Neisseria gonorrhoeae positivity in contacts presenting to a sexual health centre

Abstract

Background 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. Methods 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. Results 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. Conclusion 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.