Abstract
Background
Ocular gonorrhea infections (OGI) have been rarely reported in United States adults. Unlike other bacterial eye infections which may be treated with topical antibiotics, OGI is typically characterized by purulent conjunctivitis with profuse exudate and requires treatment with systemic antibiotics. Genital gonorrhea infections are increasing nationally and in New York City (NYC). New York State mandates prophylactic antibiotic treatment of newborns to prevent purulent conjunctivitis. We describe the number and characteristics of OGI case-patients diagnosed among NYC residents over a 12-year period.
Methods
We examined data from two different sources: (1) the NYC Health Department sexually transmitted infections (STI) surveillance registry (January 2006-October 2017) in which OGI cases were defined as laboratory-confirmed infection of the eye or eye appendages; and (2) a hospital discharge database (inpatient and emergency room) for NYC residents admitted to any New York State hospital (inpatient or emergency room discharges, January 2006–December 2016) in which cases of OGI were identified using diagnostic codes corresponding to OGI. We characterized de-duplicated OGI cases identified across these data sources for 2006–2017 and calculated the OGI rate/100,000 reported gonorrhea cases.
Results
Thirty-six OGI cases were identified in STI surveillance data and 55 additional cases in the hospital discharge database. Out of the total of 91 OGI cases, 20 (22%) were ≤1 year (11 males, 9 females), 3 (3.3%) were 2–14 years (all males), and 68 (74.7%) were ≥15 years old. Among the 68 adolescent/adult case-patients, the mean age was 29.04 ± 13.4 years. The majority were males (69.1%, 47/68,) and African American (42.6%, 29/68). The OGI rate in adolescents/adults was 39.95/100,000 gonorrhea cases (females, 35.76; males, 42.31); the rate remained almost constant since 2006 despite the increases in gonorrhea over the past decade. Conjunctivitis was the most common presentation (90.1% of all cases; 82/91), followed by eye appendage infections (2.2%; 2/91). The STI surveillance data revealed the diagnosis of OGI was made mainly by ocular culture (86.1%; 31/36), followed by nucleic acid amplification test (NAAT) (8.3%), or both culture and NAAT (5.6%).
Conclusion
OGI appear to be a rare disease in NYC. The majority of infections occurred among adolescents and adults, likely due to mandated newborn prophylaxis.
Disclosures
All authors: No reported disclosures.
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