1354. Antibiotic Resistance and Coinfections Among Women with Sexually Transmitted Infections

Abstract

Abstract Background Sexually transmitted infections (STIs) represent a growing epidemic, particularly among America’s youth. Traditional single or dual organism STI testing is limited in its utility compared to PCR panel-based vaginitis testing. PCR panel testing can identify up to 99% of vaginitis associated organisms, while simultaneously providing information about antibiotic resistance. Methods We analyzed 10,011 vaginosis panel cases released between April 2020 and May 2021. The PCR-based vaginosis panel consists of organisms associated with bacterial vaginosis, aerobic vaginitis, yeast infections, STIs, and Lactobacillus species. This panel simultaneously detects evidence of antibiotic resistance for nine classes of drugs. Results Of 9405 cases from vaginal swabs, 618 (6.8%) were positive for at least one STI including Chlamydia trachomatis (CT), Haemophilus ducreyi, Herpes Simplex Virus 1 or 2 (HSV2), Neisseria gonorrhoeae (NG), and/or Trichomonas vaginalis. Of 603 urine samples, 7.6% were positive for at least one STI and represented a younger population. Patients younger than age 25 (33% of the cohort) were disproportionately affected by STIs, consistent with CDC findings. About 50% of all positive STI cases were in patients under 25. Evidence of bacterial vaginosis was also present in 89% of CT and NG cases, and 75% of HSV2 cases. Strikingly, we found the presence of an antibiotic resistant marker(s) to first line treatment in 76.2% of CT and 19.3% of NG cases. Conclusion Our data illustrates the advantages of utilizing a PCR-panel approach to STI detection over a targeted approach for individual organisms. Coinfections with bacterial vaginosis were common and if left unidentified, patients may receive incomplete treatment. Additionally, our data suggests that antibiotic resistance testing is imperative for effective treatment planning and antibiotic stewardship in suspected STI cases. Disclosures Brittany L. Carpenter, PhD, NxGen MDx (Employee) Jacqueline D. Peacock, PhD, MB(ASCP)CM, NxGen MDx (Employee) Kyle Dubiak, PhD, NxGen MDx (Employee) Heather Fecteau, MS, LCGC, NxGen MDx (Employee) Robert Carlson, MD, FCAP, NxGen MDx (Employee)