Exploring the benefits of molecular testing for gonorrhoea antibiotic resistance surveillance in remote settings

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. and Regan, David G. (2015) Exploring the benefits of molecular testing for gonorrhoea antibiotic resistance surveillance in remote settings. PLoS One, 10 7: 1-14. doi:10.1371/journal.pone.0133202

Author 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.
Title Exploring the benefits of molecular testing for gonorrhoea antibiotic resistance surveillance in remote settings
Journal name PLoS One   Check publisher's open access policy
ISSN 1932-6203
Publication date 2015-07-16
Year available 2015
Sub-type Article (original research)
DOI 10.1371/journal.pone.0133202
Open Access Status DOI
Volume 10
Issue 7
Start page 1
End page 14
Total pages 14
Place of publication San Francisco, CA United States
Publisher Public Library of Science
Language eng
Formatted 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.

Methods and Findings

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.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
Child Health Research Centre Publications
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Citation counts: TR Web of Science Citation Count  Cited 2 times in Thomson Reuters Web of Science Article | Citations
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