Poster Presentation 25th International Pathogenic Neisseria Conference 2026

Developing ultra-rapid specific isothermal assays for Neisseria gonorrhoea including detection of SNP resistance markers to inform appropriate antimicrobial treatment (#007)

Carlos Aya-Bonilla 1 , Karen Kroeger 1 , Shane Stone 1 , Charlene Kahler 1 , Paul Watt 1
  1. Avicena Systems Limited, West Perth, WA, Australia

Molecular testing for Sexually Transmitted Infections (STI) is generally too slow to guide customised treatment at the visit, contributing to missed or inappropriate antibiotic use and to rising antimicrobial resistance (AMR).  Resistance even to last-line gonorrhoea antibiotics is escalating in urban Australia and is emerging in remote Australian communities, yet routine tests give no resistance information.   Central-laboratory PCR  tests provide accurate pathogen detection but generally lack AMR markers. Point-of-care CT/NG platforms are faster but are costly and share the same gap: only detecting infection without any integrated NG resistance prediction and lack the sensitivity of molecular tests, particularly early in the infection cycle.  Limited PCR-based AMR marker screening remains slow, covering few markers, leaving the rest to culture/sequencing. Here we present the development of a CT/NG test with integrated resistance prediction for current and emerging therapies, compatible with central laboratories but remotely deployable in mobile formats based on Avicena’s Automated Sentinel instrument.   Here we apply a novel, allele-specific Loop Mediated Isothermal Amplification to detect  allelic markers of resistance, including azithromycin, penicillin (PPNG) and ceftriaxone in order to predict resistance within 30  minutes, at low cost.   In future, this automated screening  approach could more effectively combat spread of drug resistant NG, particularly in remote areas as it does not require a laboratory or depend on high levels of training. The novel test would be rapid enough to inform prescription of antibiotics which match the  NG sensitivity profile, to optimise custodianship of antibiotic use and minimise spread of resistance.