P638 Surveillance of gonococcal infection treatment failures 2015–2018 in québec, canada

Background Incident cases of gonococcal infection are increasing. Antibiotic resistance may compromise the effectiveness of treatment. In 2017, the proportion of azithromycin-resistant strains reached 31% in Quebec and a first strain non-susceptible to ceftriaxone and cefixime was detected. Methods Since November 2014, public health departments are invited to report possible cases of treatment failures. Clinical and epidemiological information is collected using a standardized form for each report of gonococcal infection occurring Results Between November 2014 and December 2018, 44 cases of possible treatment failures were reported. After exclusion of 9 cases, 35 were analysed (25 classified as retained and 10 as suspected). There were 10 women, 24 men (68% MSM) and one trans person. Pharynx was identified as site of treatment failure for 14 cases (40%). AST were available for 23 cases (66%): 78% were resistant to ciprofloxacin and 43% to azithromycin. All strains were susceptible to cephalosporins, but one strain showed reduced susceptibility to cefixime. Eleven cases (31%) received azithromycin monotherapy as initial therapy. Conclusion Treatment failure exist and is not always related to documented resistance. This analysis probably underestimates the real extent of treatment failures since it requires TOC that are not systematically collected. Reinfection cannot be completely excluded. Disclosure No significant relationships.