Development and Evaluation of a Procedure to Identify Possible Gonorrhea Treatment Failure Cases in Illinois
Marguerite Smith1, Lesli Choat, Lynette McKinney-Colman
1From the Illinois Department of Public Health, Springfield, IL.
Background:
Cephalosporins are the last effective class of antibiotics to treat gonorrhea infections. In Illinois, gonorrhea cases have increased by 70.9% from 2015 to 2019. Because of the concern of antimicrobial resistance and the increasing number of cases, the Illinois Department of Public Health Sexually Transmitted Diseases Section established a procedure to identify possible gonorrhea treatment failure cases.
Materials And Methods:
A procedure was developed that identifies patients who have had 2 gonorrhea cases in the last 60 days, and the first case was treated with the Centers for Disease Control and Prevention-recommended treatment. Interview records were faxed to the local health department (LHD) where the patient resides. Descriptive statistics were used to analyze interview record data. A process evaluation was conducted using telephone interviews with LHDs to obtain qualitative feedback on the procedure.
Results:
A total of 310 interview records were sent for investigation in 2018 and 2019 with 263 returned. Of those returned, 140 identified reexposure, 104 were unable to be located, 12 refused to be interviewed, 6 had treatment reported incorrectly, and 1 had a possible treatment failure. From telephone interviews with 6 LHDs, 1 question was removed and 2 questions were added to the interview record.
Conclusions:
Antibiotic-resistant gonorrhea could occur in Illinois at any time. Monitoring for antibiotic-resistant gonorrhea cases is necessary as gonorrhea morbidity continues to increase. This procedure may prove to be a model for other states.
Insights
Illinois is monitoring gonorrhea treatment failures due to rising cases and antimicrobial resistance concerns. A new procedure helps identify potential treatment failures, aiming to prevent antibiotic-resistant gonorrhea spread.
Area of Science:
- Public Health
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Gonorrhea cases in Illinois increased by 70.9% between 2015 and 2019.
- Cephalosporins are the last effective antibiotic class for gonorrhea.
- Rising cases and antimicrobial resistance necessitate monitoring treatment failures.
Purpose of the Study:
- To establish a procedure for identifying potential gonorrhea treatment failures in Illinois.
- To monitor for increasing gonorrhea morbidity and the threat of antibiotic resistance.
Main Methods:
- Developed a procedure to identify patients with two gonorrhea cases in 60 days, with the first treated by CDC-recommended therapy.
- Utilized interview records faxed to local health departments (LHDs).
- Employed descriptive statistics for data analysis and conducted process evaluations via LHD telephone interviews.
Main Results:
- In 2018-2019, 263 of 310 records were returned; 140 indicated reexposure, 104 were unlocated, 12 refused, 6 had incorrect treatment, and 1 showed possible treatment failure.
- Process evaluation led to refining interview questions for LHDs.
Conclusions:
- Antibiotic-resistant gonorrhea poses a potential threat in Illinois.
- Continuous monitoring of gonorrhea cases is crucial.
- The developed procedure could serve as a model for other states.
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