P684 Gonorrhea sequence types in non-cultured specimens from a provincially representative sample in british columbia canada, 2018

Background In British Columbia (BC), Canada, enhanced gonorrhea surveillance to monitor sequence types (STs) is based on cultures which are typically performed on symptomatic individuals, at extra-genital sites, and at clinics in the Greater Vancouver Area (GVA), leaving certain subpopulations under-represented. We sought to describe Neisseria gonorrhoeae multi-antigen sequence types (NG-MASTs) in a provincially representative sample using remnant nucleic acid amplification tests (NAATs). Methods A sample of gonorrhea positive NAATs diagnosed at the BC Centre for Disease Control Public Health Laboratory from March 1 to September 31, 2018 were sent to the National Microbiology Laboratory for sequence typing using the NG-MAST method. Samples were selected to be representative of the distribution of gonorrhea in BC by sex and geography. NG-MAST was linked to case information from the provincial sexually transmitted infections surveillance database. Associations were tested using Chi-square or Fisher’s exact test. Results There were 261 NAAT-positive gonorrhea specimens selected: 129 (49%) from urine, 71 (27%) from rectal, 35 (13%) from vaginal, 19 from cervical (7.3%) and 7 (2.7%) from urethral sites. Males represented 60% of the sample (156/261) and 21% (55/261) were from outside GVA. Mean age was higher in males than females (33 vs 28 years, p Conclusion We were able to use remnant NAAT specimens from a provincially representative sample to identify STs not routinely found using culture-based surveillance (e.g. ST7638, ST-4207). Moreover, some STs were more common outside GVA supporting the need for molecular methods to improve representativeness for gonorrhea surveillance. Disclosure No significant relationships.