NEISSERIA-GONORRHOEAE ISOLATED AT ST-MARYS-HOSPITAL-LONDON, 1980-91

Objective-To describe and discuss the trends in the isolation of Neiss eria gonorrhoeae from patients attending the Genitourinary Medicine Cl inic at St. Mary's Hospital, Paddington, London between 1980 and 1991. Design-A retrospective study of the total number of gonococci isolate d over an eleven year period was performed. In addition, for the years 1988-1991 the number of isolates from homosexual men was analysed by age of the patient, site of infection and HIV antibody status of the p atient. Results-The total number of N. gonorrhoeae isolates identified declined markedly between 1980 and 1989 from 3670 to 750 isolates. Ov er the same time period the number of specimens screened for N. gonorr hoeae fell by 50%. In 1990 there was an increase in N. gonorrhoeae iso lates but this was not maintained, and in 1991 the number of N. gonorr hoeae fell to its lowest level of 638 isolates. The decrease since 198 0 occurred in both men and women although the number of rectal isolate s from men showed a steeper decline reaching its lowest level of 24 is olates in 1988. The number of rectal isolates from homosexual men has since increased with a peak in 1990. Many of the infections among homo sexual men occurred in older men and included insignificant number of patients who were HIV positive. Conclusion-Gonorrhoea among attenders at St. Mary's Hospital has declined dramatically since 1980 following trends reported from much of Europe. The increase in gonococcal isolat es since 1989 and the peak in 1990 are unexplained but are coincident with a higher number of isolates from homosexual men.