Neisseria gonorrhoeae positivity in clients presenting as asymptomatic contacts of gonorrhoea at a sexual health centre

Sexual Health ◽  
2020 ◽  
Vol 17 (2) ◽  
pp. 187 ◽  
Author(s):  
Sue Qian ◽  
Rosalind Foster ◽  
Christopher Bourne ◽  
Tobias Vickers ◽  
Ruthy McIver ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Sexual Health ◽  
Antibiotic Treatment ◽  
Health Centre ◽  
Anatomical Site ◽  
Bisexual Men ◽  
Country Of Birth ◽  
Test Results ◽  
Sex Worker ◽  
Empirical Antibiotic Treatment

Background Previous guidelines at the Sydney Sexual Health Centre (SSHC) recommended empirical antibiotic treatment for asymptomatic contacts of Neisseria gonorrhoeae at the time of testing. With increasing concerns around gonorrhoea antibiotic resistance, it has been suggested that asymptomatic contacts should only be treated based on test results. Methods: This retrospective study of data from the SSHC electronic medical record included a total of 295 gonorrhoea contacts from 1 January 2018 to 30 June 2018. The primary outcome was the proportion of asymptomatic gonorrhoea contacts with a positive gonorrhoea result from any anatomical site. Statistically significant differences in gonorrhoea positivity according to gender, sexual preference, use of PrEP, sex worker status, country of birth, preferred language and number of partners, were calculated using Fisher’s exact test. Results: The overall proportion of asymptomatic gonorrhoea contacts with a positive gonorrhoea result was 27.1% (95% CI: 22.1–32.6%). The proportion of gonorrhoea positivity was significantly higher in females compared to males (52.0% vs 25.7%, P < 0.01), gay and bisexual men compared to heterosexual men (28.7% vs 0%, P < 0.01) and non-users of PrEP compared to PrEP users (31.2% vs 12.5%, P < 0.05). No statistically significant differences in gonorrhoea positivity were found in subgroups divided by sex worker status, country of birth, preferred language and number of partners. Conclusion: The relatively low gonorrhoea positivity rate (27.1%) in asymptomatic gonorrhoea contacts at the SSHC between January and June 2018 supports guideline changes to no longer provide empirical antibiotic treatment to asymptomatic contacts.

Screening for chlamydia and gonorrhoea in men who have sex with men in clinical and non-clinical settings

Sexual Health ◽  
2006 ◽  
Vol 3 (2) ◽  
pp. 123 ◽  
Author(s):  
Marian J. Currie ◽  
Sarah J. Martin ◽  
Tuck Meng Soo ◽  
Francis J. Bowden
Keyword(s):  
Sexual Health ◽  
Health Centre ◽  
Anal Intercourse ◽  
Unprotected Anal Intercourse ◽  
Outreach Program ◽  
Published Data ◽  
Clinical Settings ◽  
Anatomical Site ◽  
Test Results ◽  
Sex With Men

Background: There are few published data on the rate of chlamydia and gonorrhoea infection in men who have sex with men (MSM). Our aim was to determine the rate of positive chlamydia and gonorrhoea tests in this population in the Australian Capital Territory (ACT). Methods: Results of all chlamydia and gonorrhoea tests generated by Canberra Sexual Health Centre between June 2001 and September 2003, including those from outreach clinics, were reviewed (audit one). Between September 2003 and April 2004, Canberra Sexual Health Centre outreach program staff and a general practitioner with a high caseload of MSM offered screening of the throat, urethra and rectum to all MSM, irrespective of their reported participation in unprotected anal intercourse. Chlamydia and gonorrhoea test results generated during this period were reviewed (audit two). Results: In the first audit, 1086 specimens from 314 individuals were tested and 30/314 (9.6%, 95% CI 6.6–13.4) men were positive for chlamydia in one or more anatomical site. A total of 306 specimens from 118 individuals were tested for gonorrhoea. Of these, eight (6.8%, 95% CI 3.0–12.9) individuals tested positive. In the second audit, 16 of 157 men (10.2%, 95% CI 9.5–16.0) tested positive for chlamydia and 4/155 (2.6%, 95% CI 0.7–6.5) tested positive for gonorrhoea. The rectum was the most commonly infected anatomical site for both infections. The overall proportions of positive chlamydia and gonorrhoea tests were 36/471 (7.6%, 95% CI 5.4–10.4) and 12/273 (4.4%, 95% CI 2.2–7.6) respectively. Conclusions: These data, collected in a range of settings, indicate high rates of chlamydia and gonorrhoea in MSM in the ACT and provide support for annual testing, particularly of the rectum, in this population.

