Changing patterns of disseminated gonococcal infection in France: cross-sectional data 2009-2011
Anna Belkacem1, Eric Caumes, Jocelyne Ouanich
1Department of Infectious and Tropical Diseases, Centre Hospitalier Intercommunal, , Villeneuve Saint Georges, France.
Objectives:
Disseminated gonococcal infections (DGIs) are rare. We describe the characteristics of DGIs in France.
Methods:
This is a 3-year retrospective analysis of DGI cases collected through two networks of microbiologists and infectious disease specialists in France between 2009 and 2011. DGI was defined either by the isolation of Neisseria gonorrhoeae from blood and synovial fluid or by the existence of a clinical syndrome consistent with DGI and the isolation of N gonorrhoeae from any site. We describe the epidemiological, clinical and microbiological characteristics and outcomes of DGIs.
Results:
21 patients (9 women, 12 men; 18-62 years old) were diagnosed with DGI. The number of DGI cases increased between 2009 and 2011. Two men who had sex with men were coinfected with HIV. We found 28 extragenital locations, including arthritis (14 cases), tenosynovitis (7), skin lesions (4), endocarditis (1), prostatitis (1) and pelvic inflammatory disease (1). Genital signs were present in five patients. The diagnosis was confirmed by cultures in 20 patients-blood (4), synovial fluid (11), genital (3), throat (1), urine (1)-and by molecular biology on a pharyngeal swab in 1 patient. Seven cases were resistant to fluoroquinolones. The patients were treated with ceftriaxone, associated with corticosteroids (two cases) and surgery (six cases). Four patients had joint sequelae.
Conclusions:
DGIs are increasing. Men seem to be at higher risk than women. Joint involvement was common. Microbiological diagnosis was based on culture, however molecular biology using pharyngeal swabs was helpful when cultures were negative.
Insights
Disseminated gonococcal infections (DGIs) are increasing in France, with men appearing to be at higher risk. Joint involvement is common, and while cultures are standard, molecular methods aid diagnosis.
Area of Science:
- Infectious Diseases
- Microbiology
- Epidemiology
Background:
- Disseminated gonococcal infections (DGIs) are a rare but serious complication of Neisseria gonorrhoeae. Understanding their characteristics is crucial for effective management.
- Recent trends in DGI incidence and presentation require updated epidemiological data.
Purpose of the Study:
- To characterize the epidemiological, clinical, and microbiological features of Disseminated Gonococcal Infections (DGIs) in France.
- To analyze treatment outcomes and identify risk factors associated with DGI.
Main Methods:
- A 3-year retrospective analysis (2009-2011) of DGI cases in France.
- Inclusion criteria: isolation of Neisseria gonorrhoeae from sterile sites (blood, synovial fluid) or compatible clinical syndrome with N. gonorrhoeae isolation from any site.
- Data collected included demographics, clinical presentation, microbiological findings, treatment, and outcomes.
Main Results:
- Twenty-one DGI cases were identified, with an increasing trend observed between 2009 and 2011.
- The most common manifestations were arthritis (14 cases) and tenosynovitis (7 cases), with extragenital sites frequently involved.
- Fluoroquinolone resistance was noted in seven cases; treatment involved ceftriaxone, with surgery and corticosteroids used in some instances. Four patients experienced joint sequelae.
Conclusions:
- Disseminated gonococcal infections (DGIs) appear to be increasing, with men potentially at higher risk.
- Joint involvement is a predominant feature of DGIs.
- While culture remains key, molecular diagnostics, particularly on pharyngeal swabs, can be valuable when cultures are negative.
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