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1520. Mind the Clap: Reported Disseminated Gonococcal Infections in the United States, 2020–2022

BACKGROUND: Disseminated gonococcal infections (DGI) are estimated to occur in 0.5% to 3% of untreated Neisseria gonorrhoeae (GC) infections; however, surveillance and population-based studies to estimate DGI burden and describe recent DGI epidemiology and clinical manifestations are limited. In res...

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Autores principales: Quilter, Laura A, Tang, Eric C, Johnson, Kelly A, Jacobson, Kathleen, Ridpath, Alison, Cohen, Stephanie, Rajagopalan, Shobita, Munoz, Monica D, Holderman, Justin L, Kent, James B, Bachmann, Laura H, Bernstein, Kyle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9751791/
http://dx.doi.org/10.1093/ofid/ofac492.082
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author Quilter, Laura A
Tang, Eric C
Johnson, Kelly A
Jacobson, Kathleen
Ridpath, Alison
Cohen, Stephanie
Rajagopalan, Shobita
Munoz, Monica D
Holderman, Justin L
Kent, James B
Bachmann, Laura H
Bernstein, Kyle
author_facet Quilter, Laura A
Tang, Eric C
Johnson, Kelly A
Jacobson, Kathleen
Ridpath, Alison
Cohen, Stephanie
Rajagopalan, Shobita
Munoz, Monica D
Holderman, Justin L
Kent, James B
Bachmann, Laura H
Bernstein, Kyle
author_sort Quilter, Laura A
collection PubMed
description BACKGROUND: Disseminated gonococcal infections (DGI) are estimated to occur in 0.5% to 3% of untreated Neisseria gonorrhoeae (GC) infections; however, surveillance and population-based studies to estimate DGI burden and describe recent DGI epidemiology and clinical manifestations are limited. In response to increased reports of DGI cases and clusters in the U.S., the Centers for Disease Control and Prevention (CDC) developed a surveillance system in 2020. We analyzed data captured by the initial two years of surveillance. METHODS: During 1/1/2020–3/31/2022, U.S. state/local health jurisdictions reported DGI cases to CDC utilizing a standardized case report form that collects demographic, sociobehavioral, and clinical information. A confirmed case was defined as isolation or detection of GC from a disseminated site of infection by culture or nucleic acid amplification test (NAAT); a probable case was defined as clinical manifestations of DGI and isolation or detection of GC from a mucosal site by culture or NAAT. RESULTS: In total, 274 DGI cases were reported to CDC from 13 U.S. states (65.7% from California): 215 (78.5%) confirmed cases and 59 (21.5%) probable cases. Among DGI cases, 51.1% were cisgender male, 33.2% were ≥ 45 years old, and 26.6% reported methamphetamine use in the past 12 months. Most patients (87.6%) did not have documented underlying immunosuppression or predisposing medical conditions. Among patients with DGI, 85.8% were hospitalized, 41.2% underwent related surgeries, and 2.2% died. Among confirmed cases, the most common disseminated sites of infection were synovial fluid (50.2%) and blood (45.1%). Among 184 (67.2%) patients with DGI who were tested for GC at a mucosal site, 115 (62.5%) were diagnosed with a mucosal GC infection (69.6% urogenital, 27.0% pharyngeal, 12.2% rectal); however, 85.5% of those not diagnosed with mucosal GC were only tested at urogenital sites. Only 89 patients (32.5%) reported mucosal symptoms present at the time of or within the month prior to DGI presentation. CONCLUSION: Health care providers should maintain a high degree of suspicion for patients presenting with DGI symptoms given the potential for significant associated morbidity and the low proportion of patients who present with concurrent GC mucosal symptoms. DISCLOSURES: Alison Ridpath, MD, MPH, 3M company: Stocks/Bonds|Abbott Laboratories: Stocks/Bonds|Abbvie Inc.: Stocks/Bonds|Allogene Theraputics: Stocks/Bonds|Amarin Corperation PLC: Stocks/Bonds|infinity Pharmaceutical Companies: Stocks/Bonds|IQVIA Holdings Inc: Stocks/Bonds|Johnson and Johnson: Stocks/Bonds|Medtronic: Stocks/Bonds|pfizer: Stocks/Bonds|Thermo Fisher Scientific: Stocks/Bonds.
