Gonorrhoea epidemiology最新文献

{"title":"O08.2 Can a rapid STI sexual health service reduce gonococcal culture testing without reducing culture sensitivity? A service evaluation","authors":"A. Tofias, R. Gardiner, P. Muir, M. Crofts, M. Clarke, P. North, J. Steer, M. Williams, L. Harryman, J. Jackson, N. Childs, H. Wheeler, S. Moses, P. Horner","doi":"10.1136/SEXTRANS-2021-STI.93","DOIUrl":"https://doi.org/10.1136/SEXTRANS-2021-STI.93","url":null,"abstract":"Background The Panther (Hologic Inc) was introduced to our specialist sexual health service at point-of-care, which could provide a rapid gonorrhoea (GC) and chlamydia (CT) nucleic acid amplification test (NAAT) result within 4 hours. GC-culture testing was limited to those testing GC NAAT-positive and/or to those who received treatment before the NAAT result was available. We hypothesised that this would reduce the number of cultures and cost, but not reduce the sensitivity of GC-culture. GC isolates are required for susceptibility testing to optimise antimicrobial therapy and for Anti-microbial Resistance surveillance. Methods We obtained and compared data on NAATs taken 12 months before and 12 months after the introduction of rapid testing in November 2019. We linked GC-cultures taken within 2 weeks of the NAAT. Chi-square was used to compare proportions. Results 23,588 CT/GC NAATs were taken before and 21,588 after the introduction of the new rapid STI service of which 684(2.9%) and 766(3.5%) were GC-positive respectively. GC cultures dropped from 10881 to 6022 after November 2019 with the proportion of cultures to NAATs decreasing from 0.46 to 0.28 (p 95% in previous 8 months. Conclusions Implementation of the rapid STI service resulted in fewer GC-culture specimens being taken which reduced the cost of GC-culture but with no loss in GC-culture sensitivity overall.","PeriodicalId":104701,"journal":{"name":"Gonorrhoea epidemiology","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117271473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O08.4 Strengthening the U.S. Response to Resistant Gonorrhea (SURRG): A program to enhance local antibiotic resistant gonorrhea preparedness capacity","authors":"Karen Schlanger, K. Mauk, E. Learner, K. Town, C. Pham, S. Bhattacharyya, M. Sankaran, J. Black, K. Wendel, C. Mcneil, A. Fukada, M. Golden, J. Schillinger, R. Kirkcaldy","doi":"10.1136/SEXTRANS-2021-STI.95","DOIUrl":"https://doi.org/10.1136/SEXTRANS-2021-STI.95","url":null,"abstract":"Background/Purpose In 2016 the U.S. Centers for Disease Control and Prevention (CDC) initiated Strengthening the U.S. Response to Resistant Gonorrhea (SURRG) in local jurisdictions to enhance antibiotic resistant gonorrhea (ARGC) rapid detection and response infrastructure and evaluate the impact of key strategies. Approach Eight jurisdictions were funded for five years to establish or enhance local specimen collection for gonococcal cultures in STD and community clinics, conduct rapid antibiotic susceptibility testing (AST) using Etest® in local public health laboratories, modify surveillance systems for enhanced data collection and rapid communication of AST results, and initiate partner services and investigations among patients with GC demonstrating reduced susceptibility (RS) to ceftriaxone, cefixime or azithromycin. Outcomes/Impact SURRG grantees incorporated robust genital, pharyngeal, and rectal gonococcal culture collection from all genders at participating clinics. During 2018–2019, grantees performed AST on >10,700 isolates with a five-day median turnaround time from specimen collection to reporting AST results to providers. Fifty-nine percent of patients with RS GC returned for a test-of-cure; no resistance-related treatment failures were detected. Among 4,511 isolates, we found ≥95% concordance (within one doubling dilution) between AST performed locally using Etest® compared to agar dilution (reference method) for ceftriaxone, cefixime and azithromycin. We conducted investigations among cases and partners, identifying >100 new GC cases. Finally, we merged epidemiologic and partner data with isolate genomic data to further explore sexual networks with GC transmission and identify opportunities for local interventions. Innovation and Significance SURRG successfully built clinic, laboratory, and epidemiological capacity for local ARGC rapid detection and response. Notable outcomes/innovations include establishing best practices for collecting and transporting gonococcal culture specimens, implementing Etest® in local jurisdictions, and measuring the value of containing