P243 Time-to-clearance of N. gonorrhoeae (NG) RNA at the pharynx following treatment with ceftriaxone and azithromycin
Year: 2021
Type: conference-abstract
Abstract: Background The time to RNA-based nucleic acid amplification tests (NAAT) clearance following treatment of NG at the pharynx remains undefined. Methods Between March 2019–2020, we enrolled 55 men who have sex with men (MSM) with untreated pharyngeal gonorrhea detected ≤14 days to self-collect daily pharyngeal swabs at home for 21 days after treatment. All men received ceftriaxone 250mg intramuscularly plus 1g azithromycin orally once at enrollment. We used Kaplan Meier estimates to determine the median days of positive NAAT following treatment and the number of positive NAAT days when >95% of the cohort cleared, with clearance defined as 2 consecutively negative tests and censoring for loss-to-follow-up. We categorized men into groups by time-to-clearance and used chi-square and t-test (categorical and continuous variables respectively) to assess for differences by demographics, clinical history and sexual behavior. Results Of 55 men enrolled, 7 (13%) were NAAT-negative at enrollment (pretreatment) and 8 (15%) did not return any home self-collected swabs. Of the remaining 40 MSM (NAAT-positive at baseline and returned swabs), all cleared between 0 and 17 days. The median time-to-clearance was 5 days (95% CI: 3–8 days); >95% of men cleared NG RNA at 12 days (95% CI: 10 – undefined days) following treatment. Compared to men in the slowest to clear group (median 9 days, range 8–16, n=7), men who cleared NG RNA most rapidly (<3 days, range 0–2 days, n=28) more frequently had a history of gonorrhea (14% vs. 58%, p=0.04), and were somewhat older (median 25 vs. 30 years), though the latter was not significant (p=0.124). Time-to-clearance did not differ by HIV status, BMI or mouthwash use. Conclusions Test-of-cure for pharyngeal gonorrhea should not be performed before 12 days following treatment when using an RNA-based NAAT. The time-to-clearance may be shorter in persons with a history of gonorrhea.
Source: Poster presentations
Authors: L Barbee, O Soge, C Khosropour, A LeClaire, M Golden
Language: English
Subfield: Microbiology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: bronze
OpenAlex ID: W3179374255