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

Since prostitution is illegal in China,few if any specific services exist for sexworkers unless they are arrested and detained in re- education centers.Staff of amaternal and neonatal hospital in Guangzhou felt a community need for a STD careand preventio…

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, riskfactors, and resistance to antibioticsSubjects & Methods From March 1998 to October 1999, 966 sex workers fromGuangzhou were recruited into a sexually transmitted diseases (STD) care and pre-vention programme through various outreach activities. Data collection was standard-ized. Cervical samples were tested for the presence of Neisseria (N. ) gonorrhoea byculture. The agar dilution method was performed to determine susceptibilities of 85isolates to penicillin, ciprofloxacin , spectinomycin and ceftriaxone. The production ofB-lactamase was determined by paper acidometric testing.Results The prevalence of gonorrhoea was 9%. Independent predictors for thedisease were inconsistent condom use, lack of regular salary, absence of a previousSTD check-up in the preceding 12 months, and a concurrent trichomoniasis or chlamy-dial infection. Dysuria, vaginal malodour, and the presence of (muco) purulent dis-charge at genital examination were also independently associated with gonorrhoea. Ofthe 85 N. gonorrhoea isolates, 3. 5% was penicillinase producing (PPNG) and 7%plasmid-mediated tetracycline resistant (TRNG). Of the non-PPNG strains 74% wasinsensitive to penicillin, while 52% and 47% were resistant or less susceptible tociprofloxacin, respectively. One strain exhibited decreased susceptibility to ceftriax-one. All strains were susceptible to spectinomycin.Conclusion A high level of resistance to penicillin and ciprofloxacin was seen, butstrains were sensitive to ceftriaxone and spectinomycin. Several personal or medicalcharacteristics were independently associated with the presence of gonorrhoea. Womendiagnosed with gonorrhoea should receive concurrent treatment for chlamydialinfection.