Culture obtained from urethral swab of asymptomatic men who screen positive for Neisseria gonorrhoeae by urine nucleic acid amplification testing

2021 ◽  
pp. sextrans-2020-054690
Author(s):  
Ayoma Ratnappuli ◽  
Melanie Bissessor ◽  
Shehara Arumugam ◽  
Deborah A Williamson ◽  
Eric P F Chow ◽  
...  
Keyword(s):  
Nucleic Acid ◽  
Neisseria Gonorrhoeae ◽  
Sexual Health ◽  
Health Centre ◽  
Antibiotic Use ◽  
Nucleic Acid Amplification ◽  
Return Visit ◽  
Nucleic Acid Amplification Testing ◽  
Culture Positive ◽  
Asymptomatic Men

BackgroundIn a previous study of men attending Melbourne Sexual Health Centre who had Neisseria gonorrhoeae detected by urine Aptima Combo 2 (AC2) testing, 11% were asymptomatic. This study aimed to determine whether N. gonorrhoeae can be cultured from asymptomatic men screening positive for N. gonorrhoeae by nucleic acid amplification testing (NAAT) of urine.MethodsBetween 1 July 2017 and 31 March 2019, all men attending Melbourne Sexual Health Centre were tested for N. gonorrhoeae by AC2 testing of urine whether urethral symptoms were reported or not. NAAT-positive men were recalled and a urethral swab performed for gonococcal culture using modified Thayer-Martin media with determination of minimum inhibitory concentrations (MICs) by agar dilution.ResultsThere were 1001 cases (860 individuals) positive for N. gonorrhoeae by urine AC2: 892 (89%) reported urethral symptoms; 109 (11%) did not. Twenty-five asymptomatic cases were excluded because of antibiotic use at or following screening. Of the remaining 84 asymptomatic men, 41 (49%) had a urethral swab performed a median of 5 days after screening. Twenty-one men had urethral discharge at the return visit, 11 of whom reported the discharge at the return visit. Of the 41 men who were swabbed, 31 (76%; 95% CI 60% to 88%) were culture positive for N. gonorrhoeae. Among the 21 men who subsequently developed discharge, 19 (90%; 95% CI 70% to 99%) were culture positive. Among the 20 men who remained asymptomatic, 12 (60%; 95% CI 36% to 81%) were culture positive. MIC profiles were obtained from all isolates.ConclusionsGonorrhoea was isolated in most but not all asymptomatic men screening positive for N. gonorrhoeae by urine NAAT. Clinicians should consider performing urethral culture in such men to ensure optimal surveillance for antimicrobial resistance. Isolation of N. gonorrhoeae by culture in men without discharge indicates these are true infections with viable organisms.

scholarly journals Potential effect of antiseptic mouthwash on the incidence of Neisseria gonorrhoeae among men who have sex with men: a mathematical modelling study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e052823
Author(s):  
Xianglong Xu ◽  
Eric P F Chow ◽  
Mingwang Shen ◽  
Zhuoru Zou ◽  
Chongjian Wang ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Neisseria Gonorrhoeae ◽  
Health Centre ◽  
Potential Effect ◽  
Sensitivity Analyses ◽  
Secondary Outcome ◽  
Anatomical Site ◽  
Total Incidence ◽  
The Usa ◽  
Sex With Men

