Ursula Fürnkranz, Maria Haller, Angelika Stary
Outpatients Centre for Diagnosis of Infectious Venero-dermatological Diseases, Vienna, Austria

Background:
Gonorrhoea is a health threat, infection levels and drug resistances increased over the last decades. The COVID-19 pandemic that hit Austria in 2020 led to several lockdown events, one constraint being to avoid direct contacts. The current evaluation was designed to investigate the influence of these restrictions on the number of infections with N. gonorrhoeae and their respective resistance patterns.

Methods:
The number of patients positive for N. gonorrhoeae by culture and resistance patterns of gonococcal strains to ceftriaxone, cefixime, azithromycin, and penicillin were compared using isolates collected in 2019 and 2020. Resistance testing was performed using Etest®; MIC values were interpreted according to the EUCAST guidelines.

Results:
From 2019 to 2020 the number of positive gonococcal cultures declined by 16%. The most prominent reduction was observed during the first lockdown from March to May 2020 with a decrease of 55.2%. This was in contrast to the lockdowns in November 2020 even with an increase of 50% and December, with equal numbers of N. gonorrhoeae positive cultures. In both years, no ceftriaxone-resistant isolate was detected. From 2019 to 2020 cefixime and azithromycin resistant strains decreased from 4% to 0% and 19% to 7%, respectively, penicillin-resistant strains increased from 9% to 20%.

Conclusion:
The first lockdown resulted in a significant decrease of N. gonorrhoeae infected individuals; however, this effect was not continued throughout the rest of the year including the other lockdown events. Although resistant strains to azithromycin and cefixime have decreased during the pandemic, culture and antimicrobial resistance testing remain indispensable to guide gonococcal treatment decisions.

 

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