{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:16:25Z","timestamp":1790381785343,"version":"4.1.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T00:00:00Z","timestamp":1559779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Australian Gonococcal Surveillance Programme"},{"name":"AGSP"},{"DOI":"10.13039\/501100003921","name":"Australian Government Department of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003921","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Australian National Health and Medical Research Council Fellowships","award":["GNT1109035"],"award-info":[{"award-number":["GNT1109035"]}]},{"name":"Australian National Health and Medical Research Council Fellowships","award":["GNT1105128"],"award-info":[{"award-number":["GNT1105128"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Our aim was to investigate the emergence and spread of ciprofloxacin resistance in clinical Neisseria gonorrhoeae isolates in New South Wales, Australia, from the first reported case in 1991 until ciprofloxacin resistance was sustained at or above the WHO threshold for treatment change of 5% (1999), to inform future strategies for controlling gonococcal antimicrobial resistance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The index isolate and all subsequent clinical isolates of ciprofloxacin-resistant N. gonorrhoeae in New South Wales from 1991 to 1999 were genotyped using a previously described method on the Agena MassARRAY iPLEX platform. Region of acquisition data, where available, were used to determine whether cases were travel associated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In New South Wales, of the 325 ciprofloxacin-resistant N. gonorrhoeae isolates reported from 1991 to 1999, 98% (320\/325) were able to be recovered and 100% (320\/320) were genotyped. There were 66 different genotypes, comprising 1\u201399 isolates each. Notably no single clone was found to account for ciprofloxacin resistance being sustained in the population, with considerable variability in genotype prevalence observed throughout the study period. A total of 65% (209\/320) of genotyped isolates had information regarding the likely place of acquisition; of these, 44% (93\/209) were associated with overseas travel or sexual contact with an overseas visitor. The first ciprofloxacin-resistant N. gonorrhoeae in New South Wales was associated with travel to Thailand. Index cases of each resistant genotype were significantly more likely to have been acquired overseas (51.5%), predominantly in Asia (45%, 30\/66).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The continued importation of multiple genotypes, rather than the expansion of a single genotype, led to ciprofloxacin-resistant N. gonorrhoeae being established in New South Wales.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkz182","type":"journal-article","created":{"date-parts":[[2019,4,29]],"date-time":"2019-04-29T07:35:41Z","timestamp":1556523341000},"page":"2214-2219","source":"Crossref","is-referenced-by-count":11,"title":["Emergence and spread of ciprofloxacin-resistant Neisseria gonorrhoeae in New South Wales, Australia: lessons from history"],"prefix":"10.1093","volume":"74","author":[{"given":"Jane K","family":"Hanrahan","sequence":"first","affiliation":[{"name":"WHO Collaborating Centre for Sexually Transmitted Infections and Antimicrobial Resistance, NSWHP Microbiology, Prince of Wales Hospital, Sydney, New South Wales 2031, Australia"},{"name":"School of Biotechnology and Biomolecular Science, The University of New South Wales, Sydney, New South Wales 2052"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany R","family":"Hogan","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Sexually Transmitted Infections and Antimicrobial Resistance, NSWHP Microbiology, Prince of Wales Hospital, Sydney, New South Wales 2031, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron","family":"Buckley","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Herston, Queensland 4029, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ella","family":"Trembizki","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Herston, Queensland 4029, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazel","family":"Mitchell","sequence":"additional","affiliation":[{"name":"School of Biotechnology and Biomolecular Science, The University of New South