Disseminated infection remains an ‘uncommon but serious’ complication of gonorrhea

February 20, 2022

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Although rates of disseminated gonococcal infection are relatively low, researchers have stated that it is a serious complication of gonorrhea.

Emily J. Weston

“Reported gonorrhea rates have increased in the United States since 2009, with more than 600,000 cases reported in 2019,” CDC epidemiologist Emily J Weston, MPH, said Healio. “Although considered an infrequent complication, gonococcal infection can spread, leading to serious sequelae such as septic arthritis, tenosynovitis/dermatitis syndrome, bacteraemia or, in rare cases, endocarditis or meningitis.”

Source: CDC.gov

Disseminated gonococcal infection remains rare, but is a serious complication of gonorrhea. Source: Adobe Stock

Weston said most studies of disseminated gonococcal infection (DGI) have been based on case studies or small outbreaks, and there are limited population-level estimates. For their study, Weston and colleagues partnered with an established active surveillance network to identify laboratory-confirmed cases of IGD at the population level and to estimate disease burden and antimicrobial susceptibility to treatment recommended by patients. CDC.

They conducted retrospective surveillance among residents of two areas of the Active Bacterial Core (ABC) surveillance system of the CDC’s Emerging Infections Program — a collaboration between the CDC, state and local health departments, and academic institutions — and prospective monitoring in three ABC areas between 2017 and 2019.

They identified 77 cases of IGD, or about 0.13 cases per 100,000 population, or 0.06% of all gonorrhea cases reported in the three surveillance areas. This rate, Weston said, shows that “IGD remains an infrequent but serious complication of gonorrhea.”

The team found that most cases of IGD occurred in men (64%) and non-Hispanic black participants (68%), who ranged in age from 16 to 67 years old. They also found that almost all cases of DGI were based on an infection identified in the blood (54.6%) or joint (40.3%), although infections were also identified in the cervix. uterus, rectum, vagina, genitals and oropharynx and in urine. However, the researchers noted that none of these isolates were available for further testing.

“As gonorrhea rates increase in the United States, providers should be aware of the changing epidemiology and clinical presentation of IGD,” Weston said. “If there is a clinical suspicion of GDI, specimens from urogenital and mucosal exposure sites – eg, pharynx, vagina, rectum – should be collected and processed using nucleic acid amplification tests. ”

Additionally, Weston said that to facilitate antimicrobial susceptibility testing, culture specimens from disseminated infection sites — skin lesions, synovial fluid — should also be collected.

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