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spelling pubmed-97517912022-12-16 1520. Mind the Clap: Reported Disseminated Gonococcal Infections in the United States, 2020–2022 Quilter, Laura A Tang, Eric C Johnson, Kelly A Jacobson, Kathleen Ridpath, Alison Cohen, Stephanie Rajagopalan, Shobita Munoz, Monica D Holderman, Justin L Kent, James B Bachmann, Laura H Bernstein, Kyle Open Forum Infect Dis Abstracts BACKGROUND: Disseminated gonococcal infections (DGI) are estimated to occur in 0.5% to 3% of untreated Neisseria gonorrhoeae (GC) infections; however, surveillance and population-based studies to estimate DGI burden and describe recent DGI epidemiology and clinical manifestations are limited. In response to increased reports of DGI cases and clusters in the U.S., the Centers for Disease Control and Prevention (CDC) developed a surveillance system in 2020. We analyzed data captured by the initial two years of surveillance. METHODS: During 1/1/2020–3/31/2022, U.S. state/local health jurisdictions reported DGI cases to CDC utilizing a standardized case report form that collects demographic, sociobehavioral, and clinical information. A confirmed case was defined as isolation or detection of GC from a disseminated site of infection by culture or nucleic acid amplification test (NAAT); a probable case was defined as clinical manifestations of DGI and isolation or detection of GC from a mucosal site by culture or NAAT. RESULTS: In total, 274 DGI cases were reported to CDC from 13 U.S. states (65.7% from California): 215 (78.5%) confirmed cases and 59 (21.5%) probable cases. Among DGI cases, 51.1% were cisgender male, 33.2% were ≥ 45 years old, and 26.6% reported methamphetamine use in the past 12 months. Most patients (87.6%) did not have documented underlying immunosuppression or predisposing medical conditions. Among patients with DGI, 85.8% were hospitalized, 41.2% underwent related surgeries, and 2.2% died. Among confirmed cases, the most common disseminated sites of infection were synovial fluid (50.2%) and blood (45.1%). Among 184 (67.2%) patients with DGI who were tested for GC at a mucosal site, 115 (62.5%) were diagnosed with a mucosal GC infection (69.6% urogenital, 27.0% pharyngeal, 12.2% rectal); however, 85.5% of those not diagnosed with mucosal GC were only tested at urogenital sites. Only 89 patients (32.5%) reported mucosal symptoms present at the time of or within the month prior to DGI presentation. CONCLUSION: Health care providers should maintain a high degree of suspicion for patients presenting with DGI symptoms given the potential for significant associated morbidity and the low proportion of patients who present with concurrent GC mucosal symptoms. DISCLOSURES: Alison Ridpath, MD, MPH, 3M company: Stocks/Bonds|Abbott Laboratories: Stocks/Bonds|Abbvie Inc.: Stocks/Bonds|Allogene Theraputics: Stocks/Bonds|Amarin Corperation PLC: Stocks/Bonds|infinity Pharmaceutical Companies: Stocks/Bonds|IQVIA Holdings Inc: Stocks/Bonds|Johnson and Johnson: Stocks/Bonds|Medtronic: Stocks/Bonds|pfizer: Stocks/Bonds|Thermo Fisher Scientific: Stocks/Bonds. Oxford University Press 2022-12-15 /pmc/articles/PMC9751791/ http://dx.doi.org/10.1093/ofid/ofac492.082 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstracts
Quilter, Laura A
Tang, Eric C
Johnson, Kelly A
Jacobson, Kathleen
Ridpath, Alison
Cohen, Stephanie
Rajagopalan, Shobita
Munoz, Monica D
Holderman, Justin L
Kent, James B
Bachmann, Laura H
Bernstein, Kyle
1520. Mind the Clap: Reported Disseminated Gonococcal Infections in the United States, 2020–2022
title 1520. Mind the Clap: Reported Disseminated Gonococcal Infections in the United States, 2020–2022
title_full 1520. Mind the Clap: Reported Disseminated Gonococcal Infections in the United States, 2020–2022
title_fullStr 1520. Mind the Clap: Reported Disseminated Gonococcal Infections in the United States, 2020–2022
title_full_unstemmed 1520. Mind the Clap: Reported Disseminated Gonococcal Infections in the United States, 2020–2022
title_short 1520. Mind the Clap: Reported Disseminated Gonococcal Infections in the United States, 2020–2022
title_sort 1520. mind the clap: reported disseminated gonococcal infections in the united states, 2020–2022
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9751791/
http://dx.doi.org/10.1093/ofid/ofac492.082
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