1302. Prevalence of Neisseria gonorrhoeae antimicrobial resistance at a sexually transmitted diseases clinic
Session: Poster Abstract Session: Clinical Infectious Diseases: Sexually Transmitted Infections
Friday, October 28, 2016
Room: Poster Hall
Background: Antimicrobial resistance to Neisseria gonorrhoeae is an increasing concern, especially among men who have sex with men (MSM). In the United States, the Gonococcal Isolate Surveillance Project (GISP) conducts national antimicrobial susceptibility surveillance. However, little data exist outside major urban centers on N. gonorrhoeaeresistance and associated risk behaviors.

Methods: From January 2015 to March 2016, all patients presenting to the Rhode Island STD Clinic who tested positive for N. gonorrhoeae by nucleic acid amplification testing were attempted to be cultured. Swabs were obtained, streaked onto Modified Thayer Martin Media (MTMM), and incubated at 36oC in a 5% CO2 atmosphere for 24 hours. Suspected N. gonorrhoeae isolates were plated onto chocolate agar and confirmed by matrix-assisted laser desorption/ionization (MALDI). Susceptibility testing was performed using the Etest (BioMerieux). Resistant/nonsusceptible was defined as the following: ceftriaxone (>0.25μg/mL), ciprofloxacin (>=1.0μg/mL), azithromycin (>=2.0μg/mL), and doxycycline (>=2.0μg/mL). Bivariate analyses were conducted using Fischer’s exact test.

Results: A total of 149 patients tested positive for N. gonorrhoeae; of these, 58% (86/149) were swabbed. Of those swabbed, 76% (65/86) grew on MTMM plates and 63% (54/86) were confirmed by MALDI. Of those confirmed to be N. gonorrhoeae, 80% (43/54) were successfully tested for resistance. The average age was 30.4 years; 100% were male; 58% were White, 21% African American, and 19% Hispanic/Latino. Seventy-two percent were MSM; 40% of patients reported >5 sex partners and 86% reported condomless sex. Resistance was detected in 44% of patients including doxycycline (40%), ciprofloxacin (14%), and azithromycin (2%). There was no significance between patients who did and did not have resistance and demographic or behavioral variables.

Conclusion: Antimicrobial resistance to ciprofloxacin and doxycycline and to a lesser degree azithromycin occurred among N. gonorrhoeae isolated from a largely MSM population at the only STD Clinic in Rhode Island. Close monitoring and aggressive treatment of N. gonorrhoeae is warranted. No specific demographics or behaviors associated with resistance were identified.

Philip Chan, MD, MS1, Alexi Almonte, BA1, Madeline Montgomery, MPH1, Ashley Robinette, MPH1, Kimberle C. Chapin, MD2 and John Lonks, MD, FIDSA1, (1)Division of Infectious Diseases, Department of Medicine, The Miriam Hospital/Warren Alpert Medical School of Brown University, Providence, RI, (2)Pathology and Laboratory Medicine, Rhode Island Hospital, Providence, RI

Disclosures:

P. Chan, None

A. Almonte, None

M. Montgomery, None

A. Robinette, None

K. C. Chapin, None

J. Lonks, None

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