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OP-5 Increased incidence of adult gonococcal keratoconjunctivitis at two tertiary eye hospitals in Western Europe: clinical features, complications and antimicrobial susceptibility
  1. Alice Milligan1,
  2. Anna Randag2,
  3. W Lekkerkerk3,
  4. Helen Fifer4
  1. 1Moorfields Eye Hospital, London, UK
  2. 2Rotterdam Eye Hospital, Rotterdam, The Netherlands
  3. 3Maasstad General Hospital, Rotterdam, The Netherlands
  4. 4Health Security Agency (UKHSA), London, UK
  5. *


Introduction Gonorrhoea is on the rise. Between 2021 and 2022, sexual health services saw a 50% and a 33% increase in diagnoses respectively in England and The Netherlands. A concurrent rise in gonococcal keratoconjunctivitis (GKC) is a serious concern due to the potentially devastating visual complications, yet there is limited national epidemiology on GKC, including on antimicrobial susceptibility. This increase coincides with a major public health concern; N. gonorrhoeae is evolving high levels of antimicrobial resistance, including to ceftriaxone, the last available option for empirical therapy.

Method A descriptive, retrospective case series was conducted in two tertiary referral centres; Moorfields Eye Hospital, London, UK and Rotterdam Eye Hospital, Rotterdam, The Netherlands between 2017 and 2023.

Results There was simultaneously increased incidence of adult GKC in both centres, with 11 cases confirmed in the first seven months of 2023, compared to ≤3 per year in 2017–2022. The clinical features, ocular complications and antimicrobial susceptibilities are reported.

Conclusions There was a notable increase in the incidence of GKC cases in our centres in 2023, which may indicate a rise across Western Europe. Emergency departments need a heightened awareness to identify and treat cases at first presentation, even in individuals without identifiable risk factors. Nationwide studies of the incidence, clinical features, risk factors, management, complications and antimicrobial resistance of adult patients with GKC have been proposed in both countries for 2024. In the UK this will be facilitated by the British Ophthalmological Surveillance Unit (BOSU) in association with the UK Health Security Agency.

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

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