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Background: The incidence of gonorrhoea at the European level increased over 2012-2019, decreased in 2020, and then reached higher values in 2021 than in 2019., Objective: Analysis in the descriptive epidemiology scheme of gonorrhoea notification in surveillance in Poland in 2021 (being the second year of the COVID-19 pandemic)., Material and Methods: Case-base data from surveillance of gonorrhoea were used: confirmed case (meeting laboratory criteria), probable (meeting clinical criteria and contact with confirmed case) and possible (only in Poland - physician diagnosed gonorrhoea, no information available for proper classification). Statistic Poland data was used to calculate the indicators. Data on patients treated in dermatology-venereology clinics between 2019-2021 were taken from the Bulletins of the Ministry of Health., Results: The incidence of gonorrhoea in Poland in 2021 was only a fraction of recorded in the EU/EEA (0.74 vs. 13.7/100000)-similar to the first pandemic year and were about half of those notified in the 2019 (the peak year; 281 vs. 522 cases). There were 15.5 men per one female (incidence: 1.6/100000 men, 0.1/100000 women). Every second case was among aged 25-34 (49.62%), every fourth-aged 35-44 (23.11%). Under 15, no cases were reported. The predominant site was the genitourinary (excluding missing data: 85.3%). The cases with missing information on transmision increased (49.1%; aged 45+: 72.0%, women: 76.5%). Delays in reporting data were identified (greater than in 2019, however, less than in 2020), ~17% cases were from 2019-2020. Dermatology-venerology clinics treated 385 people - less than in 2020, however, more than reported in epidemiological surveillance (vs. 281)., Conclusions: The COVID-19 pandemic has influenced on the surveillance system in Poland. There are difficulties in interpreting the epidemiological trend. It is necessary to: 1) intensify systemic solutions in the area of prevention, including sexual partners; 2) raise the awareness of healthcare professionals and sanitary inspection workers on the role of collecting epidemiological information.

Introduction: Gonorrhoea is one of the most common sexually transmitted diseases in the world. Fast and effective laboratory diagnostics of the infection is very important. The aim of the study was to compare Real-Time PCR and bacterial culture in diagnostics of Neisseria gonorrhoeae infections in patients of Department of Dermatology and Venereology Medical University of Warsaw., Methods: The urethral, cervical, anal and pharyngeal specimens from 93 patients of Department of Dermatology and Venereology Medical University of Warsaw were examined by two methods. The bacterial culture was performed on chocolate agar plates with antibiotics in the 5% CO2 atmosphere at 37°C. N. gonorrhoeae was identified by colony-morphology, Gram stain and oxidase reaction, followed by carbohydrate utilization test. The DNA Bact Extra Pure Kit (Euroclone®) to isolate DNA was used. Real-Time PCR DUPLICα® Real-Time Neisseria gonorrhoeae 2nd Generation Detection Kit (Euroclone®) was performed using Smart Cycler® Dx., Results: In 85.9% of results of Real-Time PCR and culture were identical. The remaining 14.1% of samples were culture negative and PCR positive. The results ofthe Real-Time PCR and culture were more often concordant in the case of samples obtained from men (96.8%) than from woman (85%). In patients after treatment with antibiotics the concordance of the results obtained with these two methods was 81%., Conclusions: In laboratory diagnostics of N. gonorrhoeae infections, Real-Time PCR was more sensitive than the culture, but in some cases it was less specific.

The Aim of the Study: Was to assess epidemiological situation of sexually transmitted diseases in Poland in 2011., Materials and Methods: Analysis of the data on prevalence of syphilis, gonorrhoea, non-gonococcal urethritis, genital herpes and genital warts was gathered from yearly reports MZ-14 from several didtricts., Results: In 2011 there were 841 reported cases of all types of syphilis, which was higher by 24 than in 2010. Within the reported cases, 554 cases were of early syphilis, 274 cases of late syphilis, and 11 cases of congenital syphilis. Syphilis during pregnancy and childbirth was reported in 13 women. The highest incidence of syphilis in 2011, similarly to previous years was in Mazowieckie district (4.7/100,000) and the lowest in Swietokrzyskie district (0.2/100,000), the average in a whole country accounted to 2.2/100,000. In 2011 there were 351 cases of gonorrhoea reported, which was higher by 77 cases than reported in the previous year. The highest incidence was reported in Mazowieckie voivodeship. Non-gonococcal urethritis -NGU was identified in 484 persons; this was less by 294 cases than reported in the previous year. The highest incidence rate was reported in Dolnoślaskie voivodeship 9.6/100,000. There were 428 cases of genital warts reported which was less by 174 cases than reported in 2010. The highest incidence rate was reported in Mazowieckie voivodeship, Warminsko- Mazurskie voivodeship and Kujawsko-Pomorskie voivodeship. As in previous years the most unfavourable epidemiological situation in terms of all registered sexually transmitted diseases was in Mazowieckie voivodeship., Conclusion: In 2011 among sexually transmitted diseases NGU and genital warts were reported in lower numbers then in previous year. In the same time numbers of reported cases of gonorrhoea and syphilis increased. There is a continued decrease in the number of serological tests done for syphilis. Epidemiological indicators of treatment for gonorrhoea and syphilis are very low for number of years. The epidemiological data is probably incomplete due to the low sensitivity of reporting.

