{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T15:08:24Z","timestamp":1771340904861,"version":"3.50.1"},"reference-count":34,"publisher":"CSIRO Publishing","issue":"5","license":[{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"vor","delay-in-days":2071,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,13]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antimicrobial-resistant (AMR) gonorrhoea is a global public health threat. Discriminatory point-of-care tests (POCT) to detect drug sensitivity are under development, enabling individualised resistance-guided therapy. Methods: An individual-based dynamic transmission model of gonorrhoea infection in MSM living in London has been developed, incorporating ciprofloxacin-sensitive and resistant strains. The time-dependent sexual contact network is captured by periodically restructuring active connections to reflect the transience of contacts. Different strategies to improve treatment selection were explored, including discriminatory POCT and selecting partner treatment based on either the index case or partner susceptibility. Outcomes included population prevalence of gonorrhoea and drug dose counts. Results: It is shown that using POCT to detect ciprofloxacin-sensitive infections could result in a large decrease in ceftriaxone doses (by 70% compared with the reference case in the simulations of this study). It also suggests that ceftriaxone use can be reduced with existing technologies, albeit to a lesser degree; either using index case sensitivity profiles to direct treatment of partners, or testing notified partners with strain discriminatory laboratory tests before treatment, reduced ceftriaxone use in our model (by 27% and 47% respectively). Conclusions: POCT to detect ciprofloxacin-sensitive gonorrhoea are likely to dramatically reduce reliance on ceftriaxone, but requires the implementation of new technology. In the meantime, the proportion of unnecessary ceftriaxone treatment by testing partners before treatment could be reduced significantly. Alternatively, index case sensitivity profiles could be used to select effective treatments for partners.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh18235","type":"journal-article","created":{"date-parts":[[2019,9,2]],"date-time":"2019-09-02T19:43:00Z","timestamp":1567453380000},"page":"514-522","source":"Crossref","is-referenced-by-count":10,"title":["Agent-based modelling study of antimicrobial-resistant Neisseria gonorrhoeae transmission in men who have sex with men: towards individualised diagnosis and treatment"],"prefix":"10.1071","volume":"16","author":[{"given":"Adam K.","family":"Zienkiewicz","sequence":"first","affiliation":[{"name":"ADepartment of Engineering Mathematics, University of Bristol, Bristol BS8 1UB, UK."},{"name":"BSchool of Veterinary Sciences, University of Bristol, Langford House, Langford, Bristol BS40 5DU, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicol\u00e1s","family":"Verschueren van Rees","sequence":"additional","affiliation":[{"name":"ADepartment of Engineering Mathematics, University of Bristol, Bristol BS8 1UB, UK."},{"name":"BSchool of Veterinary Sciences, University of Bristol, Langford House, Langford, Bristol BS40 5DU, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Homer","sequence":"additional","affiliation":[{"name":"ADepartment of Engineering Mathematics, University of Bristol, Bristol BS8 1UB, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason J.","family":"Ong","sequence":"additional","affiliation":[{"name":"CClinical Research and Development, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK."},{"name":"DCentral Clinical School, Monash University, Clayton, Vic. 3800, Australia."},{"name":"EPopulation Health Sciences, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Christensen","sequence":"additional","affiliation":[{"name":"EPopulation Health Sciences, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darryl","family":"Hill","sequence":"additional","affiliation":[{"name":"FSchool of Cellular and Molecular Medicine, University of Bristol, Biomedical Sciences Building, University Walk, Bristol BS8 1TD, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharine J.","family":"Looker","sequence":"additional","affiliation":[{"name":"EPopulation Health Sciences, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paddy","family":"Horner","sequence":"additional","affiliation":[{"name":"EPopulation Health Sciences, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2090-7702","authenticated-orcid":true,"given":"Gwenda","family":"Hughes","sequence":"additional","affiliation":[{"name":"GInstituto de Medicina Tropical, Universidade de S\u00e3o Paulo, Avenuenida Dr En\u00e9as Carvalho de Aguiar, 470, CEP 05403-000, S\u00e3o Paulo, Brasil."},{"name":"HBlood Safety, Hepatitis, STI & HIV Division, National Infection Service, Public Health England, NW9 5EQ, UK."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katy M. E.","family":"Turner","sequence":"additional","affiliation":[{"name":"BSchool of Veterinary Sciences, University of Bristol, Langford House, Langford, Bristol BS40 5DU, UK."