Update on multi-drug resistant shigella

SHINE SA, 7/3/2019

The shigella outbreak is continuing in South Australia. This is to advise clinicians to be on alert for a potential increase in shigella cases, and to highlight updated recommendations on treatment as released by the Communicable Disease Control Branch (CDCB).

The outbreak is predominantly in men who have sex with men (MSM) and there is a potential for further increase in numbers related to a larger outbreak in Victoria and NSW. We encourage you to be alert for clients who have recently traveled interstate.The CDCB is now recommending that patients with confirmed multi-drug resistant (MDR) shigella (or at risk of MDR shigella while awaiting sensitivities) be treated with five days of Ceftrixaone 1g IV, rather than 1 day (as recommended in the Public Health Alert issued in December 2018).

Gonorrhoea: Drug Resistance in Australia

Australian Federation of AIDS Organisations (AFAO), 26 June 2018

There has long been concern globally about the potential emergence of drug resistant STIs. In response, the World Health Organisation released new treatment guidelines for three common STIs – chlamydia, gonorrhoea and syphilis – in 2016.

At present, strains resistant to first line treatment of syphilis and chlamydia are not common and not a concern in Australia. There is, however, a growing level of concern about gonorrhoea. This paper therefore focuses on the likelihood and implications of the emergence of drug resistant cases of gonorrhoea in Australia. It also highlights treatment options in Australia and current and emerging strategies for preventing drug resistant gonorrhoea.

Download paper: AFAO Brief – Gonorrhoea – Drug Resistance in Australia – 26 June 2018

Gonorrhoea ‘super-superbugs’ triple in six months [in Australia]

SMH, 13/02/2018

Cases of a strain of gonorrhoea impervious to an antibiotic have almost tripled in six months, the latest report from the National Alert System for Critical Antimicrobial Resistance (CARAlert) reveals.

The result was a “warning shot across the bow” for doctors and public health officials fighting antibiotic resistance, CARAlert’s senior medical adviser said.

Treatment guidelines after an outbreak of azithromycin-resistant Neisseria gonorrhoeae in SA

The Lancet Infectious Diseases, 17 (2), February 2017

Abstract:

Antimicrobial resistance in Neisseria gonorrhoeae is recognised globally as a public health threat. Dual therapy with ceftriaxone and azithromycin has been introduced in Australia and elsewhere as the first-line treatment recommendation for gonorrhoea. While there have been only sporadic reports of ceftriaxone-resistant gonococci, globally there have been increasing reports of N gonorrhoeae resistance to azithromycin.1 The Australian Gonococcal Surveillance Programme2 is one of the most comprehensive N gonorrhoeae antimicrobial resistance surveillance programmes worldwide.

Antibiotic-Resistant Gonorrhea is On the Rise: Should Gay and Bi Men Be Concerned?

Slate, Sept. 2 2016 1:07 PM

For many gay and bi men, it’s a perennial point of contention: Are “minor” sexually transmitted infections—like chlamydia or gonorrhea—a cause for serious concern or major behavior modification?

A recent study by the Centers for Disease Control and Prevention, featured in its Morbidity and Mortality Weekly Report, found a significant rise in resistance to one of the drugs used to treat gonorrhea: azithromycin.