Infection with neisseria gonorrhoeae and association between rising ceftriaxone minumum inhibitory concentration and men who have sex with men

Abstract

Objectives The aim of this study was to review patients presenting with Neisseria gonorrhoeae over a 5 year period. Methods We performed a retrospective cohort study, using a prospective database and retrospective review of medical records, of patients with gonorrhoea infection presenting between January 2008 and November 2013. Results 215 patients screened positive by NAAT and treatment failure occurred in 2 patients after both initially received treatment with ciprofloxacin. of the 106 culture positive Neisseria gonorrhoeae isolates, 37 had ceftriaxone MIC >0.008. In addition, there were 4 penicillinase producing Neisseria gonorrhoeae (PPNG) isolates, 30 quinolone resistant Neisseria gonorrhoeae (QRNG) isolates, 9 tetracycline resistant Neisseria gonorrhoeae (TRNG) isolates and 4 isolates resistant to azithromycin. On a multivariate model, an association was seen between ceftriaxone MIC >0.008 and a history of men who have sex with men (MSM, OR 11.81, 95% CI 2.51–55.59, p = 0.02). Univariate analysis was statistically significant for infection involving either rectal or pharyngeal sites (OR 3.02, 95 CI 1.24–7.34, p = 0.02). Conclusion Screening for Neisseria gonorrhoea in rectal and pharyngeal sites is important amongst patients presenting with a history of MSM. Rising ceftriaxone MIC is associated with MSM and infection in rectal or pharyngeal sites.