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Improving clinical practice and service delivery
P161 Routine three-site NAAT testing in MSM increases pharyngeal and rectal diagnoses of chlamydia and gonorrhoea
  1. N Dufty,
  2. S Herbert,
  3. P French,
  4. D Mercey
  1. Mortimer Market, London, UK

Abstract

Background BASHH and Health Protection Agency guidelines acknowledge the increased sensitivity of Gonorrhoea (GC) NAAT testing compared to culture at extragenital sites. Chlamydia (CT) NAAT testing is also the test of choice at these sites. Routine three-site GC and CT testing in MSM was implemented at a genitourinary medicine clinic using urethral, pharyngeal and rectal sites.

Objectives To compare the number of diagnoses of CT and GC before and after implementation of routine three-site NAAT testing for MSM.

Methods Records were reviewed of MSM testing positive for CT or GC from the urethra, pharynx and/or rectum between 1 January 2010 and 1 April 2010 and compared to the same 3-month period in 2011.

Results Number of cases: The proportion of GC cultures resistant to >1 antibiotic increased from 15.9% (18/113) to 41.8% (28/67), however cultures were only taken in 51.1% (138/270) of NAAT positive GC specimens (see abstract P161 table 1).

Abstract P161 Table 1

Comparison of CT/GC diagnosed

Discussion Pharyngeal GC, CT and rectal GC diagnoses increased with three-site NAAT testing, making the pharynx and the rectum the main sites of GC and CT infection. This increase in diagnoses has implications for clinical service provision. The increase in antibiotic resistance to GC has important clinical implications and when using routine three-site NAAT testing, cultures should always be taken prior to antibiotics being given.

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