P028 Characterising neisseria gonorrhoeae (NG) infections and treatment in a large, urban cohort

Abstract

IntroductionBetter detection and more frequent testing may explain increases in NG. We wished to characterise patients attending our clinics with NG, and audit management against BASHH standards.Methods300 sequential NG patients attending in 2016 were reviewed. Data collected: demographics, NAAT/culture positivity (per site), antimicrobial treatment and resistance, and test of cure (TOC).ResultsMean age was 34 (17–65); 92% male; 75% white; 86% MSM. 415 site specific infections captured. Site distribution by NAAT, culture concordance/sensitivities, and TOC are presented below:Abstract P028 Table 1Gonorhoea infectionsSexualityCulture resultsTest of CureNAAT+ by SITEMSMHetero – MaleHetero – FemaleCultures takenCulture negativeCiprofloxacin resistanceTOC DoneTOC FailureVVSNANA7%(21/300)76%(16/21)19%(3/16)7.6%(1/13)76%(16/21)0%(0/16)Urethra42%(126/300)7%(21/300)NA90%(132/147)3.7%(5/132)33%(43/127)53%(78/147)2.6%(2/78)Pharynx37%(111/300)0.7%(2/300)1%(3/300)68%(79/116)51%(37/72)43%(18/42)66%(77/116)5.2%(4/77)Rectum43%(128/300)0.3%(1/300)0.7%(2/300)63%(83/131)12%(10/83)48%(35/73)65%(85/131)3.5%(3/85)75% NAAT+ patients (310/415) had cultures performed. There was one case of ciprofloxacin and azithromycin resistance (MSM). 96% (287/300) received ceftriaxone plus azithromycin. Reasons for alternatives related to penicillin allergy. Median time to treatment 0 days (0-45d). 63% (189/300) attended for TOC (median time: 21d (7-188d)) and 94% (177/189) patients tested negative. Failed TOC was due to reinfection in 92%.DiscussionOur clinics maintain reasonable adherence to BASHH standards. Cephalosporin resistance was not observed. TOC times can be lengthy.