Neisseria gonorrhoeae positivity in contacts presenting to a sexual health centre
T. Bromley
A * , D. Sundran B , C. Khaw A B and M. Ratnayake A
A
B
Sexual Health - https://doi.org/10.1071/SH22160
Submitted: 19 October 2022 Accepted: 29 August 2023 Published online: 26 September 2023
Abstract
Concerns regarding antimicrobial resistance and the appropriate use of antibiotics have resulted in many sexual health clinics moving away from the epidemiological treatment of contacts of gonorrhoea. The aim of this study was to inform decision-making regarding patients who are contacts who should be given epidemiological treatment.
This is a retrospective study of positivity rates of symptomatic and asymptomatic contacts of gonorrhoea who attended the Adelaide Sexual Health Centre from 1 January 2018 to 31 December 2019. Relevant demographic and behavioural characteristics were examined. Non-parametric continuous data were examined as medians and interquartile ranges, and categorical variables were examined as proportions and percentages. Chi-squared tests were used to determine any statistically significant differences in the proportions of participants testing positive to gonorrhoea based on the categorical variables.
A total of 402 clients were identified as contacts, of which 124 (30.8%) tested positive for gonorrhoea. Women were statistically more likely to test positive than men (27/56 (48.2%) of women vs 96/345 (27.8%) of men (P = 0.002), 0/1 transgender female). From a total of 76 heterosexual men, 14 (18.4%) tested positive as contacts, compared to 82/269 (30.5%) of bisexual/MSM (P = 0.038). Of the 214 asymptomatic bisexual/MSM, 55 (25.7%) were positive, 2/56 (3.6%) asymptomatic heterosexual men were positive and 10/29 (34.5%) asymptomatic females were positive for gonorrhoea.
This study identifies some demographic and behavioural characteristics that may be associated with a higher rate of gonorrhoea positivity as a contact, particularly females and MSM. Careful consideration may be required as to who should be given epidemiological treatment to ensure appropriate and judicious use of antibiotics.
Keywords: Australasia, contact, HIV/AIDS, men who have sex with men, Neisseria gonorrhoea, partner notification, STIs, testing.
References
1 Newman L, Rowley J, Vander Hoorn S, Wijesooriya NS, Unemo M, et al. Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting. PLoS ONE 2015; 10(12): e0143304.
| Crossref | Google Scholar |
2 Kirkcaldy RD, Harvey A, Papp JR, del Rio C, Soge OO, Holmes KK, Hook EW, III, Kubin G, Riedel S, Zenilman J, Pettus K, Sanders T, Sharpe S, Torrone E. Neisseria gonorrhoeae antimicrobial susceptibility surveillance – the Gonococcal Isolate Surveillance Project, 27 sites, United States, 2014. MMWR Surveill Summ 2016; 65(7): 1-19.
| Crossref | Google Scholar | PubMed |
3 Qian S, Foster R, Bourne C, Vickers T, McIver R, McNulty A. Neisseria gonorrhoeae positivity in clients presenting as asymptomatic contacts of gonorrhoea at a sexual health centre. Sex Health 2020; 17(2): 187-91.
| Crossref | Google Scholar |
4 McIver R, Low S, Varma R, Vickers T, McNulty A. Empirical treatment of asymptomatic contacts of gonorrhoea: patient views. Sex Health 2020; 17(5): 462-6.
| Crossref | Google Scholar | PubMed |
5 Low S, Varma R, McIver R, Vickers T, McNulty A. Provider attitudes to the empiric treatment of asymptomatic contacts of gonorrhoea. Sex Health 2020; 17(2): 155-9.
| Crossref | Google Scholar | PubMed |
6 Burton R, Duncan S, Wardle E, Patel C, Clarke E. Unintended consequences: the potential impacts of the British Association for Sexual Health and HIV (BASHH) 2019 gonorrhoea guidelines. Int J STD AIDS 2021; 32(4): 344-51.
| Crossref | Google Scholar | PubMed |
7 Dutt K, Chow EPF, Huffam S, Klassen K, Fairley CK, Bradshaw CS, Denham I, Chen MY. High prevalence of rectal gonorrhoea among men reporting contact with men with gonorrhoea: implications for epidemiological treatment. BMC Public Health 2015; 15(1): 658.
| Crossref | Google Scholar |
8 Chow EPF, Chen MY, Williamson DA, Bradshaw CS, Vodstrcil LA, Trumpour S, Howden BP, Fairley CK. Oropharyngeal and genital gonorrhea infections among women and heterosexual men reporting sexual contact with partners with gonorrhea: implication for oropharyngeal testing of heterosexual gonorrhea contacts. Sex Transm Dis 2019; 46(11): 743-7.
| Crossref | Google Scholar |
9 Rowlinson E, Golden MR, Berzkalns A, Thibault C, Barbee LA. Epidemiologic treatment for contacts to Neisseria gonorrhoeae and Chlamydia trachomatis infection in sexually transmitted disease clinic patients in Seattle, WA; 1994 to 2018. Sex Transm Dis 2020; 47(10): 665-71.
| Crossref | Google Scholar | PubMed |
