Objectives This was a retrospective analysis of antibiotic use and resistance profiles of GC at a UK GU clinic.
Methods All GC cases at our clinic between 1 January to 1 June in 2007, 2009, and 2011 were identified. The case notes were assessed for antibiotic resistance. The number of cases identified was 41, 78 and 75 for these respective years. Data on diagnostic method was also collected last two cohorts.
Results 63%, 56%, and 69% of patients diagnosed with GC were male in 2007, 2009, 2011 respectively. In 2011 the mean age of patients was 26, and the median 23. 19.5%, 8% and 12% were men who have sex with men (MSM) in 2007, 2009, 2011 respectively. First line antibiotics each year were as per BASHH guidelines (see abstract P130 table 1).
Discussion In 2011 the antibiotic sensitivity was unknown in 41%, it was 35% of cases in 2009. In 2011 27% of all cases were culture negative despite positive NAAT test. In 15% of all cases no culture was performed. Those without positive culture were diagnosed by NAAT, and in one case microscopy. Of those positive by NAAT alone 52% were female, compared to 75% in 2009. In 2011 54% with positive NAAT alone had co-current Chlamydia trachomatis infection, compared with 40% of all GC patients. 100% of females with GC in 2011 were NAAT positive, compared with 69% in 2009. 83% of males with GC in 2011 were NAAT positive compared with 80% in 2009.
Conclusions This data suggests that the levels of resistant gonorrhoea within our clinic reduced between 2007 and 2009, but has since risen in the last 2 years. This would indicate the need for the recent change in first line antibiotics. This could be a reflection of the changing percentages of MSM in the cohorts, which have altered in line with our antibiotic sensitivity. A large number of patients diagnosed with GC are culture negative. This may reflect the high sensitivity of NAAT or a high rate of false positive NAAT. It is interesting that a large proportion of those positive by NAAT alone are co-infected.