Changing Epidemiology of Gonorrhea in Adelaide, South Australia

Ellis SL, Tsourtos G, Waddell R, Woodman R, Miller ER.

Changing Epidemiology of Gonorrhea in Adelaide, South Australia.

Sex Transm Dis. 2020 Jun;47(6):402-408. doi: 10.1097/OLQ.0000000000001162.

Abstract

Background: Gonorrhea is a significant public health concern. The changing epidemiology of gonorrhea in Australia has highlighted the need for detailed examination of surveillance data to determine population groups at greatest risk for infection.

Methods: We analyzed deidentified gonorrhea notification data for the years 2012 to 2017, in Adelaide (N = 3680), calculating age-adjusted notification and antibiotic resistance rates. Age, gender, year, sexual orientation, and socioeconomic status were assessed for associations with gonorrhea notifications using negative binomial, log binomial and spatial autoregressive models. Maps were generated to examine spatial localization of gonorrhea rates in Adelaide.

Results: Gonorrhea notification rates in Adelaide increased annually, with a 153% adjusted increase in rates from 2012 to 2017, localized to specific areas and inversely associated with income levels. The increase in rates in 2016 and 2017 was associated with young heterosexuals from low income areas. Azithromycin-resistant notifications increased significantly in 2016 in young heterosexuals. Reinfections were significantly more likely in men who have sex with men than other population groups.

Conclusions: This study demonstrates the changing epidemiology of gonorrhea in Adelaide from a largely men who have sex with men profile toward an increase in young heterosexual gonorrhea. This could be seen as a harbinger for future increases in heterosexually transmitted HIV and other sexually transmitted infections in Australia.

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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.

Early warning system exposes the rise of the gonorrhoea ‘super-superbug’

The Age, July19th 2017 – 8:32 AM

A critically drug-resistant strain of gonorrhoea dubbed a “super-superbug” has been detected in every Australian state and territory by a new national surveillance system.

The National Alert System for Critical Antimicrobial Resistance (CARAlert) identified 1,064 bacteria highly resistant to last-line antibiotics between 17 March 2016 and 31 March 2017 across 73 laboratories.

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.