P229 Are cases of gonorrhoea rising in very young patients in south west london? a retrospective case review of patients aged 18 years and younger diagnosed with gonorrhoea in a london teaching hospital gum service:

Abstract

Background Cases of Gonorrhoea continue to rise in the UK and young people (YP) remain disproportionally affected despite efforts to reduce infection rates. Aim To identify if there been a true rise in Gonorrhoea cases in very YP (≤18 years) attending our GUM service. Methods We identified all GUM (New and Rebook) attendances and Gonorrhoea diagnoses from 01/01/2011–31/12/2014 in patients ≤18 from MILLCARE. Electronic records were reviewed for demographics, infection site (s), antimicrobial resistance, re-infection and Chlamydia co-infection. Results There were 99 Gonorrhoea diagnoses in 84 patients, 94/99 (84.4%) in females and 15/99 (15.2%) in males (5/15 (33.3%) MSM). 1/84 (1.2%) was HIV+ (MSM). 26/99 (26.2%) infections were in White, 19/99 (19.2%) in Caribbean/Mixed-Caribbean, 11/99 (11.1%) in African/Mixed-African and 7/99 (7.1%) in Other-Mixed ethnicities. 80/84 (95.2%) were UK born. Age range was 15–18. 83/99 (83.8%) were genital and 12/99 (12.1%) were multiple site infections. We found concurrent Chlamydia in 53/99 (53.3%). Antimicrobial resistance was detected in 15/68 (22%) culture+ cases, 13/15 (86.7%) in females and 2/15 (13.3%) in MSM. 11/84 (13.1%) patients had ≥1 re-infection (positive test at ≥3 months), 10/11 (90.9%) females and 1/11 (9.1%) MSM. Mean time to re-infection was 5.1 months. Discussion NAAT testing was introduced into our service preceding the study period. We found Gonorrhoea diagnoses in patients ≤18 have increased three-fold in 4 years in our clinic with high rates of Chlamydia co-infection, antimicrobial resistance and re-infection. MSM, females and patients of Black/Mixed ethnicity are disproportionally affected. Further work is required to investigate factors contributing to the observed rise in Gonorrhoea in YP, and strategies to reduce infection rates.