},{"name":"EPopulation Health Sciences, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK."},{"name":"ICorresponding author. Email: katy.turner@bristol.ac.uk"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2019,9,3]]},"reference":[{"key":"2025102419093514600_R1"},{"issue":"10","key":"2025102419093514600_R2","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1258\/ijsa.2011.011267","article-title":"UK national guideline for the management of gonorrhoea in adults, 2011.","volume":"22","author":"Bignell","year":"2011","journal-title":"Int J STD AIDS"},{"key":"2025102419093514600_R3","unstructured":"Public Health England. Sexually transmitted infections: annual data tables 2008\u20132017. London: Public Health England; 2018. Available online at: https:\/\/www.gov.uk\/government\/statistics\/sexually-transmitted-infections-stis-annual-data-tables [verified 13 August 2019]."},{"issue":"1","key":"2025102419093514600_R4","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1136\/sextrans-2016-052583","article-title":"Drifting towards ceftriaxone treatment failure in gonorrhoea: risk factor analysis of data from the Gonococcal Resistance to Antimicrobials Surveillance Programme in England and Wales.","volume":"93","author":"Town","year":"2017","journal-title":"Sex Transm Infect"},{"key":"2025102419093514600_R5"},{"issue":"3","key":"2025102419093514600_R6","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1128\/CMR.00010-14","article-title":"Antimicrobial resistance in Neisseria gonorrhoeae in the 21st century: past, evolution, and future.","volume":"27","author":"Unemo","year":"2014","journal-title":"Clin Microbiol Rev"},{"issue":"2","key":"2025102419093514600_R7","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1097\/00007435-198304000-00007","article-title":"Introduction of sulfonamide therapy for gonorrhea.","volume":"10","author":"Kampmeier","year":"1983","journal-title":"Sex Transm Dis"},{"issue":"6","key":"2025102419093514600_R8","doi-asserted-by":"publisher","first-page":"A244","DOI":"10.1289\/ehp.117-a244","article-title":"The landscape of antibiotic resistance.","volume":"117","author":"Rosenblatt-Farrell","year":"2009","journal-title":"Environ Health Perspect"},{"issue":"9372","key":"2025102419093514600_R9","doi-asserted-by":"publisher","first-page":"1867","DOI":"10.1016\/S0140-6736(03)13489-7","article-title":"Ciprofloxacin resistance in Neisseria gonorrhoeae in England and Wales in 2002.","volume":"361","author":"Fenton","year":"2003","journal-title":"Lancet"},{"issue":"5","key":"2025102419093514600_R10","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1136\/sti.2004.012781","article-title":"BASHH guideline for gonorrhoea.","volume":"80","author":"Bignell","year":"2004","journal-title":"Sex Transm Infect"},{"key":"2025102419093514600_R11","unstructured":"Public Health England. Surveillance of antimicrobial resistance in Neisseria gonorrhoeae in England and Wales: key findings from the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) \u2013 data to May 2018. London: Public Health England; 2018. Available online at: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/746261\/GRASP_2017_report.pdf [verified 13 August 2019]."},{"issue":"10","key":"2025102419093514600_R12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002416","article-title":"Estimating the fitness cost and benefit of cefixime resistance in Neisseria gonorrhoeae to inform prescription policy: a modelling study.","volume":"14","author":"Whittles","year":"2017","journal-title":"PLoS Med"},{"issue":"25","key":"2025102419093514600_R13","doi-asserted-by":"publisher","first-page":"2504","DOI":"10.1056\/NEJMc1512757","article-title":"Failure of dual antimicrobial therapy in treatment of gonorrhea.","volume":"374","author":"Fifer","year":"2016","journal-title":"N Engl J Med"},{"issue":"27","key":"2025102419093514600_R14","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2018.23.27.1800323","article-title":"Gonorrhoea treatment failure caused by a Neisseria gonorrhoeae strain with combined ceftriaxone and high-level azithromycin resistance, England, February 2018.","volume":"23","author":"Eyre","year":"2018","journal-title":"Euro Surveill"},{"issue":"7","key":"2025102419093514600_R15","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1016\/S1473-3099(18)30340-2","article-title":"Genetic characterisation of Neisseria gonorrhoeae resistant to both ceftriaxone and azithromycin.","volume":"18","author":"Whiley","year":"2018","journal-title":"Lancet Infect Dis"},{"issue":"3","key":"2025102419093514600_R16","doi-asserted-by":"publisher","first-page":"608","DOI":"10.3201\/eid2403.171892","article-title":"Ceftriaxone-resistant Neisseria gonorrhoeae, Canada, 2017.","volume":"24","author":"Katz","year":"2018","journal-title":"Emerg Infect Dis"},{"key":"2025102419093514600_R17","unstructured":"O\u2019Neill LJ. Tackling drug-resistant infections globally: final report and recommendations \u2013 the Review on Antimicrobial Resistance chaired by Jim O\u2019Neill. 2016. 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