Neisseria gonorrhoeae culture growth rates from asymptomatic individuals with a positive nucleic acid amplification test.

Gonorrhoea infections are frequently diagnosed at extragenital locations in asymptomatic individuals and are historically related to poor recovery in culture, which hinders antimicrobial susceptibility testing. The aim of this study was to evaluate recovery rates of Neisseria gonorrhoeae by culture among asymptomatic individuals who tested positive by nucleic acid amplification tests between 2018 and 2019 in Barcelona (Spain). In total, 10 396 individuals were tested for N. gonorrhoeae on first-void urine, rectal, pharyngeal and/or vaginal swabs depending on sexual behaviour. Overall infection prevalence was 5·5% (95% confidence interval [CI] 5·0-5·9). Seven hundred and ten samples were positive corresponding to 567 individuals. The most common site of infection was the pharynx (71·3%), followed by rectum (23·1%) and genitals (4·7%) (P < 0·0001). The N. gonorrhoeae recovery rate in culture, time from positive screening to culture specimen and inoculation delay were calculated. Recovery rate was 21·7% in pharynx, 66·9% in rectum and 37·0% in genitals (25·0% vagina, 71·4% urethra) (P < 0·0001). Median culture collection time was 1 [0; 3] days, and median inoculation delay was 5·01 [4·99-7·99] h, with no impact on N. gonorrhoeae recovery, P = 0·8367 and P = 0·7670, respectively. Despite efforts towards optimizing pre-analytical conditions, the N. gonorrhoeae recovery rate in asymptomatic individuals is unacceptably low (especially for pharynx), representing a problem for monitoring antimicrobial-resistant infections.

[Tuberculosis in recent immigrants in Barcelona]. / Tuberculosis en inmigrantes recién llegados a Barcelona.

BACKGROUND: The aim of the present was to study the prevalence of infection and tuberculous disease as well as the fulfillment of secondary antituberculin chemoprophylaxis in immigrants according to their geographic origin. PATIENTS AND METHODS: A descriptive study was carried out of 1,489 immigrants under the age of 35 years attended in the Tropical and Imported Disease Unit Drassanes in Barcelona, Spain from 1989 to 1994. RESULTS: The patients were from 79 countries, with 81.7% being males and 18.3% females (p < 0.001) of a mean age 26.1 +/- 5.7 and 23.4 +/- 7.5 years, respectively. Forty-three percent of the cases presented Mantoux test response > or = 10 mm of induration. The highest percent of positivity was observed in patients from Subsaharian Africa (52%) followed by Eastern Europeans and Asians (44%), South and Central Americans (38%) and Middle East and Northern Africa (34%) (p < 0.001). Thirty-nine percent of the 359 patients who initiated secondary antituberculin chemoprophylaxis completed the 6 months of treatment with the highest fulfillment being found in Africans (49%) followed by Americans (42%) and Asians (39%). The lowest rate was observed in the Eastern Europeans (20%) (p < 0.001). Fifty-six percent of the patients abandoned secondary antituberculin prophylaxis within the first three months. Eighteen cases of active tuberculosis were diagnosed. CONCLUSIONS: The prevalence of tuberculous infection and disease is high immigrants in Barcelona, Spain. The fulfillment of chemoprophylaxis is low and abandoned early. These facts should be evaluated when designing prevention and control programs.