Wales, Sydney, New South Wales 2052"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen L","family":"Lau","sequence":"additional","affiliation":[{"name":"Research School of Population Health, The Australian National University, Canberra, ACT 2600, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M","family":"Whiley","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Centre for Clinical Research, The University of Queensland, Herston, Queensland 4029, Australia"},{"name":"Pathology Queensland, Microbiology Department, Herston, Queensland 4029, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica M","family":"Lahra","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Sexually Transmitted Infections and Antimicrobial Resistance, NSWHP Microbiology, Prince of Wales Hospital, Sydney, New South Wales 2031, Australia"},{"name":"School of Biotechnology and Biomolecular Science, The University of New South Wales, Sydney, New South Wales 2052"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,6,6]]},"reference":[{"key":"2019071909304764000_dkz182-B1","first-page":"e1002366","author":"Alirol","year":"2017"},{"key":"2019071909304764000_dkz182-B2","year":"2013"},{"key":"2019071909304764000_dkz182-B3","volume-title":"Global Action Plan on Antimicrobial Resistance","year":"2013"},{"key":"2019071909304764000_dkz182-B4","doi-asserted-by":"crossref","first-page":"e1002344","DOI":"10.1371\/journal.pmed.1002344","article-title":"Antimicrobial resistance in Neisseria gonorrhoeae: global surveillance and a call for international collaborative action","volume":"14","author":"Wi","year":"2017","journal-title":"PLoS Med"},{"key":"2019071909304764000_dkz182-B5"},{"key":"2019071909304764000_dkz182-B6","first-page":"58","article-title":"Gaining control of gonorrhoea","volume":"15","author":"Bourne","year":"2014","journal-title":"Med Today"},{"key":"2019071909304764000_dkz182-B7","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1186\/s12879-015-1029-2","article-title":"Current and future antimicrobial treatment of gonorrhoea\u2014the rapidly evolving Neisseria gonorrhoeae continues to challenge","volume":"15","author":"Unemo","year":"2015","journal-title":"BMC Infect Dis"},{"key":"2019071909304764000_dkz182-B8","volume-title":"Global Antimicrobial Resistance Surveillance System (GLASS) Report: Early Implementation","year":"2017"},{"key":"2019071909304764000_dkz182-B9","volume-title":"WHO Guidelines for the Treatment of Neisseria gonorrhoeae","year":"2016"},{"key":"2019071909304764000_dkz182-B10","doi-asserted-by":"crossref","first-page":"606","DOI":"10.7326\/0003-4819-148-8-200804150-00005","article-title":"Emerging antimicrobial resistance in Neisseria gonorrhoeae: urgent need to strengthen prevention strategies","volume":"148","author":"Workowski","year":"2008","journal-title":"Ann Intern Med"},{"key":"2019071909304764000_dkz182-B11","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1016\/S1473-3099(16)30157-8","article-title":"Whole-genome sequencing to determine transmission of Neisseria gonorrhoeae: an observational study","volume":"16","author":"De Silva","year":"2016","journal-title":"Lancet Infect Dis"},{"key":"2019071909304764000_dkz182-B12","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1038\/nrmicro3217","article-title":"Molecular approaches to enhance surveillance of gonococcal antimicrobial resistance","volume":"12","author":"Goire","year":"2014","journal-title":"Nat Rev Microbiol"},{"key":"2019071909304764000_dkz182-B13","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1093\/jac\/dkr549","article-title":"Enhanced gonococcal antimicrobial surveillance in the era of ceftriaxone resistance: a real-time PCR assay for direct detection of the Neisseria gonorrhoeae H041 strain","volume":"67","author":"Goire","year":"2012","journal-title":"J Antimicrob Chemother"},{"key":"2019071909304764000_dkz182-B14","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1016\/S1473-3099(13)70693-5","article-title":"Genomic epidemiology of Neisseria gonorrhoeae with reduced susceptibility to cefixime in the USA: a retrospective observational study","volume":"14","author":"Grad","year":"2014","journal-title":"Lancet Infect Dis"},{"key":"2019071909304764000_dkz182-B15","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1136\/sextrans-2016-052738","article-title":"Identifying factors that lead to the persistence of imported gonorrhoeae