Men at risk of gonococcal urethritis: a case-control study in a Darwin sexual health clinic

dc.contributor.authorChen, Winnie
dc.contributor.authorConnor, Suzanne
dc.contributor.authorGunathilake, Manoji
dc.date.accessioned2022-12-02T02:21:56Z
dc.date.available2022-12-02T02:21:56Z
dc.date.issued2019-11-21
dc.description.abstractBackground: Male urethritis is primary sexually transmitted. Northern Territory (NT) has the highest rates of gonococcal infection in Australia and local guidelines recommend empiric treatment with azithromycin and ceftriaxone for all men presenting with urethritis. As gonococcal drug resistance is a growing concern, this study aims to improve empiric use of ceftriaxone through examining local patterns of male urethritis, comparing cases of gonococcal urethritis (GU) to controls with non-gonococcal urethritis (NGU). Methods: A retrospective study was undertaken of all men with symptomatic urethritis presenting to Darwin sexual health clinic from July 2015 to July 2016 and aetiology of urethritis in this population was described. Demographic, risk profile, and clinical features of GU cases were compared to NGU controls. Results: Among n = 145 men, the most common organisms identified were Chlamydia trachomatis (23.4%, SE 3.5%) and Neisseria gonorrhoeae (17.2%, SE 3.1%). The main predictors of GU were any abnormalities on genital examination (aOR 10.4, 95% CI 2.1 to 50.8) and a history of urethral discharge (aOR 5.7, 95% CI 1.4 to 22.6). Aboriginal patients (aOR 3.0, 95% CI 0.9 to 9.6) and those over 30 years of age (aOR 1.4, 95% CI 0.3 to 7.0) were more likely to have GU in the unadjusted analysis, but not in the adjusted model. Conclusion: This is the first study looking at patterns of male urethritis in urban NT and the results support a move towards adopting national guidelines to use ceftriaxone for empiric management of syndromic urethritis only in high-risk patients. In addition to traditional demographic risk factors, clinical features remain an important component of risk stratification.en_US
dc.identifier.citationChen, W., Connor, S., & Gunathilake, M. (2019). Men at risk of gonococcal urethritis: a case-control study in a Darwin sexual health clinic. BMC infectious diseases, 19(1), 991. https://doi.org/10.1186/s12879-019-4625-8en_US
dc.identifier.otherDOI: 10.1186/s12879-019-4625-8
dc.identifier.urihttps://hdl.handle.net/20.500.14041/4304
dc.language.isoen_USen_US
dc.publisherBMC Infectious Diseasesen_US
dc.rightsAttribution-NonCommercial-NoDerivs 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/us/*
dc.subjectUrethritisen_US
dc.subjectMenen_US
dc.subjectNeisseria Gonorrhoeaeen_US
dc.subjectChlamydia Trachomatisen_US
dc.subjectCeftriaxoneen_US
dc.subjectAntimicrobial Resistanceen_US
dc.titleMen at risk of gonococcal urethritis: a case-control study in a Darwin sexual health clinicen_US
dc.typeArticleen_US
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