O09.6 Typing outer membrane vesicle proteins of Neisseria gonorrhoeae provides insight into antimicrobial resistance

gonococcal isolate demonstrating a minimum inhibitory concentration of AZM 2.0mg/mL. We used inverse variance weighting to account for heterogeneity in sample size across jurisdictions to estimate pooled AZM-RS prevalences and 95% confidence intervals. Results Across eight sites, 8,859 people (4,521 MSM, 758 women, and 3,580 MSW) provided at least one isolate for susceptibility testing; 1,052 people (10.4% [95% CI: 6.4%– 14.4%]) had gonorrhea demonstrating AZM-RS. AZM-RS prevalence was markedly high among MSM (15.1% [95% CI: 10.2%–20.0%]), and lower yet elevated among women and MSW combined (5.3% [95% CI: 2.9%–7.7%]). Among MSM with AZM-RS gonorrhea, 16.2% (95% CI: 10.9%–21.4%) reported having 3+ sexual partners in the last 2–3 months and 16.7% (95% CI: 12.6%–20.9%) reported previous gonococcal infections. Among women/MSW with AZM-RS, 6.2% (95% CI: 3.7%–8.7%) reported 3+ recent sexual partners, and 4.8% (95% CI: 2.4%–7.3%) reported previous gonococcal infections. Conclusions AZM-RS prevalence among women/MSW was lower than among MSM but still elevated, and a lower proportion of women/MSW reported multiple recent sexual partners and previous gonococcal infections. These data highlight differences in the epidemiology of reduced gonococcal susceptibility and the need to tailor resistant gonorrhea control approaches to affected populations.