In 2009, as compared with the previous year, was the rise in cases of syphilis by 36%, gonorrhea by 35%, for genital warts by 41%. Congenital syphilis was diagnosed in 13 children, and syphilis in pregnancy or childbirth were found in 69 women. Still the number of screening serological tests for syphilis decreases, resulting in reduced detection of asymptomatic cases of the disease.

In 2008 as far as statistics are concerned this situation did not change to the worse. Number of cases of syphilis has significantly risen (by over 100) compared to 2003-4 and this tendency seams to be fixed. Number of serological screening tests for syphilis has dramatically dropped resulting in decreasing of the likelihood of discovering the symptomless cases of syphilis. It seems, that reports of gonorrhoea and nongonococcal urethritis are incomplete.

In 2003 year 982 cases of all forms of syphilis were notified in Poland; incidence 2.57 per 100 000 population. The largest number of cases was in mazowieckie (257), dolnoślaskie (124) and slaskie (131) voivodeships. The lowest was registered in kujawsko-pomorskie (13), opolskie (14) and swietokrzyskie (15) voivodeships. There were 446 recognized cases of early symptomatic syphilis and 13 cases of congenital syphilis. Latent syphilis (early and tarda) was diagnosed insufficiently due to decreased number of screening studies. In 2003 year there were 941 932 serum samples tested toward sexually transmitted diseases--it is 35% of the number of 1999 year. In 2003 year there were 670 cases of gonorrhoea notified; incidence 1.75 per 100 000 population. The lower number of venereal diseases notified in 2003 does not imply the actual smaller number of illness (cases). It suggests the less number of case reports. It is necessary to increase the budget assigned to diagnose and cost-free treatment of all venereal patients.

The sexually transmitted infection (STI) in an infant can be an early consequence of child sexual abuse (CSA). The risk of acquisition of a STI depends, among others, on the prevalence of these infections in the abusing population and the type of sexual assault. As the detection of sexually transmissible organism can be an unique evidence of CSA, only the best standardized methods should be used for the diagnosis of STIs in children. STIs are seen in less than 10% of abused child and in a half of them are asymptomatic. The relevance of STIs for the diagnosis of CSA should be assessed taking into consideration the age of a child, a type of sexually transmissible organism and its localization. Generally, postnatally acquired gonorrhoea, syphilis and genital Chlamydia trachomatis infection in a child more than 2-year old are most clinically evident for CSA. Infections with HPV, HIV and HSV can also be important.

A group of 326 prostitutes were examined for gonorrhoea and the result was positive in 45 cases (14%). Smears were stained with methylene blue and by Gram's method, cultures were conducted on suitable media and the immunoenzymatic method EIA-Gonozyme (Abbott) was used. Smear evaluation was insufficiently sensitive and specific, but it made possible a rapid diagnosis of 17 cases. Most positive result were obtained with the Gonozyme test (41 cases), including 15 women (37%) in whom a positive result was obtained only in urethral secretion, despite a negative result of the examination of cervical secretion. Gonococci were cultured in 29 cases (9%), including 5 (17%) with bacterial growth obtained only from the urethral secretion in 13 (45%) only in cervical secretion. In 27 of these patients the Gonozyme test was positive. Gonozyme was highly useful in the examinations of prostitutes in view of its sensitivity and the fact that the gonococcal antigen can be detected also when the result of culture was negative due to antibiotic taking. Always secretion from the urethra and cervix should be examined, since in 17% of the infected women the diagnosis was established by culture and the Gonozyme test demonstrated infection only in urethral secretion in 37% of the infected women.