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Clin Infect Dis. 2016 Dec 15;63(12):1591-1598. Epub 2016 Sep 28.

The Molecular Epidemiology and Antimicrobial Resistance of Neisseria gonorrhoeae in Australia: A Nationwide Cross-Sectional Study, 2012.

Author information

1
UQ Centre for Clinical Research, The University of Queensland, Brisbane.
2
Kirby Institute, UNSW Australia, Sydney.
3
Sydney Sexual Health Centre, Sydney Hospital, New South Wales.
4
Melbourne Sexual Health Centre, Alfred Health, Carlton.
5
Central Clinical School Monash University, Melbourne, Victoria.
6
Microbiology Laboratory, Pathology Department, Royal Darwin Hospital, Northern Territory.
7
WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, New South Wales.
8
Microbiology and Infectious Diseases Department, Women's and Children's Hospital, North Adelaide, South Australia.
9
Department of Global Health, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory.
10
PathWest Laboratory Medicine-WA, Royal Perth Hospital, Western Australia.
11
HNE Sexual Health, Hunter New England Local Health District, New South Wales.
12
Public Health Microbiology, Communicable Disease, Queensland Health Forensic and Scientific Services, Archerfield.
13
Microbiological Diagnostic Unit, Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Victoria.
14
Sexual Health and Blood Borne Virus Unit, Centre for Disease Control, Darwin, Northern Territory.
15
South Australian Health and Medical Research Institute, Adelaide, South Australia.
16
Pathology Queensland Central Laboratory, Herston, Australia.

Abstract

BACKGROUND:

 Antimicrobial resistance (AMR) by Neisseria gonorrhoeae is considered a serious global threat.

METHODS:

 In this nationwide study, we used MassARRAY iPLEX genotyping technology to examine the epidemiology of N. gonorrhoeae and associated AMR in the Australian population. All available N. gonorrhoeae isolates (n = 2452) received from Australian reference laboratories from January to June 2012 were included in the study. Genotypic data were combined with phenotypic AMR information to define strain types.

RESULTS:

 A total of 270 distinct strain types were observed. The 40 most common strain types accounted for over 80% of isolates, and the 10 most common strain types accounted for almost half of all isolates. The high male to female ratios (>94% male) suggested that at least 22 of the top 40 strain types were primarily circulating within networks of men who have sex with men (MSM). Particular strain types were also concentrated among females: two strain types accounted for 37.5% of all isolates from females. Isolates harbouring the mosaic penicillin binding protein 2 (PBP2)-considered a key mechanism for cephalosporin resistance-comprised 8.9% of all N. gonorrhoeae isolates and were primarily observed in males (95%).

CONCLUSIONS:

 This large scale epidemiological investigation demonstrated that N. gonorrhoeae infections are dominated by relatively few strain types. The commonest strain types were concentrated in MSM in urban areas and Indigenous heterosexuals in remote areas, and we were able to confirm a resurgent epidemic in heterosexual networks in urban areas. The prevalence of mosaic PBP2 harboring N. gonorrhoeae strains highlight the ability for new N. gonorrhoeae strains to spread and become established across populations.

KEYWORDS:

gonorrhea; molecular; resistance; surveillance; typing

PMID:
27682063
DOI:
10.1093/cid/ciw648
[Indexed for MEDLINE]

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