Methods: We reviewed patient records for all laboratory confirmed NG cases between January 1st 2015 and May 5th 2016 to determine HIV-infection status, time-to-treatment and gyrA genotype results by anatomic site. At least one NG infection detected from a patient on a single date was considered a case. Infections in different anatomic locations were considered unique infections.
Results: Among 199 patients (84% men; 35% HIV-infected), there were 221 cases and 233 unique NG infections. Of cases, 78 (35%) were treated the same day as specimen collection. The mean time to treatment among non-empirically treated cases (N=118) was 5.3 days (SD 4.8 days). Of 101 infections after routine genotyping began, 68 (67%) were successfully genotyped. Of those 46 (68%) were wild-type gyrA and 22 (32%) were mutated. Among the remaining 33 infections, 29 could not be genotyped (23 pharyngeal, 3 urethral, 2 rectal, 1 genital) and 4 were not attempted. Among cases, 202 (91%) were treated with ceftriaxone: 125 (95%) of 131 before assay introduction versus 77 (86%) of 90 after assay introduction (chi-square statistic=6.6; p-value=0.01). Among 23 cases with wild-type gyrA genotype NG infection treated at least two days after specimen collection, two (9%) were treated with ciprofloxacin.
Conclusion: A large health system successfully implemented routine NG gyrA genotyping on NG positive specimens. Successful genotyping may depend on anatomic site of infection. Introduction of NG genotyping was associated with a significant reduction in ceftriaxone use.
L. T. Allan-Blitz,
P. Hemarajata, None
X. Wang, None
J. Klausner, None
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