The Australian Gonococcal Surveillance Programme 1979–2017

Neisseria gonorrhoeae (NG) is an important human bacterial pathogen responsible for more than 78 million infections per annum globally 1 .In Australia and elsewhere, NG infection rates are increasing and, critically, antimicrobial resistance (AMR) in NG poses a substantial threat to health security 2 .In response, the Australian Gonococcal Surveillance Programme (AGSP) was established in 1979, and has steadfastly evolved since that time to meet the challenges of continuously emerging AMR (Figure 1).Effective antibiotic treatment for gonorrhoea is critical for gonococcal disease control, minimising sequelae, reducing HIV transmission 3 , and NG elimination and eradication efforts (theoretically possible as there is no external host).Heightened concerns regarding NG AMR are based on the fact that NG has acquired resistance to all of the antibiotics used as treatment, and has maintained resistance to these various antibiotics even in the absence of selection pressure 4 .The current first line treatment recommended for gonorrhoea in urban Australia, Europe, the United States of America, the United Kingdom, in many countries in the Asia Pacific, and elsewhere, is ceftriaxone and azithromycin.