ObjectivesThe incidence of Neisseria gonorrhoeae and its antimicrobial resistance is increasing in many countries. Antibacterial mouthwash may reduce gonorrhoea transmission without using antibiotics. We modelled the effect that antiseptic mouthwash may have on the incidence of gonorrhoea.DesignWe developed a mathematical model of the transmission of gonorrhoea between each anatomical site (oropharynx, urethra and anorectum) in men who have sex with men (MSM). We constructed four scenarios: (1) mouthwash had no effect; (2) mouthwash increased the susceptibility of the oropharynx; (3) mouthwash reduced the transmissibility from the oropharynx; (4) the combined effect of mouthwash from scenarios 2 and 3.SettingWe used data at three anatomical sites from 4873 MSM attending Melbourne Sexual Health Centre in 2018 and 2019 to calibrate our models and data from the USA, Netherlands and Thailand for sensitivity analyses.ParticipantsPublished available data on MSM with multisite infections of gonorrhoea.Primary and secondary outcome measuresIncidence of gonorrhoea.ResultsThe overall incidence of gonorrhoea was 44 (95% CI 37 to 50)/100 person-years (PY) in scenario 1. Under scenario 2 (20%–80% mouthwash coverage), the total incidence increased (47–60/100 PY) and at all three anatomical sites by between 7.4% (5.9%–60.8%) and 136.6% (108.1%–177.5%). Under scenario 3, with the same coverage, the total incidence decreased (20–39/100 PY) and at all anatomical sites by between 11.6% (10.2%–13.5%) and 99.8% (99.2%–100%). Under scenario 4, changes in the incidence depended on the efficacy of mouthwash on the susceptibility or transmissibility. The effect on the total incidence varied (22–55/100 PY), and at all anatomical sites, there were increases of nearly 130% and large declines of almost 100%.ConclusionsThe effect of mouthwash on gonorrhoea incidence is largely predictable depending on whether it increases susceptibility to or reduces the transmissibility of gonorrhoea.

Is rectal gonorrhoea a lead indicator of HIV transmission among men who have sex with men in Victoria, Australia?

Sexual Health ◽  
2013 ◽  
Vol 10 (2) ◽  
pp. 188
Author(s):  
Anna L. Wilkinson ◽  
Megan S. C. Lim ◽  
Mark Stoové ◽  
Christopher K. Fairley ◽  
Marcus Chen ◽  
...  
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Sexual Health ◽  
Hiv Transmission ◽  
Health Centre ◽  
P Value ◽  
Hiv Diagnosis ◽  
Sex With Men ◽  
Hiv Negative

Objectives To examine whether rectal gonorrhoea (RG; Neisseria gonorrhoeae) can be used as a lead indicator of trends in HIV diagnosis in men who have sex with men (MSM). Methods: Data from a metropolitan sexual health centre in Victoria, Australia, on RG and HIV tests in HIV-negative MSM from January 2006 to December 2011 were examined. Results: Allowing RG a 12-month lead over HIV showed no concordance in proportion positive (r = 0.27; P-value = 0.28). Conclusions: The data do not support use of RG trends as a lead indicator of trends in HIV among MSM.

HIV is rare among low-risk heterosexual men and significant potential savings could occur through phone results

Sexual Health ◽  
2010 ◽  
Vol 7 (4) ◽  
pp. 495 ◽  
Author(s):  
Matiu R. Bush ◽  
Henrietta Williams ◽  
Christopher K. Fairley
Keyword(s):  
Sexual Health ◽  
Health Centre ◽  
Low Risk ◽  
Female Partner ◽  
Hiv Positive ◽  
Heterosexual Men ◽  
Test Results ◽  
Health Clinics ◽  
Hiv Test ◽  
Sexual Health Clinics

Background: The legislation in Victoria requires HIV-positive results to be given in person by an accredited health professional. Many sexual health clinics require all men to receive HIV results in person. Our aim was to determine the proportion of low-risk heterosexual men at a sexual health centre who tested HIV-positive. Methods: The electronic data on all HIV tests performed between 2002 and 2008 on heterosexual men at the Melbourne Sexual Health Centre (MSHC) was reviewed. The individual client files of all heterosexual men who tested HIV-positive were reviewed to determine their risks for HIV at the time that the HIV test was ordered. Results: Over the 6 years there were 33 681 HIV tests performed on men, of which 17 958 tests were for heterosexual men. From these heterosexual men, nine tested positive for the first time at MSHC (0.05%, 95% confidence interval (CI): 0.01%, 0.09%). These nine cases included six men who had had sex with a female partner from the following countries: Thailand, Cambodia, China, East Timor, Botswana and South Africa. Two men had injected drugs and one had a HIV-positive female partner. Of the 17 958 test results for heterosexual males, 14 902 (83% 95% CI: 84%, 86%) test results were for men who did not have a history of intravenous drug use or had sexual contact overseas. Of these 14 902 low-risk men, none tested positive (0%, 95% CI: 0, 0.00025). Conclusion: Asking the 83% of heterosexual men who have an extremely low risk of HIV to return in person for their results is expensive for sexual health clinics and inconvenient for clients. We have changed our policy to permit heterosexual men without risk factors to obtain their HIV-negative results by phone.

