An outbreak of a penicillin-sensitive strain of gonorrhoea in Sydney men

Abstract

Objective: To describe an outbreak of gonorrhoea caused by penicillin sensitive Wild type 1B2-Wt/1B2(FS), in homosexual men in Sydney.

Design and setting: The study sample comprised all gonococcal isolates referred to the Gonococcal Reference Laboratory (GRL), New South Wales, Australia between 1 January 1990 and 30 June 1992. Demographic data on Wt/1B2(FS) were sought by review of all request forms accompanying specimens to the GRL. Detailed review was undertaken of the clinical records of all men with gonorrhoea which had been differentiated by auxotype and serotype (A/S) from two large STD clinics in Sydney.

Measurements and main results: The first isolation of Wt/1B2(FS) was made in April 1990 and by the end of July 1992, 140 such isolates were identified in 131 patients. The male:female ratio was 130:1 suggesting male homosexual transmission, which was confirmed in 55 of 57 evaluable cases. There was a higher proportion of pharyngeal and anal infections among Wt/1B2(FS) isolates compared with all other male gonorrhoea. Demographic information showed that 60% of men with Wt/1B2(FS) were under the age of 30, and 80% lived in Central or Eastern Sydney.

Conclusions: An outbreak of a penicillin sensitive strain of gonorrhoea has occurred in Sydney, primarily among gay men living in the inner city. The extent to which the outbreak represents an increase in the risk of HIV transmission is unclear.