strains: a modelling study","volume":"93","author":"Hui","year":"2017","journal-title":"Sex Transm Infect"},{"key":"2019071909304764000_dkz182-B16","first-page":"705","article-title":"Changes in the rates of Neisseria gonorrhoeae antimicrobial resistance are primarily driven by dynamic fluctuations in common gonococcal genotypes","volume":"72","author":"Lahra","year":"2017","journal-title":"J Antimicrob Chemother"},{"key":"2019071909304764000_dkz182-B17","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1093\/cid\/ciw648","article-title":"The molecular epidemiology and antimicrobial resistance of Neisseria gonorrhoeae in Australia: a nationwide cross-sectional study, 2012","volume":"63","author":"Trembizki","year":"2016","journal-title":"Clin Infect Dis"},{"key":"2019071909304764000_dkz182-B18","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1128\/CMR.00040-10","article-title":"Review and international recommendation of methods for typing Neisseria gonorrhoeae isolates and their implications for improved knowledge of gonococcal epidemiology, treatment, and biology","volume":"24","author":"Unemo","year":"2011","journal-title":"Clin Microbiol Rev"},{"key":"2019071909304764000_dkz182-B19","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1128\/AAC.40.4.1020","article-title":"Quinolone-resistant Neisseria gonorrhoeae: correlation of alterations in the GyrA subunit of DNA gyrase and the ParC subunit of topoisomerase IV with antimicrobial susceptibility profiles","volume":"40","author":"Deguchi","year":"1996","journal-title":"Antimicrob Agents Chemother"},{"key":"2019071909304764000_dkz182-B20","first-page":"292","article-title":"High level ciprofloxacin resistance in N. gonorrhoeae","volume":"70","author":"Birley","year":"1994","journal-title":"Genitourin Med"},{"key":"2019071909304764000_dkz182-B21","doi-asserted-by":"crossref","first-page":"33","DOI":"10.3201\/eid0301.970104","article-title":"Fluoroquinolone resistance in Neisseria gonorrhoeae","volume":"3","author":"Knapp","year":"1997","journal-title":"Emerg Infect Dis"},{"key":"2019071909304764000_dkz182-B22","year":"2014"},{"key":"2019071909304764000_dkz182-B23","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1128\/JCM.02071-09","article-title":"High-throughput identification of bacteria and yeast by matrix-assisted laser desorption ionization-time of flight mass spectrometry in conventional medical microbiology laboratories","volume":"48","author":"van Veen","year":"2010","journal-title":"J Clin Microbiol"},{"key":"2019071909304764000_dkz182-B24","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.diagmicrobio.2016.04.016","article-title":"A comparison of agar dilution with the Calibrated Dichotomous Sensitivity (CDS) and Etest methods for determining the minimum inhibitory concentration of ceftriaxone against Neisseria gonorrhoeae","volume":"86","author":"Enriquez","year":"2016","journal-title":"Diagn Microbiol Infect Dis"},{"key":"2019071909304764000_dkz182-B25","volume-title":"Antibiotic Susceptibility Testing by the CDS Method","author":"Bell","year":"2018"},{"key":"2019071909304764000_dkz182-B26","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1093\/jac\/dkt544","article-title":"High-throughput informative single nucleotide polymorphism-based typing of Neisseria gonorrhoeae using the Sequenom MassARRAY iPLEX platform","volume":"69","author":"Trembizki","year":"2014","journal-title":"J Antimicrob Chemother"},{"key":"2019071909304764000_dkz182-B27","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1071\/SH07037","article-title":"Using epidemiological and molecular methods to investigate an outbreak of gonorrhoea associated with heterosexual contact in Newcastle, NSW, Australia","volume":"4","author":"Todd","year":"2007","journal-title":"Sex Health"},{"key":"2019071909304764000_dkz182-B28","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1093\/infdis\/jix450","article-title":"Impact of rapid susceptibility testing and antibiotic selection strategy on the emergence and spread of antibiotic resistance in gonorrhea","volume":"216","author":"Tuite","year":"2017","journal-title":"J Infect Dis"},{"key":"2019071909304764000_dkz182-B29","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1080\/14737159.2017.1360137","article-title":"Recent advances in the development and use of molecular tests to predict antimicrobial resistance in