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.