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Surveillance of gonococcal antibiotic susceptibility patterns is fundamental to prevention and control of gonorrhoea. In Northern Australia the rates of gonorrhoea are high and to date the overwhelming majority has been sensitive to penicillin. The advent of highly sensitive and robust polymerase chain reaction (PCR) testing has lead to increased diagnosis and treatment of gonorrhoea, at the same time, fewer specimens are being sent to laboratories for culture (and antibiotic susceptibility testing).
The effect of this was recently highlighted after reports of increased numbers of penicillin resistant gonorrhoea in Far North Queensland (FNQ) were received. There is considerable travel between the Northern Territory and FNQ residents, with the potential for wide transmission of resistant strains.
The NT response to this included:
- Confirmation that notified cases of PPNG had remained steady, but that cases diagnosed by culture had decreased by 400 per cent;
- Identification that there are deficiencies in the surveillance system at all levels and development of methods to improve this;
- Establishment of a Gonococcal Advisory Group (GAG) to examine and advise on issues of diagnosis, surveillance, management etc. Members of this group include infectious diseases clinicians, public health practitioners, representatives from all laboratories and Assoc Prof John Tapsall;
- Investigation of the establishment of sentinel surveillance sites;
- Education of clinicians of the importance of requesting culture as well as PCR on all specimens.
This article was published in Communicable Diseases Intelligence Volume 24, No 7, July 2000.