(P43) DISSEMINATED GONOCOCCAL INFECTIONS REPORTED IN NEW YORK CITY, 2018-2023

Background:
New York City (NYC) Department of Health and Mental Hygiene began special surveillance of disseminated gonococcal infections (DGI) in 2018.  We obtain gonococcal isolates from sterile sites, with the goal of comparing the molecular characteristics of those isolates to those of urogenital isolates. We describe the epidemiology, specimen characteristics and antimicrobial susceptibility testing (AST) results of DGI cases in NYC.

Methods:
A DGI case was defined as isolation of gonococcus from a normally sterile anatomic site. Data on reported DGI cases from 2018-2023 were extracted from the STI surveillance and case management system. We analyzed case counts, demographic information, specimen characteristics, and results of antibiotic susceptibility testing.

Results:
From 2018-2023, 24 DGI cases were reported in NYC (4 in 2018, 3 in 2019, 2 in 2020, 3 in 2021, 8 in 2022 and 4 in 2023) and accounted for 0.01% of the total number of reported gonorrhea cases (0.27 DGI cases/100,000 population). Just over half (54%) of cases were male (13/24), 67% (16/24) were aged 25-54 years, and 63% (15/24) were Black or Hispanic. Synovial fluid was the most common specimen source (25%). AST was done on most isolates (88%, 21/24) and 95% (20/21) were ceftriaxone susceptible. One case (4%) was HIV-positive and 1 case (4%) was concurrently diagnosed with late syphilis. Six cases (25%) had a history of at least one reportable bacterial STI in the previous 12 months and, among those, 4 (67%) had a history of gonorrhea.

Conclusion:
Reported DGI cases are infrequent in NYC, consistent with findings in other jurisdictions, and do not appear to be increasing over time. History of STI was relatively rare, however the high proportion of previous gonorrhea diagnoses may suggest a history of untreated or inadequately treated infection.