Broad, C

Fuller, SS

Furegato, M

Harding-Esch, E

Harrison, M

Okala, S

Phillips, L

Pond, M

Sadiq, ST

Tan, N

Zhou, L

St George's Online Research Archive

Abstract 1352Importation of ciprofloxacin resistant Neisseria gonorrhoeae into the UK: a public health challenge.Type: Open SubmissionTopic: Epidemiology & MonitoringAuthors: M. Furegato, C.E. Broad, L.T. Phillips, M.A. Harrison, M.J. Pond, L. Zhou, N. Tan, S. Okala, S.S. Fuller, S.T.Sadiq, E. Harding-Esch; London/GBBackgroundCurrent UK guidelines for managing Neisseria gonorrhoeae (NG) infection include ciprofloxacin use ifantimicrobial susceptibility is indicated, but this option would be less useful if ciprofloxacin resistant NG (CpR-NG) rates increased, for example to levels reported in some parts of Asia. CpR-NG rates in the Americas arelower than in the UK. We investigated whether having recent condomless sex in “high” CpR-NG (HCpR-NG)regions (sex abroad, but not in the Americas) was associated with being infected with CpR-NG. MethodsWe conducted two cross-sectional surveys of UK Sexual Health Clinics (March 2015-March 2016; May 2017-June 2018). Patients aged ≥16 years with symptoms of an STI provided samples: vulvovaginal swab (females);first void urine (men-who-have-sex-with-women (MSW) and men-who-have-sex-with-men (MSM)); pharyngealand rectal swabs (MSM). Data were collected on travel-associated sexual behaviour, including condomless sexabroad (CSA) in the past three months with a new partner. Routine clinic NG results were obtained. Resistance-associated mutations in gyrA (fluoroquinolones) for NG were identified using Sanger sequencing. Patientsreporting CSA in HCpR-NG regions were compared to no sex abroad using Pearson's chi-squared test andmultivariable logistic regression models.. ResultsOverall, 71/1055 (6.7%) reported CSA in HCpR-NG regions. Of these, 12/71 (16.9%) compared to 85/984 (8.6%)not reporting CSA had NG (p=0.02). Among-NG positive patients, fluoroquinolone resistant mutations werefound in 9/12 (75.0%) patients reporting CSA in HCpR-NG regions, compared to 35/85 (41.2%) who did notreport CSA (p=0.03). After adjustment for other risk factors, the association between fluoroquinolone resistantNG and CSA in HCpR-NG regions remained significant (aOR:2.33[95%CI:1.03-5.24]). ConclusionHaving recent condomless sex with a new partner in regions of high ciprofloxacin resistance was associatedwith being NG-positive in the UK and having ciprofloxacin resistant NG. Importation of resistance mayundermine attempts to recycle older antibiotics in the management of NG infection. Print#1352: Importation of ciprofloxacin resistant Neisseria gonorrhoeae into t... https://cpaper.ctimeetingtech.com/stihiv2019/submission/preview/print?p...1 of 1 01/02/2019, 09:00

Importation of ciprofloxacin resistant neisseria gonorrhoeae into the UK: a public health challenge

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P681 Importation of ciprofloxacin resistant
                    neisseria gonorrhoeae

http://openaccess.sgul.ac.uk/111081/6/%231352_%20Importation%20of%20ciprofloxacin%20resistant%20Neisseria%20gonorrhoeae%20into%20the%20UK_%20a%20public%20health%20challenge.pdf

Importation of ciprofloxacin resistant neisseria gonorrhoeae into the UK: a public health challenge

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