INFECTION WITH NEISSERIA GONORRHOEAE AND ASSOCIATION BETWEEN RISING CEFTRIAXONE MINUMUM INHIBITORY CONCENTRATION AND MEN WHO HAVE SEX WITH MEN. (February 2015) - Henderson, A. J.
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.