Clients’ preferred methods of obtaining sexually transmissable infection or HIV results from Sydney Sexual Health Centre

Sexual Health ◽  
2013 ◽  
Vol 10 (1) ◽  
pp. 91 ◽  
Author(s):  
Lynne Martin ◽  
Vickie Knight ◽  
Phillip J. Read ◽  
Anna McNulty
Keyword(s):  
Sexual Health ◽  
Text Messaging ◽  
Health Centre ◽  
Text Messages ◽  
Phone Call ◽  
Short Message ◽  
Test Results ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Message Service

Given the documented benefits of using text messaging (short message service; SMS), the internet and email to deliver sexually transmissible infection (STI) test results, including high acceptability among clients, Sydney Sexual Health Centre (SSHC) aimed to identify which methods our clients preferred for receiving their results, using a cross-sectional survey. There was a preference for SMS (32%) for negative STI results, and for SMS (27%), phone call (27%) and in-person (26%) for negative HIV results. An in-person preference was shown for receiving positive STI results (40%) and positive HIV results (56%, P < 0.001). While many clients would prefer to receive STI test results via text messages or phone call, many also still prefer a return visit, with this preference is dependent on the type and nature of the results. Our study suggests that, ideally, several options for obtaining results should be available.

scholarly journals Neisseria gonorrhoeae resistance test against cefixime in gonorrhea patients in Surabaya

2019 ◽  
Author(s):  
Amalia Rositawati ◽  
S. Sawitri ◽  
Afif Nurul Hidayati
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Sexually Transmitted Diseases ◽  
Health Centre ◽  
Generation Cephalosporin ◽  
Test Results ◽  
Diffusion Test ◽  
First Line ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
The Third

Gonorrhea remains as one of the most common sexually transmitted diseases in developing countries. The third generation cephalosporin such as cefixime is now one of the first-line therapies in many regions. Over the last decade, strains of Neisseria gonorrhoeae have been reported to develop high levels of resistance against several antimicrobial agent cefixime. The purpose of this study is to evaluate the susceptibility of cefixime to Neisseria gonorrhoeae. Methods: The study design was descriptive laboratory observational cross sectional from June 2017 to September 2017. Twenty isolates Neisserria gonorrhoeae taken from outpatients with positive complaints of purulent secretions, who visited 7 Community Health Centre in Surabaya and met the inclusion criterias, were tested with cefixime diffusion susceptibility test. Results: 7 of 20 isolates (35%) were resistant to cefixime and 13 of 20 isolates (65%) sensitive to cefixime. Conclusions: Neisseria gonorhoeae strain was proven to be resistant to cefixime by performing diffusion test.

Assortative sexual mixing among heterosexuals in Australia: implications for herd protection in males from a female human papillomavirus vaccination program

Sexual Health ◽  
2016 ◽  
Vol 13 (4) ◽  
pp. 395 ◽  
Author(s):  
Eric P. F. Chow ◽  
Christopher K. Fairley
Keyword(s):  
Human Papillomavirus ◽  
Sexual Health ◽  
Health Centre ◽  
Vaccination Program ◽  
Country Of Birth ◽  
Heterosexual Couples ◽  
Human Papillomavirus Vaccination ◽  
Men And Women ◽  
Herd Protection

The aim was to investigate the assortative sexual mixing by country of birth among heterosexuals in Australia. An analysis of 1060 heterosexual couples who attended the Melbourne Sexual Health Centre between 2011 and 2014 was conducted. Of the 1060 couples, 27% (n = 281) were both Australian-born men and women, and 42% (n = 445) were both overseas-born. Of the 171 couples with women aged ≤21 years, 41% (n = 70) were both born in Australia and 33% (n = 56) were both born overseas. A strong assortative mixing pattern by country of birth was observed among all 1060 couples (r = 0.361; 95% CI: 0.320–0.403), and among 171 couples with women aged ≤21 years (r = 0.481; 95% CI: 0.379–0.584).

scholarly journals Gonorrhoea gone wild: rising incidence of gonorrhoea and associated risk factors among gay and bisexual men attending Australian sexual health clinics

Sexual Health ◽  
2019 ◽  
Vol 16 (5) ◽  
pp. 457 ◽  
Author(s):  
Denton Callander ◽  
Rebecca Guy ◽  
Christopher K. Fairley ◽  
Hamish McManus ◽  
Garrett Prestage ◽  
...  
Keyword(s):  
Sexual Health ◽  
Cox Regression ◽  
Cohort Analysis ◽  
Temporal Trends ◽  
Gay And Bisexual Men ◽  
Anatomical Site ◽  
Bisexual Men ◽  
Health Clinics ◽  
And Bisexual ◽  
Sexual Health Clinics

