Cisgender women have been underrepresented in antibiotic-resistant gonorrhea (ARGC) surveillance systems. Three of eight project sites (City of Milwaukee [MIL], Guilford County [GRB], Denver County [DEN]), funded under the Centers for Disease Control and Prevention’s Strengthening the U.S. Response to Resistant Gonorrhea (SURRG), focused efforts to better include cisgender women in ARGC surveillance.
MIL, GRB, and DEN partnered with diverse healthcare settings and developed gonorrhea culture criteria to facilitate urogenital specimen collection in cisgender women and men. Regional laboratories within the Antibiotic Resistance Laboratory Network performed agar dilution antibiotic susceptibility testing (AST) of gonococcal isolates. Data from 2018 and 2019 were analyzed.
In SURRG, 90.5% (11,464/12,667) of the cisgender women from whom urogenital culture specimens were collected were from MIL, GRB, and DEN. Of women in SURRG whose gonococcal isolates underwent AST, 70% were from these three sites. In these three sites, a substantial proportion of cisgender women with positive urogenital cultures and AST were from healthcare settings other than STD clinics (non-STD clinics) (MIL 56.0%, GRB 80.4%, and DEN 23.5%). Isolates with AST were obtained from 5.1%, 10.2%, and 2.4% of all diagnosed gonorrhea cases among cisgender women in MIL, GRB, and DEN, respectively, and were more often susceptible to all antibiotics than those from cisgender men from each of these sites.
With focused efforts and partnerships with non-STD clinics, three SURRG sites were able to include robust ARGC surveillance from cisgender women. These findings may guide further efforts to improve gender equity in ARGC surveillance.