{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T23:51:02Z","timestamp":1789775462374,"version":"4.0.1"},"reference-count":30,"publisher":"BMJ","issue":"Suppl 4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2013,9,20]]},"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To outline the current situation of gonococcal antimicrobial resistance (AMR) in the Western Pacific region and factors that impact on this.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>The Western Pacific region is densely populated with many living in poverty. There are high rates of infectious diseases, and a disproportionate burden of gonococcal disease. In many countries there is uncontrolled antimicrobial use: these are ideal conditions for the emergence of AMR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Gonococcal AMR in this region has been monitored for more than 20\u2005years. Clinical isolates, predominantly from unselected patients attending sexually transmitted diseases clinics, are tested against a panel of antibiotics. Quality assurance and control strategies are in place.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There is widespread, high level resistance to penicillin and ciprofloxacin. Decreased susceptibility to ceftriaxone (MIC\u22650.06\u2005mg\/L) is reported in high levels from some countries in the region. Low numbers of isolates tested in some countries reflect capacity for testing, and are suboptimal for surveillance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The raised MIC values to ceftriaxone, and the emergence and spread of ceftriaxone resistant strains regionally is alarming. Sustaining and enhancing surveillance is critical; however obtaining an adequate sample size is a long-standing issue. The implementation of molecular surveillance strategies could provide broader information on the spread and threat of AMR.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2012-050906","type":"journal-article","created":{"date-parts":[[2013,11,15]],"date-time":"2013-11-15T14:33:46Z","timestamp":1384526026000},"page":"iv19-iv23","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Gonococcal antimicrobial resistance in the Western Pacific Region"],"prefix":"10.1136","volume":"89","author":[{"given":"Monica M","family":"Lahra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying-Ru","family":"Lo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M","family":"Whiley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2013,11,15]]},"reference":[{"key":"2024051410035260000_89.Suppl_4.iv19.1","unstructured":"WHO. 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Surveillance of antibiotic resistance in Neisseria gonorrhoeae in the WHO Western Pacific and South East Asian Regions, 2010 Communicable Diseases Intelligence Volume 36 No 1\u2014March 2012, 2012."},{"key":"2024051410035260000_89.Suppl_4.iv19.18","doi-asserted-by":"crossref","unstructured":"Zheng H-P Yang B Wu X-Z . Increase of African-type penicillinase-producing N. gonorrhoeae strains isolated in Guangzhou, China, 2001\u20132011 XVIIIth International Pathogenic Neisseria Conference. Germany, 2012.","DOI":"10.1136\/sextrans-2013-051184.1147"},{"key":"2024051410035260000_89.Suppl_4.iv19.19","doi-asserted-by":"crossref","unstructured":"Su X Jiang F Qimuge . Surveillance of antimicrobial susceptibilities in Neisseria gonorrhoeae in Nanjing, China, 1999\u20132006. 2007.","DOI":"10.1097\/OLQ.0b013e3180ca8f24"},{"key":"2024051410035260000_89.Suppl_4.iv19.20","unstructured":"Programme AGS. 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