(P41) CHARACTERISTICS OF NEISSERIA GONORRHOEAE CULTURE-POSITIVE PATIENTS, BY ANTIBIOTIC SUSCEPTIBILITY STATUS, NEW YORK CITY (NYC), 2017 TO 2021

Background:
Gonorrhea (GC) with reduced susceptibility (RS) to antibiotics is an urgent public health threat. The national Strengthening the U.S. Response to Resistant Gonorrhea (SURRG) project monitors RS in gonorrhea cases. The NYC Health Department’s eight Sexual Health Clinics and two community partner clinics participated in the first SURRG cycle from 2017-2021.

Methods:
Using all SURRG collected GC isolates from 2017-2021, we compared demographics, prior/concurrent sexually transmitted infections (STI), and sexual behavior of patients with susceptible GC to those with RS GC. RS GC was defined as a culture isolate with a minimum inhibitory concentration of ≥ 2.0 µg/ml for azithromycin, ≥0.125 µg/ml for ceftriaxone, and ≥0.25 µg/ml for cefixime.

Results:
Of 3,972 isolates, 3,417 (86%) were susceptible and 555 (14%) demonstrated reduced antibiotic susceptibility. Among RS cases, 517/555 (93%) demonstrated RS to azithromycin and 38/555 (7%) to ceftriaxone and/or cefixime. GC cases were mostly male (approximately 96%) and half were aged 25-34 years; patient gender and age did not differ by susceptibility status of isolates. RS GC cases were more likely than cases with susceptible GC to be White (29% vs 21%, p<0.001). Among cases, HIV-positive status (12%) and history of any bacterial STI in the previous 12 months (38%) were virtually identical for both groups. Compared with male cases with susceptible GC, a higher proportion of male cases with RS GC reported only male sex partners (74% (386/522) vs 60% (2,025/3,205); p<0.001), and fewer reported only female sex partners (16% vs 31%). A higher proportion of cases with RS GC had chlamydia and/or syphilis coinfection compared with those with susceptible GC (15% vs 9%, p<0.001).

Conclusion:
RS GC in NYC was relatively low, but higher among men who have sex with men. With few distinguishing patient characteristics to identify likelihood of RS GC, ongoing GC surveillance with monitoring for RS remains necessary.