Epidemiology
Your Organisational Guidance
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Diagnose en aanpak van gonorroePublished by: KCELast published: 2023Diagnostic et prise en charge de la gonorrhéePublished by: KCELast published: 2023Gonorrhoea is the second most common bacterial sexually transmitted infection (STI) worldwide.[3] The World Health Organization estimated that there were 78 million new cases of gonorrhoea in 2012 among those aged 15 to 49 years worldwide, with a global incidence rate of 19 per 1000 women and 24 per 1000 men.[3] The Western Pacific and African regions had the highest prevalence of gonorrhoea.[3]
In the US, gonorrhoea is the second most commonly reported communicable disease, and the number of cases has shown a sustained increase over the past 10 years.[4] During 2021 and 2022, however, rates of reported gonorrhoea decreased among both men (5.4%) and women (14.5%).[4] From 2022 to 2023, rates of infection continued to decrease, with the decrease more pronounced among women (14.1%) than men (3.4%).[4] These years coincide with the COVID-19 pandemic, which introduced uncertainty and difficulty in interpreting STI surveillance data.[4] In 2023, the gonorrhoea rate in the US was 179.5 cases per 100,000.[4] The southern US continues to have the highest rates in the country. Rates continue to be highest among certain groups, such as men who have sex with men or black and African American black people. Rates also continue to be higher in men than in women. The highest rates in men and women are seen in the 20 to 24 years age group.[4]
Rising rates of gonorrhoea have also been seen in England.[5] Many of those infected with gonorrhoea also have co-infections. A cross-sectional study of new patients attending King’s College Hospital (London) with either gonorrhoea or chlamydia found that 24.2% (124/512) of heterosexual men and 38.5% (136/335) of women with gonorrhoea also had chlamydia.[6]
High rates of antimicrobial resistance to penicillin, tetracycline, and fluoroquinolones have been reported from the Gonococcal Isolate Surveillance Project, and there is concern about the potential of reduced susceptibility to extended-spectrum cephalosporins and macrolides.[7] Rare isolates have also been found with reduced susceptibility to cephalosporins and azithromycin, which has led to increased vigilance for antimicrobial resistance and updated treatment guidance.
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