scholarly journals Azithromycin-resistant Neisseria gonorrhoeae spreading amongst men who have sex with men (MSM) and heterosexuals in New South Wales, Australia, 2017

2018 ◽  
Vol 73 (5) ◽  
pp. 1242-1246 ◽  
Author(s):  
David M Whiley ◽  
Ratan L Kundu ◽  
Amy V Jennison ◽  
Cameron Buckley ◽  
Athena Limnios ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
New South ◽  
New South Wales ◽  
South Wales ◽  
Sex With Men

Whole genome sequencing to characterise azithromycin resistant Neisseria gonorrhoeae from New South Wales in 2017

Pathology ◽  
2018 ◽  
Vol 50 ◽  
pp. S51
Author(s):  
C.R.Robert George ◽  
R. Rockett ◽  
David M. Whiley ◽  
Rodney P. Enriquez ◽  
R. Kundu ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
New South ◽  
New South Wales ◽  
Whole Genome ◽  
South Wales

Emergence and spread of ciprofloxacin-resistant Neisseria gonorrhoeae in New South Wales, Australia: lessons from history

2019 ◽  
Vol 74 (8) ◽  
pp. 2214-2219 ◽  
Author(s):  
Jane K Hanrahan ◽  
Tiffany R Hogan ◽  
Cameron Buckley ◽  
Ella Trembizki ◽  
Hazel Mitchell ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
New South ◽  
New South Wales ◽  
Treatment Change ◽  
Resistant Genotype ◽  
South Wales ◽  
Overseas Travel ◽  
Single Clone ◽  
Ciprofloxacin Resistance ◽  
Index Cases

Abstract Objectives Our aim was to investigate the emergence and spread of ciprofloxacin resistance in clinical Neisseria gonorrhoeae isolates in New South Wales, Australia, from the first reported case in 1991 until ciprofloxacin resistance was sustained at or above the WHO threshold for treatment change of 5% (1999), to inform future strategies for controlling gonococcal antimicrobial resistance. Methods The index isolate and all subsequent clinical isolates of ciprofloxacin-resistant N. gonorrhoeae in New South Wales from 1991 to 1999 were genotyped using a previously described method on the Agena MassARRAY iPLEX platform. Region of acquisition data, where available, were used to determine whether cases were travel associated. Results In New South Wales, of the 325 ciprofloxacin-resistant N. gonorrhoeae isolates reported from 1991 to 1999, 98% (320/325) were able to be recovered and 100% (320/320) were genotyped. There were 66 different genotypes, comprising 1–99 isolates each. Notably no single clone was found to account for ciprofloxacin resistance being sustained in the population, with considerable variability in genotype prevalence observed throughout the study period. A total of 65% (209/320) of genotyped isolates had information regarding the likely place of acquisition; of these, 44% (93/209) were associated with overseas travel or sexual contact with an overseas visitor. The first ciprofloxacin-resistant N. gonorrhoeae in New South Wales was associated with travel to Thailand. Index cases of each resistant genotype were significantly more likely to have been acquired overseas (51.5%), predominantly in Asia (45%, 30/66). Conclusions The continued importation of multiple genotypes, rather than the expansion of a single genotype, led to ciprofloxacin-resistant N. gonorrhoeae being established in New South Wales.

Using mathematical modelling to help explain the differential increase in HIV incidence in New South Wales, Victoria and Queensland: importance of other sexually transmissible infections

Sexual Health ◽  
2008 ◽  
Vol 5 (2) ◽  
pp. 169 ◽  
Author(s):  
Alexander Hoare ◽  
David P. Wilson ◽  
David G. Regan ◽  
John Kaldor ◽  
Matthew G. Law
Keyword(s):  
New South ◽  
New South Wales ◽  
Fold Increase ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Biological Data ◽  
Biological Factor ◽  
South Wales ◽  
Sexually Transmissible Infections ◽  
Sex With Men

Background: Since 1999 there has been an increase in the number of HIV diagnoses in Australia, predominantly among men who have sex with men (MSM), but the magnitude of increase differs between states: ~7% rise in New South Wales, ~96% rise in Victoria, and ~68% rise in Queensland. Methods: Epidemiological, clinical, behavioural and biological data were collated into a mechanistic mathematical model to explore possible reasons for this increase in HIV notifications in MSM. The model was then used to make projections to 2015 under various scenarios. Results: The model suggests that trends in clinical and behavioural parameters, including increases in unprotected anal intercourse, cannot explain the magnitude of the observed rise in HIV notifications, without a substantial increase in a ‘transmission-increasing’ factor. We suggest that a highly plausible biological factor is an increase in the prevalence of other sexually transmissible infections (STI). It was found that New South Wales required an ~2-fold increase in other STI to match the data, Victoria needed an ~11-fold increase, and Queensland required an ~9-fold increase. This is consistent with observed trends in Australia for some STI in recent years. Future projections also indicate that the best way to control the current rise in HIV notifications is to reduce the prevalence of other STI and to promote condom use, testing for HIV, and initiation of early treatment in MSM diagnosed during primary infection. Conclusions: Our model can explain the recent rise in HIV notifications with an increase in the prevalence of other STI. This analysis highlights that further investigation into the causes and impact of other STI is warranted in Australia, particularly in Victoria.

scholarly journals Is gentamicin a viable therapeutic option for treating resistant Neisseria gonorrhoeae in New South Wales?

2021 ◽  
Vol 45 ◽  
Author(s):  
Benjamin H Armstrong ◽  
Athena Limnios ◽  
David A Lewis ◽  
Tiffany Hogan ◽  
Ratan Kundu ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Large Scale ◽  
New South ◽  
Therapeutic Option ◽  
New South Wales ◽  
Newborn Health ◽  
Population Level ◽  
Clinical Isolates ◽  
National Guidelines ◽  
South Wales

The key issues with Neisseria gonorrhoeae infections, in Australia and elsewhere, are coincident increases in disease rates and in antimicrobial resistance (AMR), although these factors have not been shown to be correlated. Despite advances in diagnosis, control of this disease remains elusive, and incidence in Australia continues to increase. Of the Australian jurisdictions, New South Wales (NSW) has the highest N. gonorrhoeae notifications, and over the five-year period 2015–2019, notifications in NSW have increased above the national average (by 116% versus 85%, respectively). Gonococcal disease control is reliant on effective antibiotic regimens. However, escalating AMR in N. gonorrhoeae is a global health priority, as the collateral injury of untreated infections has substantive impacts on sexual and newborn health. Currently, our first-line therapy for gonorrhoea is also our last line, with no ideal alternative identified. Despite some limitations, gentamicin is licensed and readily available in Australia, and is proposed for treatment of resistant N. gonorrhoeae in national guidelines; however, supportive published microbiological data are lacking. Analysis of gonococcal resistance patterns within Australia for the period 1991–2019, including 35,000 clinical isolates from NSW, illustrates the establishment and spread of population-level resistance to all contemporaneous therapies. An analysis of gentamicin susceptibility on 2,768 N. gonorrhoeae clinical isolates from NSW, for the period 2015–2020, demonstrates that the median minimum inhibitory concentration (MIC) for gentamicin in NSW has remained low, at 4.0 mg/L, and resistance was not detected in any isolate. There has been no demonstration of MIC drift over time (p = 0.91, Kruskal-Wallis test), nor differences in MIC distributions according to patients’ sex or site of specimen collection. This is the first large-scale evaluation of gentamicin susceptibility in N. gonorrhoeae in Australia. No gentamicin resistance was detected in clinical isolates, 2015–2020, hence this is likely to be an available treatment option for resistant gonococcal infections in NSW.

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