Background Gonorrhoea notifications continue to rise among gay and bisexual men in Australia and around the world. More information is needed on infection trends, accounting for testing and complimented by demographics and risk practices. Methods: A retrospective cohort analysis was undertaken using repeat gonorrhoea testing data among gay and bisexual men from 2010 to 2017, which was extracted from a network of 47 sexual health clinics across Australia. Poisson and Cox regression analyses were used to determine temporal trends in gonorrhoea incidence rates, as well as associated demographic and behavioural factors. Results: The present analysis included 46904 gay and bisexual men. Gonorrhoea incidence at any anatomical site increased from 14.1/100 person years (PY) in 2010 to 24.6/100 PY in 2017 (P&lt;0.001), with the greatest increase in infections of the pharynx (5.6-15.9/100 PY, P&lt;0.001) and rectum (6.6–14.8/100 PY, P&lt;0.001). After adjusting for symptomatic and contact-driven presentations, the strongest predictors of infection were having more than 20 sexual partners in a year (hazard ratio (HR)=1.9, 95% confidence interval (CI): 1.7–2.2), using injecting drugs (HR=1.7, 95%CI: 1.4–2.0), being HIV positive (HR=1.4, 95%CI: 1.2–1.6) and being aged less than 30 years old (HR=1.4, 95%CI: 1.2–1.6). Conclusions: Gonorrhoea has increased dramatically among gay and bisexual men in Australia. Enhanced prevention efforts, as well as more detailed, network-driven research are required to combat gonorrhoea among young men, those with HIV and those who use injecting drugs.

scholarly journals Genomic assessment of within-host population variation in Neisseria gonorrhoeae: Implications for gonorrhoea transmission

2020 ◽  
Author(s):  
Melinda M. Ashcroft ◽  
Eric P. F. Chow ◽  
Darren Y. J. Lee ◽  
Vesna De Petra ◽  
Maree Soumilas ◽  
...  
Keyword(s):  
Genetic Diversity ◽  
Neisseria Gonorrhoeae ◽  
Sexual Health ◽  
Genetic Relatedness ◽  
Population Variation ◽  
Health Clinic ◽  
Clinical Samples ◽  
Anatomical Site ◽  
Implicit Assumption ◽  
Primary Sample

Objectives: Mathematical modelling and genomic analyses are powerful methods for investigating the transmission dynamics of Neisseria gonorrhoeae, however, often make the implicit assumption that N. gonorrhoeae isolates at different anatomical sites within the same individual are the same strain. Methods: In this study, two approaches were used to explore genetic diversity. First, we examined a collection of stored, clinical N. gonorrhoeae isolates sourced from multiple anatomical sites of single individuals attending a sexual health clinic in Melbourne from 2011-2019. Second, we obtained multiple colony picks from primary clinical samples from individuals attending a sexual health clinic in Melbourne from 2019-2020. Whole genome sequencing and a variety of bioinformatics approaches were used to determine both within-host and within-sample genetic diversity. Results: Thirty-seven individuals were identified that had cultured N. gonorrhoeae from two or more anatomical sites (urogenital, anorectal, or oropharyngeal), with a final dataset of 105 isolates. In 35/37 (94.6%) individuals, infections were highly similar at the genetic level, with identical MLST and NG-MAST profiles. Pairwise comparisons of isolates within each individual indicated that the maximum within-host pairwise SNP distance was 13 SNPs (median = 1, IQR: 0-3). Notably, four distinct multi-individual phylogenetic clusters were identified, where the maximum pairwise SNP distance was 19 SNPs (median = 6, IQR = 2-11). Similarly, comparisons of isolates within each primary sample indicated that the maximum pairwise SNP distance was 8 SNPs (median = 2, IQR:1-3). Conclusions: This study suggests that in most cases of multi-site infection, the same strain of N. gonorrhoeae causes the infection at each anatomical site. However, WGS data alone cannot differentiate between the same infecting strain or (re)infections from the same transmission network. These data guide recommendations regarding optimal bioinformatic approaches to infer genetic relatedness of N. gonorrhoeae and will help inform future studies of gonorrhoea transmission and epidemiology.

Sign in / Sign up

Export Citation Format

Share Document