Increase in disseminated gonococcal infections in Belgium in 2023: clinical and molecular characteristics

As in other countries, Belgium is facing an increase in gonococcal infections.1 2 Globally, the increases in Neisseria gonorrhoeae infections have been associated with higher numbers of disseminated gonococcal infection or DGI.3 DGI is a rare complication and occurs in 0.5–3% of untreated gonorrhoea cases and is characterised by bacteraemia with associated arthritis or skin lesions. Infrequently, it can also lead to endocarditis and meningitis.4 5 DGI cases require hospitalisation and intravenous ceftriaxone therapy.4 5

In Belgium, the average number of N. gonorrhoeae isolates from suspected DGI cases received by the national reference centre for STIs (NRC-STI) was 4 per year since 2013 (range 0–6). In 2023, 14 cases were submitted to the NRC-STI, indicating a potential increase in DGI incidence.6 At the NRC-STI, phenotypic antimicrobial susceptibility testing (AST) to azithromycin, ciprofloxacin and ceftriaxone (Etest, Biomerieux,…

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