The Occurrence of Single-Site Pharyngeal Neisseria gonorrhoeae Among Female Sex Workers in the Netherlands

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BACKGROUND: Female sex workers (FSWs) have a higher burden of sexually transmitted infections (STI), including Neisseria gonorrhoeae (NG), than the non-sex worker population, mainly due to social vulnerability and work-related factors. This large study evaluated the anatomical site distribution of NG, and specifically the occurrence of single-site pharyngeal NG, among FSWs visiting Dutch STI clinics in the Netherlands. METHODS: Coded STI clinic consultations from FSW attending any Dutch STI clinic between 2016 and 2021, in which tests were performed on all 3 anatomical sites, according to the Dutch testing policy for FSW, were included in analyses (n = 22,304). To compare the anatomical site distribution of NG among FSWs with women in general, 15,494 consultations from women who were tested on 3 anatomical sites in clinics that performed standard testing at 3 anatomical sites were used. Descriptive statistics were used to compare the anatomical site distribution of NG and occurrence of single-site pharyngeal NG among FSW and universally tested women. RESULTS: NG was diagnosed among 3.5% (782 of 22,034) among FSWs and 1.7% (271 of 15,494) among universally tested women ( P < 0.001). Pharyngeal NG was diagnosed among 2.3% of FSWs versus 0.8% of universally tested women ( P < 0.001). Single-site pharyngeal NG was diagnosed in 19.9% (156 of 782) of all NG infections, compared with 14.8% (40 of 271) of NG infections among universally tested women. CONCLUSION: The substantial proportion pharyngeal NG and single-site pharyngeal NG among FSW confirms the relevance of pharyngeal testing among this key population for optimal patient management, also in the context of the potential role of pharyngeal NG in antimicrobial resistance.

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