The increasing rates of gonorrhea infections worldwide and the evolving profile of antimicrobial resistance has prompted global public health concerns regarding the successful management of gonorrhea. In the absence of new antimicrobials, the use of point-of-care (POC) tests for identifying infected individuals and guiding precision treatment has been proposed as a strategy to mitigate the effects of antimicrobial resistant (AMR) gonorrhea. However, despite advancements in nucleic acid amplification technologies, there is no commercially available test for antimicrobial susceptibility testing (AST) that we can be implemented at the POC. Genotyping assays for prediction of antimicrobial susceptibility have been developed and are beginning to be implemented in the clinical setting for precision treatment. However, these assays are not at the POC and cannot reliably be used to predict susceptibility to all antimicrobials. While still in the early stages of development, novel phenotypic approaches targeting antimicrobial-reactive markers have shown promise as an approach on which to build rapid AST assays. Due to their speed, diagnostic performance, and portability, microfluidic-based technologies meet several of the diagnostic criteria for the development of rapid AST assays which could be implemented at the POC. Implementation in the clinical setting of these AST POC tests is another major challenge which should be evaluated and implementation strategies developed concurrently to test development.

Disclosure No significant relationships.