the Australian Gonococcal Surveillance Programme (AGSP) were used to analyse changes in the patterns of gonococcal disease in Australia over the period July 1, 1981 to June 30, 1987. The AGSP is a continuing multicentric study of aspects of gonococcal disease and bases its analyses on laboratory-confirmed cases of gonorrhoea. The number of gonococcal isolates was highest in 1982-1983, when 6599 strains were cultured, but it fell in each subsequent year of the study until fewer than half this number was isolated in 1986-1987. The decrease in the number of isolated strains was proportionately-greater in men than in women, but in spite of this, the male-to-female ratio of disease in Australia remains unacceptably-high at two to one. In male patients, the decrease in the incidence of rectal isolates from 11.7% of all strains in 1981-1982 to 1.8% of all strains in 1986-1987 particularly was noteworthy. In female patients, pharyngeal isolates constituted an increasing proportion of strains and rose from 4.6% of all strains in 1981-1982 to 9.0% of all strains in 1986-1987; this has implications for the diagnosis and management of gonococcal disease in this group.

The National Neisseria Network (NNN), Australia, established in 1979, comprises reference laboratories in each state and territory. Since 1981, the NNN has reported data for the Australian Gonococcal Surveillance Programme (AGSP), on antimicrobial susceptibility profiles for Neisseria gonorrhoeae isolated from each jurisdiction for an agreed group of agents. The antibiotics reported represent current or potential agents used for the treatment of gonorrhoea, and include ceftriaxone, azithromycin, ciprofloxacin and penicillin. More recently, gentamicin and tetracycline are included in the AGSP Annual Report. Ceftriaxone, combined with azithromycin, is the recommended treatment regimen for gonorrhoea in Australia. Historically, there were substantial geographic differences in susceptibility patterns across the country, with certain remote regions of the Northern Territory and Western Australia having low gonococcal antimicrobial resistance rates. In these regions, an oral treatment regimen comprising amoxycillin, probenecid, and azithromycin was recommended. However, since January 2023, increasing reports of penicillin-resistant N. gonorrhoeae in the Northern Territory have changed treatment recommendations to align with the majority of Australia.1Additional data on other antibiotics are reported in the AGSP Annual Report. The AGSP has a programme-specific quality assurance process.

We describe the development of the Australian gonococcal surveillance programme from February 1979 to July 1982. Participants in the programme were the major public health laboratories in each state, which perform quantitative sensitivity tests on about 5400 strains of Neisseria gonorrhoeae yearly. Participating laboratories conducted sensitivity tests by a standardised technique which is described, and the results from each centre were collated quarterly. Temporal and regional differences in gonococcal sensitivity patterns were noted and, in the twelve months ending June 1982, there was a trend towards a decrease in gonococci sensitive to penicillin. Increasing numbers of penicillinase producing gonococci were found, and the isolation rates of these strains varied in different regions at different times.

Australian Gonococcal Surveillance Programme 1 April to 30 June 2017.

The Australian Gonococcal Surveillance Programme examined 3,583 isolates of Neisseria gonorrhoeae in 1998. Again in 1998 the rates and sites of infection and antibiotic susceptibility patterns varied considerably between regions, reflecting considerable differences between rural and urban gonorrhoea in Australia. Resistance to the penicillin and quinolone groups of antibiotics was highest in urban centres, but penicillins remained suitable for use in many parts of rural Australia. Quinolone-resistant gonococci continued to be concentrated in New South Wales (NSW) where sustained domestic transmission of these strains was maintained but at a lower rate than in 1997. Endemic transmission of Quinolone-resistant gonococci in homosexually active men was found for the first time. Quinolone-resistant gonococci in other centres continued to be isolated mostly from overseas travellers and at a lower frequency. All isolates remained sensitive to spectinomycin and ceftriaxone. Strains showing high level tetracycline resistance increased by 300% in NSW and were acquired predominantly through local contact. A significant increase in the number of isolates was recorded in NSW and Victoria in 1998, this increase being mainly attributable to an increase in gonorrhoea in homosexually active males. Strains examined in South Australia (SA), NSW and Victoria were predominantly from male patients and rectal and pharyngeal isolates were common. In other centres the male to female ratio was lower, and most isolates were from the genital tract in rates similar to those occurring in 1997.

