Surveillance for Disseminated Gonococcal Infections, Active Bacterial Core Surveillance (ABCs)-United States, 2015-2019

Clin Infect Dis. 2022 Sep 29;75(6):953-958. doi: 10.1093/cid/ciac052.

Abstract

Background: Disseminated gonococcal infections (DGIs) are thought to be uncommon; surveillance is limited, and case reports are analyzed retrospectively or in case clusters. We describe the population-level burden of culture-confirmed DGIs through the Active Bacterial Core surveillance (ABCs) system.

Methods: During 2015-2016, retrospective surveillance was conducted among residents in 2 ABCs areas and prospectively in 3 ABCs areas during 2017-2019. A DGI case was defined as isolation of Neisseria gonorrhoeae from a normally sterile site. A case report form was completed for each case and antimicrobial susceptibility testing (AST) was performed on available isolates.

Results: During 2015-2019, 77 DGI cases were identified (a rate of 0.13 cases per 100 000 population) and accounted for 0.06% of all reported gonorrhea cases in the 3 surveillance areas. Most DGI cases were male (64%), non-Hispanic Black (68%), and ranged from 16 to 67 years of age; blood (55%) and joint (40%) were the most common sterile sites. Among 29 isolates with AST results during 2017-2019, all were susceptible to ceftriaxone.

Conclusions: DGI is an infrequent complication of N gonorrhoeae; because it can quickly develop antimicrobial resistance, continued DGI surveillance, including monitoring trends in antimicrobial susceptibility, could help inform DGI treatment recommendations.

Keywords: Neisseria gonorrhoeae; Active Bacterial Core surveillance (ABCs) system; disseminated gonococcal infections; gonorrhea.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents*
  • Ceftriaxone
  • Drug Resistance, Bacterial
  • Female
  • Gonorrhea* / drug therapy
  • Gonorrhea* / epidemiology
  • Gonorrhea* / microbiology
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Neisseria gonorrhoeae
  • Retrospective Studies
  • United States / epidemiology

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Ceftriaxone