Rising gonorrhoea rates and antimicrobial resistance
Gonorrhoea is increasing in Australia. Between 2014 and 2023 there was a 127% increase in the gonorrhoea notification rate (from 67.9 to 153.9 per 100 000) (Kirby Annual surveillance report 2024- STI).
In NSW, gonorrhoea notifications almost doubled from 2022 to 2024, with over 14,000 notifications in 2024. This is the highest number of gonorrhoea notifications ever received in one year (NSW Health).
While gonorrhoea prevalence is highest among men who have sex with men (MSM) and remote Aboriginal and Torres Strait Islander communities, there is increasing prevalence of gonorrhoea in the general population, especially in women of reproductive age.
Reduced susceptibility to first-line treatment is emerging in urban Australia and is being monitored closely.
Practice points
Testing:
For a patient with symptoms of gonorrhoea, collect x2 swabs
a) One for nucleic acid amplification test (PCR) and,
b) One for gonorrhoea culture antimicrobial sensitivities.
For patients who are PCR-positive for gonorrhoea, collect a swab for culture to enable detection of antimicrobial resistance (if not already done so).
Treatment:
Correct treatment of gonorrhoea prevents the emergence of resistant strains, see: Australian STI Management Guidelines
Contact tracing:
Contact tracing is essential for all people with gonorrhoea to reduce transmission and prevent re-infection. All partners should be traced back for a minimum of 2 months.
Follow up:
Test of cure should be performed from each site of infection by PCR 2 weeks after treatment is completed.
NSW Health Gonorrhoea Fact Sheet for Clients
For further information:
NSW Health Infectious Disease Alerts Antimicrobial resistant gonorrhoea alert March 2025
NSW Health's Safety Alert Broadcast System (SABS): SI:007/25 Antimicrobial resistant gonorrhoea 24 April 2025