ARGC spread through partner services. Lessons learned and project-informed identification of additional ARGC control needs at the local and national level are being used to inform CDC’s ongoing ARGC control efforts.","PeriodicalId":104701,"journal":{"name":"Gonorrhoea epidemiology","volume":"320 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116429208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O08.5 Impact of increased asymptomatic testing for gonorrhoea among MSM on PrEP on the transmission and development of antimicrobial resistance","authors":"J. Heijne, M. Visser, J. Riou, N. Low","doi":"10.1136/SEXTRANS-2021-STI.96","DOIUrl":"https://doi.org/10.1136/SEXTRANS-2021-STI.96","url":null,"abstract":"Background In many countries, men who have sex with men (MSM) using pre-exposure prophylaxis (PrEP) are routinely three-monthly tested and treated for Neisseria gonorrhoeae (gonorrhoea), which might increase antimicrobial resistance (AMR). However, there is uncertainty about how AMR emerges. We investigated the impact of frequent testing and treating on gonorrhoea prevalence and AMR assuming different ways of AMR emergence. Methods We developed a compartmental model, which included three sexual activity classes that differed in unprotected sex partner numbers and testing uptake. AMR to ceftriaxone was incorporated as stepwise increases in minimum inhibitory concentrations and eventual resistance (MIC drift) in three separate ways: direct selection pressure through ceftriaxone treatment; indirect selection pressure through antimicrobials treatment for other reasons; or imported infection. Each model was calibrated to the ceftriaxone MIC curve from the Dutch Gonococcal Resistance to Antimicrobials Surveillance program (2015–2019). We estimated the impact of three-monthly testing of high-risk MSM on overall and AMR prevalence in 2030. Results Overall gonorrhoea model prevalence was 3.4% (95% uncertainty interval 3.2%–3.5%), and 14.3% (11.7%–18.0%) in high-risk MSM. Three-monthly testing resulted in 66%–93% reductions in overall prevalence for all three ways in which AMR development was modelled. AMR prevalence was low in 2030 for all three mechanisms, but increased fastest with direct selection compared to indirect or imported. With direct selection, AMR prevalence was 1.7 (1.3–2.0) times higher than with indirect selection and 8.2 (2.7–16.1) times higher than through imported infection. When high-risk MSM increased numbers of unprotected sex partners, three-monthly testing reduced overall prevalence less and AMR prevalence increased, especially with direct selection. Conclusion With frequent testing of MSM, direct selection pressure through treatment leads to more gonococcal resistance than indirect selection or imported infection. This study highlights the need to increase our understanding of mechanisms of AMR emergence in N. gonorrhoeae.","PeriodicalId":104701,"journal":{"name":"Gonorrhoea epidemiology","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116812094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O08.3 Disseminated Gonococcal Infection (DGI) in Seattle-King County, Washington (WA), 2006–2020","authors":"S. Mclaughlin, L. Barbee, C. Thibault, M. Golden, O. Soge","doi":"10.1136/SEXTRANS-2021-STI.94","DOIUrl":"https://doi.org/10.1136/SEXTRANS-2021-STI.94","url":null,"abstract":"","PeriodicalId":104701,"journal":{"name":"Gonorrhoea epidemiology","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131386976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O08.6 Assessing within-host genetic variation in Neisseria gonorrhoeae at different anatomical locations and over time","authors":"J de Korne, S. Bruisten, H. D. Vries, A. V. Dam","doi":"10.1136/SEXTRANS-2021-STI.97","DOIUrl":"https://doi.org/10.1136/SEXTRANS-2021-STI.97","url":null,"abstract":"","PeriodicalId":104701,"journal":{"name":"Gonorrhoea epidemiology","volume":"35 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131150734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"O08.1 Oropharyngeal gonorrhoea infections among females and heterosexual males with genital gonorrhoea attending a sexual health clinic in Melbourne, Australia","authors":"C. Allen, C. Fairley, Marcus Y. Chen, Kate Maddaford, J. Ong, D. Williamson, E. Chow","doi":"10.1136/SEXTRANS-2021-STI.92","DOIUrl":"https://doi.org/10.1136/SEXTRANS-2021-STI.92","url":null,"abstract":"","PeriodicalId":104701,"journal":{"name":"Gonorrhoea epidemiology","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115183498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}