Ongoing emergence and spread of Neisseria gonorrhoeae antimicrobial resistance is of global concern and was recently designated an “urgent threat” by the United States Centres for Disease Control and Prevention. Australia is not immune to the N. gonorrhoeae resistance problem as highlighted by the first report of a ceftriaxone-resistant strain from Australia in 2014. Enhancing antimicrobial resistance (AMR) surveillance strategies to advance detection of gonococcal AMR is a priority. Whilst bacterial culture-based methods remain the most definitive means of assessing N. gonorrhoeae AMR, there has been decreasing availability of cultured isolates for AMR susceptibility testing owing to increased use of nucleic acid amplification test (NAAT)-based methods for gonorrhoea diagnosis. Molecular AMR surveillance tools have the potential to overcome these problems. In particular, polymerase chain reaction (PCR)-based methods targeting key genetic markers of resistance can facilitate rapid, more intense sampling, for N. gonorrhoeae strains of public health importance following NAAT-based diagnosis. This presentation will discuss the development of real-time PCR methods for N. gonorrhoeae AMR detection and in doing so will highlight potential technical obstacles that may impinge upon assay design and performance.
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