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Bacterial STIs
P64 High rates of rectal Chlamydia trachomatis in women reporting anal sex in the GUM clinic
  1. S Simon,
  2. M Hassan-Ibrahim,
  3. S Soni
  1. Brighton and Sussex University Hospitals NHS Trust, Brighton, UK

Abstract

Background Nucleic acid amplification (NAAT) testing for Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) is now widely available but not licensed for use at non-genital sites. Despite this, high rates of pharyngeal and rectal GC and CT have been demonstrated in MSM. Currently there is little data on the prevalence of infection at these sites in women reporting oral and anal sex.

Aim To determine the prevalence of pharyngeal and rectal CT and GC in women attending GUM.

Methods Between 1 June and 31 October 2011 all women reporting oral and anal sex were offered pharyngeal and blind rectal swabs as well as cervical testing for CT and GC. Samples were analysed using the BD ProbeTecTM CT/GC Qx Amplified DNA assay in the BD ViperTM system. All women with positive GC NAAT results had swabs sent for GC culture and sensitivities.

Results Median age was 25 years (IQR 21–31) and most women were of white ethnicity. 2235 swabs were taken, 124 were excluded due to incomplete labelling. 2111 women had non-genital sampling: 165 rectal swabs only, 1652 pharyngeal swabs only, 147 both sites. In nine and five women the pharynx and rectum were the sole sites of CT infection respectively. In two women, the pharynx was the sole site of GC infection. All women were asymptomatic at throat and rectum (see abstract P64 table 1).

Abstract P64 Table 1

CT and GC prevalence at different sites

Discussion Rectal CT rates were high among women reporting anal sex. As the antibiotic treatment of cervical and rectal CT differs, this pool of infection could remain untreated. We recommend routinely asking about anal sex and testing where appropriate. Rates of pharyngeal CT were low but higher than GC overall. Although 11 women had pharyngeal CT/GC only, and would have been missed, the cost of detecting one of these infections was £1727 and this has precluded ongoing screening.

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