The Australian Gonococcal Surveillance Programme monitors the antibiotic susceptibility of Neisseria gonorrhoeae isolated in all states and territories. In 2004, the in vitro susceptibility of 3,640 isolates of gonococci from public and private sector sources was determined by standardised methods. Different antibiotic susceptibility patterns were again seen in the various jurisdictions and regions. Resistance to the penicillins nationally was 22 per cent and, with the exception of the Northern Territory, ranged between 12 and 30 per cent. Resistance to quinolones was found in all jurisdictions in a larger proportion of strains and with higher MICs. Nationally, 23 per cent of all isolates were ciprofloxacin-resistant, and most of this resistance was at high MIC levels. All isolates remained sensitive to spectinomycin. A small number of isolates showed some decreased susceptibility to ceftriaxone (MIC 0.06 mg/L or more) and were again concentrated in New South Wales. A high proportion of gonococci examined in larger urban centres were from male patients and rectal and pharyngeal isolates were common. In other centres and in rural Australia the male to female ratio of cases was lower, and most isolates were from the genital tract.

The National Neisseria Network (NNN), Australia, comprises reference laboratories in each state and territory established in 1979. The NNN has reported data on susceptibility profiles for all Neisseria gonorrhoeae isolated from each jurisdiction for an agreed group of antimicrobial agents for the Australian Gonococcal Surveillance Programme (AGSP) since 1981. The antibiotics reported represent current or potential agents used for the treatment of gonorrhoea and include ceftriaxone; azithromycin; ciprofloxacin; and penicillin. More recently, gentamicin susceptibilities are included in the AGSP Annual Report. Ceftriaxone, combined with azithromycin, is the recommended treatment regimen for gonorrhoea in the majority of Australia. However, there are substantial geographic differences in susceptibility patterns in Australia, with certain remote regions of the Northern Territory and Western Australia having low gonococcal antimicrobial resistance rates. In these regions, an oral treatment regimen comprising amoxycillin, probenecid, and azithromycin is recommended for the treatment of gonorrhoea.

Aim: To characterize mutations in penA, mtrR, ponA, and porBIB, considered target genes for antimicrobial resistance, in Neisseria gonorrhoeae isolates with elevated minimum inhibitory concentrations (MICs) of ceftriaxone cultured from patients in New Zealand. Results: Out of 28 isolates supplied by the Institute of Environmental Science and Research Limited (ESR), Porirua, New Zealand, 14 were found to show reduced susceptibility to ceftriaxone (MIC of 0.06 mg/L) according to criteria used by the ESR and the Australian Gonococcal Surveillance Programme (AGSP) when tested in our laboratory. Rates of resistance to ciprofloxacin, azithromycin, penicillin, and tetracycline were 100% (28/28), 7% (2/28), 36% (10/28), and 25% (7/28), respectively. Ten different penA (Penicillin binding protein 2 [PBP2]) sequences were observed. The most common mosaic penA M-1 resembled mosaic penA XXXIV, which has been associated with ceftriaxone treatment failures in other countries. Four semimosaic PBP2 sequences were observed and may be novel PBP sequences, while four out of five nonmosaic PBP2 sequences were similar to PBP2 sequences reported in Australia. Twenty-one isolates harbored mutations in all 4 genes (penA, mtrR, porBIB, and ponA), and 13 of these exhibited reduced susceptibility to ceftriaxone. Conclusion: Mutations in penA, mtrR, porBIB, and ponA observed in this study may have contributed to reduced susceptibility to ceftriaxone among New Zealand gonococcal isolates. Over half (16/22) of mosaic penA sequences from the gonococcal isolates resembled penA XXXIV.

The Australian Gonococcal Surveillance Programme (AGSP) monitors the antibiotic susceptibility of Neisseria gonorrhoeae isolated in all states and territories. In 2006 the in vitro susceptibility of 3,850 isolates of gonococci from public and private sector sources was determined by standardised methods. Different antibiotic susceptibility patterns were again seen in the various jurisdictions and regions. Resistance to the penicillins nationally was at 34% and, with the exception of the Northern Territory, ranged between 17% and 51%. Quinolone resistance in gonococci increased, especially in Queensland, with resistance to this agent found in all jurisdictions. Nationally, 38% of all isolates were ciprofloxacin-resistant, and most of this resistance was at high minimum inhibitory concentration (MIC) levels. With the exception of the Northern Territory excepted, proportions of quinolone resistant gonococci ranged between 16% and 54%. All isolates remained sensitive to spectinomycin. Less than 1% of isolates showed some decreased susceptibility to ceftriaxone. A high proportion of gonococci examined in larger urban centres were from male patients and rectal and pharyngeal isolates were common. In other centres and in rural Australia the male to female ratio of cases was lower, and most isolates were from the genital tract.

Australian Gonococcal Surveillance Programme, 1 October to 31 December 2021.