S02.4 Concordance between genotypic and phenotypic resistance, and implications for surveillance of AMR

Abstract

The gonococcus is now presenting some serious public health and clinical challenges. Notably, antibiotic-resistant Neisseria gonorrhoeae strains continue to emerge and spread and now threaten key gonorrhoea treatments, including ceftriaxone. Alternate treatment strategies are needed. Individualized therapy, whereby a rapid resistance test is used to inform individual patient treatment, is one proposed strategy. The use of individualised therapy in now already embedded in treatment of antibiotic (azithromycin)-resistant Mycoplasma genitalium infection, but is still in its infancy for the gonococcus. Key challenges exist, including knowledge gaps relating resistance mechanisms, the fact that sequence targets may change over time. These hurdles are not insurmountable, and can potentially be overcome via enhanced international collaboration and sequence/data sharing.