Gonorrhoea among Sex Workers in China: Prevalence, Risk Factors, and Resistance to Antibiotics

Objective To study gonorrhoea among sex workers in China as to prevalence, risk factors, and resistance to antibiotics Subjects & Methods From March 1998 to October 1999, 966 sex workers from Guangzhou were recruited into a sexually transmitted diseases (STD) care and prevention programme through various outreach activities. Data collection was standardized. Cervical samples were tested for the presence of Neisseria (N.) gonorrhoea by culture. The agar dilution method was performed to determine susceptibilities of 85 isolates to penicillin, ciprofloxacin, spectinomycin and ceftriaxone. The production of B-lactamase was determined by paper acidometric testing. Results The prevalence of gonorrhoea was 9%. Independent predictors for the disease were inconsistent condom use, lack of regular salary, absence of a previous STD check-up in the preceding 12 months, and a concurrent trichomoniasis or chlamydial infection. Dysuria, vaginal malodour, and the presence of (muco) purulent discharge at genital examination were also independently associated with gonorrhoea. Of the 85 N. gonorrhoea isolates, 3.5% was penicillinase producing (PPNG) and 7% plasmid-mediated tetracycline resistant (TRNG). Of the non-PPNG strains 74% was insensitive to penicillin, while 52% and 47% were resistant or less susceptible to ciprofloxacin, respectively. One strain exhibited decreased susceptibility to ceftriaxone. All strains were susceptible to spectinomycin. Conclusion A high level of resistance to penicillin and ciprofloxacin was seen, but strains were sensitive to ceftriaxone and spectinomycin. Several personal or medical characteristics were independently associated with the presence of gonorrhoea. Women diagnosed with gonorrhoea should receive concurrent treatment for chlamydial infection.