Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/11270
Title: Exploring the Benefits of Molecular Testing for Gonorrhoea Antibiotic Resistance Surveillance in Remote Settings.
Authors: 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
Affiliation: The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia..
Sexual Health and Blood Borne Virus Unit, Centre for Disease Control, Department of Health, Darwin, Northern Territory, Australia..
Sexual Health and Blood Borne Virus Unit, Centre for Disease Control, Department of Health, Darwin, Northern Territory, Australia..
South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, Australia..
Central Clinical School, Monash University, Melbourne, Victoria, Australia; Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia; School of Population and Global Health, University of Melbourne, Melbourne, Australia..
The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia; Sydney Sexual Health Centre, Sydney Hospital, Sydney, New South Wales, Australia..
Central Clinical School, Monash University, Melbourne, Victoria, Australia; Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia; School of Population and Global Health, University of Melbourne, Melbourne, Australia..
The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia..
WHO Collaborating Centre for STD, Microbiology Department, South Eastern Area Laboratory Services, Prince of Wales Hospital, Sydney, New South Wales, Australia..
The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia..
Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Health Services, Queensland, Australia; Queensland Children's Medical Research Institute, University of Queensland, Queensland, Australia..
The Kirby Institute, UNSW Australia, Sydney, New South Wales, Australia..
Issue Date: 2015
Citation: PloS one 2015; 10(7): e0133202
Abstract: 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.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/11270
DOI: 10.1371/journal.pone.0133202
Type: Journal Article
Research Support, Non-U.S. Gov't
Subjects: 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
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