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P28 Extra-genital gonorrhoea testing in heterosexual patients. is it worth it?
  1. Laura Percy,
  2. Kate Langley,
  3. Emily Harrison,
  4. Nathan Sankar,
  5. Laura Mitchell
  1. New Croft Centre, Newcastle Upon Tyne, UK


Background/introduction Current clinic policy is to offer extra-genital testing to all patients reporting a history of active oral sex and/or receptive anal sex. These swabs are analysed using the Aptima Combo II platform, for Neisseria gonorrhoea (GC).

Aim(s)/objectives With analysis costing £6.20 per swab we sought to explore cost effectiveness, review culture results and partner notification results.

Methods Inclusion criteria were heterosexual patients with exclusively extra-genital GC who did not present as a contact of GC. We performed a retrospective case note review of 54 sets of notes asserting symptom history, concurrent STI diagnosis, culture results and any positive contacts.

Results Over the year, a total of 13123 throat swabs were sent. There were 50 confirmed positive results giving swabs sent per positive result ratio of 262:1, or a cost of £1624.40 per positive result. For rectal swabs; a total of 1362 were sent. There were 4 positive results (all female) giving swabs sent per positive result ratio of 341:1, or a cost of £2114.20 per positive result. 2% of patients with a positive extra-genital swab result gave a history of throat or rectal symptoms. 18% had a concurrent STI diagnosis, 0% had a positive culture result from the same site. 6% had at least one subsequent positive contact, all of which were pharyngeal positive.

Discussion/conclusion Extra-genital testing has detected cases which would otherwise have been missed with purely genital screening. However numbers are too small to advocate a change in practice to routine extra-genital screening in all asymptomatic individuals.

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