2014
DOI: 10.1128/jcm.00301-14
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Azithromycin-Resistant Syphilis-Causing Strains in Sydney, Australia: Prevalence and Risk Factors

Abstract: e Azithromycin has shown high efficacy in randomized trials when used for treating infectious syphilis in Africa. However, its use in clinical practice has been limited by the development of antimicrobial drug resistance. Resistance has not previously been reported from Australasia. The aim of this study was to determine the prevalence of and risk factors for azithromycin-resistant syphilis-causing strains in Sydney, Australia. We evaluated 409 samples that were PCR positive for Treponema pallidum DNA collecte… Show more

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Cited by 31 publications
(19 citation statements)
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“…The mechanism and spread of this resistance have been described previously in an excellent review [47]. Figure 2 summarizes the global prevalence of T. pallidum macrolide resistance, which varies widely from 80% in Sydney to 0.7% in Taiwan [38,48]. Of concern, there is evidence of rising prevalence in some centres [49,58].…”
Section: Treponema Pallidum Macrolide Resistancementioning
confidence: 95%
“…The mechanism and spread of this resistance have been described previously in an excellent review [47]. Figure 2 summarizes the global prevalence of T. pallidum macrolide resistance, which varies widely from 80% in Sydney to 0.7% in Taiwan [38,48]. Of concern, there is evidence of rising prevalence in some centres [49,58].…”
Section: Treponema Pallidum Macrolide Resistancementioning
confidence: 95%
“…The presence of A2058G and A2059G mutations causing macrolide resistance was screened in TPA clinical samples in a number of studies from different countries including Australia, 46 Canada, [47][48][49] Figure 1. In all published studies from the same area, it was clear that the number of macrolide-resistant TPA in clinical samples increased over time (Figure 2).…”
Section: Prevalence Of Macrolide-resistant Samples Of Tpa Patient's mentioning
confidence: 99%
“…In Sydney, Australia, just 16 cases of infectious syphilis were reported in 1999, compared to 745 cases in 2014, mainly among men who have sex with men (MSM) (1). Despite numerous public health and testing campaigns, this epidemic shows no signs of abating, and increasing reports of macrolide resistance create further challenges (2). An enhanced understanding of the dynamics of this epidemic is required to better inform public health responses.…”
mentioning
confidence: 99%