Neisseria gonorrhoeae","volume":"17","author":"Don\u00e0","year":"2017","journal-title":"Expert Rev Mol Diagn"},{"key":"2019071909304764000_dkz182-B30","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1136\/sti.2010.044230","article-title":"Point-of-care antibiotic susceptibility testing for gonorrhoea: improving therapeutic options and sparing the use of cephalosporins","volume":"86","author":"Sadiq","year":"2010","journal-title":"Sex Trans Infect"},{"key":"2019071909304764000_dkz182-B31","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1093\/jac\/dkx333","article-title":"High levels of susceptibility to new and older antibiotics in Neisseria gonorrhoeae isolates from Saskatchewan (2003\u201315): time to consider point-of-care or molecular testing for precision treatment?","volume":"73","author":"Thakur","year":"2017","journal-title":"J Antimicrob Chemother"},{"key":"2019071909304764000_dkz182-B32","first-page":"1268","article-title":"Implementation of a rapid genotypic assay to promote targeted ciprofloxacin therapy of Neisseria gonorrhoeae in a large health system","volume":"64","author":"Allan-Blitz","year":"2016","journal-title":"Clin Infect Dis"},{"key":"2019071909304764000_dkz182-B33","first-page":"353","article-title":"A real-time PCR assay for direct characterization of the Neisseria gonorrhoeae GyrA 91 locus associated with ciprofloxacin susceptibility","volume":"71","author":"Fairley","year":"2015","journal-title":"J Antimicrob Chemother"},{"key":"2019071909304764000_dkz182-B34","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1128\/AAC.01104-08","article-title":"Quinolone resistance in Neisseria gonorrhoeae: rapid genotyping of quinolone resistance-determining regions in gyrA and parC genes by melting curve analysis predicts susceptibility","volume":"53","author":"Vernel-Pauillac","year":"2009","journal-title":"Antimicrob Agents Chemother"},{"key":"2019071909304764000_dkz182-B35","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1136\/sti.2010.044321","article-title":"Genotypes and antimicrobial-resistant phenotypes of Neisseria gonorrheae in Portugal (2004\u20132009)","volume":"86","author":"Florindo","year":"2010","journal-title":"Sex Trans Infect"},{"key":"2019071909304764000_dkz182-B36","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.1093\/infdis\/jis277","article-title":"Impact of fluoroquinolone resistance mutations on gonococcal fitness and in vivo selection for compensatory mutations","volume":"205","author":"Kunz","year":"2012","journal-title":"J Infect Dis"},{"key":"2019071909304764000_dkz182-B37","doi-asserted-by":"crossref","first-page":"2085","DOI":"10.1086\/386312","article-title":"Quinolone resistance-determining region mutations and por type of Neisseria gonorrhoeae isolates: resistance surveillance and typing by molecular methodologies","volume":"189","author":"Yuenger","year":"2004","journal-title":"J Infect Dis"},{"key":"2019071909304764000_dkz182-B38","doi-asserted-by":"crossref","first-page":"188.","DOI":"10.5694\/mja18.00564","article-title":"An era of untreatable gonorrhoea?","volume":"209","author":"Sutton","year":"2018","journal-title":"Med J Aust"},{"key":"2019071909304764000_dkz182-B39","doi-asserted-by":"crossref","first-page":"735","DOI":"10.3201\/eid2404.171873","article-title":"Cooperative recognition of internationally disseminated ceftriaxone-resistant Neisseria gonorrhoeae strain","volume":"24","author":"Lahra","year":"2018","journal-title":"Emerg Infect Dis"}],"container-title":["Journal of Antimicrobial Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jac\/advance-article-pdf\/doi\/10.1093\/jac\/dkz182\/28772519\/dkz182.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jac\/article-pdf\/74\/8\/2214\/28963358\/dkz182.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T22:29:56Z","timestamp":1569968996000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jac\/article\/74\/8\/2214\/5512101"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,6]]},"references-count":39,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2019,6,6]]},"published-print":{"date-parts":[[2019,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jac\/dkz182","relation":{},"ISSN":["0305-7453","1460-2091"],"issn-type":[{"value":"0305-7453","type":"print"},{"value":"1460-2091","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,8]]},"published":{"date-parts":[[2019,6,6]]}}}