Australian Gonococcal Surveillance Programme annual report, 2014.

The Australian Gonococcal Surveillance Programme (AGSP) has continuously monitored antimicrobial resistance in clinical isolates of Neisseria gonorrhoeae from all states and territories since 1981. In 2014, 4,804 clinical isolates of gonococci from public and private sector sources were tested for in vitro antimicrobial susceptibility by standardised methods. Decreased susceptibility to ceftriaxone (MIC value 0.06-0.125 mg/L) was found nationally in 5.4% of isolates, a lower proportion than that reported in the AGSP 2013 annual report (8.8%). The highest proportions were reported from New South Wales and Victoria (7.1% and 6.6% respectively). The proportion of strains resistant to penicillin in urban and rural Australia ranged from 11% in South Australia to 43% in New South Wales. In rural and remote Northern Territory penicillin resistance rates remained low (1.5%). In remote Western Australia relatively low numbers of strains are available for testing, however there is now widespread molecular testing for penicillin resistance in Western Australia to monitor resistance and inform guidelines and, for first time, these data are included in the AGSP annual report. Quinolone resistance ranged from 27% in the urban and rural areas of the Northern Territory, to 44% in the Australian Capital Territory, and quinolone resistance rates remain comparatively low in remote areas of the Northern Territory (3.1%) and remote areas of Western Australia (5.6%). Azithromycin resistance ranged from 0.5% in South Australia to 5.3% in rural and urban Western Australia. High rates were also reported from the Australian Capital Territory but relatively low numbers were tested. High level resistance to azithromycin (MIC value ≥256 mg/L) was again reported in 2014, in 2 strains from New South Wales. No resistance was reported from the Northern Territory, or remote Western Australia.