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Volume 32, Number 6—June 2026
Research
Antimicrobial-Resistant Neisseria gonorrhoeae of Public Health Concern, New South Wales, Australia, 2022–2024
, Sebastiaan J. Van Hal1, Cecilia Li, Steven J. Nigro, Ellen Donnan, Nathan Ryder, Monica Lahra2, and Janaki Amin2
Table 3
Characteristics of antimicrobial-resistant Neisseria gonorrhoeae cases of public health concern, New South Wales, Australia, 2022–2024*
| Characteristic | Overall, N = 94 | Ceftriaxone DS, n = 54 | Azithromycin HLR, n = 40 | p value |
|---|---|---|---|---|
| Patient age at diagnosis, median (IQR) |
33 (25–42) |
36 (24–43) |
30 (27–36) |
0.12† |
| Sex at birth | <0.001‡ | |||
| F | 18 (19.1) | 17 (31.5) | 1 (2.5) | |
| M |
76 (80.9) |
37 (68.5) |
39 (97.5) |
|
| Sexual risk group | <0.001‡ | |||
| Heterosexual | 41 (43.6) | 39 (72.2) | 2 (5.0) | |
| MSM | 49 (52.1) | 14 (25.9) | 35 (87.5) | |
| Bisexual |
4 (4.3) |
1 (1.9) |
3 (7.5) |
|
| Previous STI | <0.002‡ | |||
| Y | 47 (50.0) | 19 (35.2) | 28 (70.0) | |
| N |
47 (50.0) |
35 (64.8) |
12 (30.0) |
|
| Most recent previous STI occurrence§ | 0.7‡ | |||
| Co-infection | 18 (38.3) | 7 (36.8) | 11 (39.3) | |
| <1 y | 22 (46.8) | 8 (42.1) | 14 (50.0) | |
| >1 y | 7 (14.9) | 4 (21.1) | 3 (10.7) | |
| None |
47 |
35 |
12 |
|
| No. previous STIs, median (IQR) | 3 (1–5) | 2 (1–4) | 4 (2–6) | 0.11‡ |
| Unknown |
47 |
35 |
12 |
|
| Sex worker or client or SOPV attendance | 0.13‡ | |||
| Yes | 15 (16.0) | 10 (18.5) | 5 (12.5) | |
| No | 38 (40.4) | 17 (31.5) | 24 (60.0) | |
| Unknown |
41 (43.6) |
27 (50.0) |
14 (35.0) |
|
| Signs and symptoms | 0.095‡ | |||
| Symptomatic | 63 (67.0) | 38 (70.4) | 25 (62.5) | |
| Asymptomatic | 24 (25.5) | 10 (18.5) | 14 (35.0) | |
| Unknown |
7 (7.4) |
6 (11.1) |
1 (2.5) |
|
| Site of infection | <0.001‡ | |||
| Genitourinary tract | 58 (61.7) | 44 (81.5) | 14 (35.0) | |
| Rectal | 18 (19.1) | 3 (5.6) | 15 (37.5) | |
| Pharynx | 12 (12.8) | 4 (7.4) | 8 (20.0) | |
| Eye | 1 (1.1) | 1 (1.9) | 0 | |
| Multiple sites |
5 (5.3) |
2 (3.7) |
3 (7.5) |
|
| Source of infection | <0.001‡ | |||
| Australia | 74 (78.7) | 46 (85.2) | 28 (70.0) | |
| Africa | 1 (1.1) | 0 | 1 (2.5) | |
| Americas | 6 (6.4) | 0 | 6 (15.0) | |
| Europe | 3 (3.2) | 0 | 3 (7.5) | |
| Western Pacific | 9 (9.6) | 7 (13.0) | 2 (5.0) | |
| Unknown |
1 (1.1) |
1 (1.9) |
0 |
|
| Partners within 2-month lookback | ||||
| Total no. partners, median (IQR) | 2 (1–5) | 1 (1–2) | 5 (2–9) | <0.001‡ |
| Unknown |
26 |
17 |
9 |
|
| Diagnosing facility | 0.001‡ | |||
| General practice | 28 (29.8) | 22 (40.7) | 6 (15.0) | |
| Sexual health clinic | 62 (66.0) | 28 (51.9) | 34 (85.0) | |
| Hospital |
4 (4.3) |
4 (7.4) |
0 |
|
| Locality | 0.030‡ | |||
| Metropolitan | 90 (95.7) | 54 (100.0) | 36 (90.0) | |
| Regional |
4 (4.3) |
0 |
4 (10.0) |
|
| Outcome of initial test of cure | 0.14‡ | |||
| Negative | 81 (86.2) | 44 (81.5) | 37 (92.5) | |
| Positive | 4 (4.3) | 2 (3.7) | 2 (5.0) | |
| No follow-up visits | 9 (9.6) | 8 (14.8) | 1 (2.5) |
*Values are no. (%) except as indicated. Ceftriaxone DS is defined as MIC >0.125 mg/L; azithromycin HLR is defined as MIC >256 mg/L. Bold text indicates statistical significance. DS, decreased susceptibility; HLR, high-level resistance; IQR, interquartile range; MSM, men who have sex with men; SOPV, sex on premises venue; STI, sexually transmitted infection. †By Wilcoxon rank-sum test. ‡By Fisher exact test. §Categorizes the most recent STI occurrence.
1These first authors contributed equally to this article.
2These joint senior authors contributed equally to this article.