Management of gonorrhoea in a hospital network: are we following best practice?
Leong Shuen Loo A , Kathryn Cisera B C , Tony M. Korman A B C and Ian Woolley
A B D
A School of Clinical Sciences at Monash Health, Monash University, 246 Clayton Road, Clayton, Vic. 3168, Australia.
B Monash Infectious Diseases, Monash Health, 246 Clayton Road, Clayton, Vic. 3168, Australia.
C Department of Microbiology, Monash Health, 246 Clayton Road, Clayton, Vic. 3168, Australia.
D Corresponding author. Email: ian.woolley@monash.edu
Sexual Health 16(5) 523-525 https://doi.org/10.1071/SH19018
Submitted: 1 February 2019 Accepted: 30 April 2019 Published: 11 July 2019
Journal Compilation © CSIRO 2019 Open Access CC BY-NC-ND
Abstract
Background: Gonorrhoea is usually managed in community sexual health or general practice, but a proportion of cases present to hospital settings. In this study, we examined how gonorrhoea was managed through a large hospital network and what the implications may be for public health management. Methods: A retrospective chart review was performed of the management of patients with Neisseria gonorrhoeae infection diagnosed at a large Australian healthcare network from January 2015 to May 2018. Documentation rates of five parameters of care were assessed: (1) the presence (or absence) of previous sexually transmissible infections (STIs); (2) recent travel; (3) discussion of HIV testing; (4) contact tracing; and (5) public health notification. Results: In all, 110 cases (48 male, 62 female) were analysed. Most cases were in the 15–39 years age group; 98 cases (89%) were symptomatic, and 12 (11%) were screening tests. The most common presenting syndromes were pelvic inflammatory disease (32%; 31/98 symptomatic cases), urethritis (26%; 25/98) and epididymo-orchitis (13%; 13/98). None of the five parameters assessed were documented in most cases. Documentation was most likely to occur in patients admitted to hospital. When HIV testing was performed, no new cases of HIV were identified. Conclusion: Infections with gonorrhoea present on a regular basis to hospital practice, but overall management is suboptimal. Automated prompts for other recommended tests, including HIV testing when testing for other sexually transmissible diseases is ordered, may improve management. Better awareness of best practice is needed, which can be facilitated with ongoing education. However, the greatest benefit is likely achieved by linking patients back to community-based services, which are best placed to provide ongoing long-term care.
Additional keywords: infectious diseases, Neisseria gonorrhoeae, public health, sexually transmitted infection, sexual health.
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