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P229 Are cases of gonorrhoea rising in very young patients in south west london? a retrospective case review of patients aged 18 years and younger diagnosed with gonorrhoea in a london teaching hospital gum service
  1. Rachel Hill-Tout,
  2. Katia Prime
  1. St Georges NHS Trust, London, UK

Abstract

Background Cases of Gonorrhoea continue to rise in the UK and young people (YP) remain disproportionally affected despite efforts to reduce infection rates.

Aim To identify if there been a true rise in Gonorrhoea cases in very YP (≤18 years) attending our GUM service.

Methods We identified all GUM (New and Rebook) attendances and Gonorrhoea diagnoses from 01/01/2011–31/12/2014 in patients ≤18 from MILLCARE. Electronic records were reviewed for demographics, infection site (s), antimicrobial resistance, re-infection and Chlamydia co-infection.

ResultsThere were 99 Gonorrhoea diagnoses in 84 patients, 94/99 (84.4%) in females and 15/99 (15.2%) in males (5/15 (33.3%) MSM). 1/84 (1.2%) was HIV+ (MSM). 26/99 (26.2%) infections were in White, 19/99 (19.2%) in Caribbean/Mixed-Caribbean, 11/99 (11.1%) in African/Mixed-African and 7/99 (7.1%) in Other-Mixed ethnicities. 80/84 (95.2%) were UK born. Age range was 15–18.

83/99 (83.8%) were genital and 12/99 (12.1%) were multiple site infections. We found concurrent Chlamydia in 53/99 (53.3%). Antimicrobial resistance was detected in 15/68 (22%) culture+ cases, 13/15 (86.7%) in females and 2/15 (13.3%) in MSM. 11/84 (13.1%) patients had ≥1 re-infection (positive test at ≥3 months), 10/11 (90.9%) females and 1/11 (9.1%) MSM. Mean time to re-infection was 5.1 months.

Discussion NAAT testing was introduced into our service preceding the study period. We found Gonorrhoea diagnoses in patients ≤18 have increased three-fold in 4 years in our clinic with high rates of Chlamydia co-infection, antimicrobial resistance and re-infection. MSM, females and patients of Black/Mixed ethnicity are disproportionally affected. Further work is required to investigate factors contributing to the observed rise in Gonorrhoea in YP, and strategies to reduce infection rates.

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