Annual report of the Australian Gonococcal Surveillance Programme, 1998.

The Australian Gonococcal Surveillance Programme examined 3,583 isolates of Neisseria gonorrhoeae in 1998. Again in 1998 the rates and sites of infection and antibiotic susceptibility patterns varied considerably between regions, reflecting considerable differences between rural and urban gonorrhoea in Australia. Resistance to the penicillin and quinolone groups of antibiotics was highest in urban centres, but penicillins remained suitable for use in many parts of rural Australia. Quinolone-resistant gonococci continued to be concentrated in New South Wales (NSW) where sustained domestic transmission of these strains was maintained but at a lower rate than in 1997. Endemic transmission of Quinolone-resistant gonococci in homosexually active men was found for the first time. Quinolone-resistant gonococci in other centres continued to be isolated mostly from overseas travellers and at a lower frequency. All isolates remained sensitive to spectinomycin and ceftriaxone. Strains showing high level tetracycline resistance increased by 300% in NSW and were acquired predominantly through local contact. A significant increase in the number of isolates was recorded in NSW and Victoria in 1998, this increase being mainly attributable to an increase in gonorrhoea in homosexually active males. Strains examined in South Australia (SA), NSW and Victoria were predominantly from male patients and rectal and pharyngeal isolates were common. In other centres the male to female ratio was lower, and most isolates were from the genital tract in rates similar to those occurring in 1997.