Hui, Ben B

Ryder, Nathan

Su, Jiunn-Yih

Ward, James

Chen, Marcus Y

Donovan, Basil

Fairley, Christopher K

Guy, Rebecca J

Lahra, Monica M

Law, Mathew G

Whiley, David M

Regan, David G

2015

Surveillance for gonorrhoea antimicrobial resistance (AMR) is compromised by a move away from culture-based testing in favour of more convenient nucleic acid amplification test (NAAT) tests. We assessed the potential benefit of a molecular resistance test in terms of the timeliness of detection of gonorrhoea AMR. An individual-based mathematical model was developed to describe the transmission of gonorrhoea in a remote Indigenous population in Australia. We estimated the impact of the molecular test on the time delay between first importation and the first confirmation that the prevalence of gonorrhoea AMR (resistance proportion) has breached the WHO-recommended 5% threshold (when a change in antibiotic should occur). In the remote setting evaluated in this study, the model predicts that when culture is the only available means of testing for AMR, the breach will only be detected when the actual prevalence of AMR in the population has already reached 8 - 18%, with an associated delay of ~43 - 69 months between first importation and detection. With the addition of a molecular resistance test, the number of samples for which AMR can be determined increases facilitating earlier detection at a lower resistance proportion. For the best case scenario, where AMR can be determined for all diagnostic samples, the alert would be triggered at least 8 months earlier than using culture alone and the resistance proportion will have only slightly exceeded the 5% notification threshold. Molecular tests have the potential to provide more timely warning of the emergence of gonorrhoea AMR. This in turn will facilitate earlier treatment switching and more targeted treatment, which has the potential to reduce the population impact of gonorrhoea AMR.

PloS one 2015; 10(7): e0133202

https://pubmed.ncbi.nlm.nih.gov/26181042/?otool=iaurydwlib

https://hdl.handle.net/10137/5456

Adolescent

Adult

Anti-Bacterial Agents

Australia

Bacterial Typing Techniques

Disease Notification

Epidemiological Monitoring

Female

Gonorrhea

Humans

Male

Microbial Sensitivity Tests

Neisseria gonorrhoeae

Oceanic Ancestry Group

Penicillin Resistance

Penicillins

Population Groups

Prevalence

Exploring the Benefits of Molecular Testing for Gonorrhoea Antibiotic Resistance Surveillance in Remote Settings.

Journal Article

Publication