1499. Gonorrhea and Chlamydia Infections in the Department of Veterans Affairs (VA), 2013–2017

Abstract

BackgroundGonorrhea (GC) and Chlamydia (CT) infections caused by Neisseria gonorrhoeae and Chlamydia trachomatis, respectively, are an ongoing public health issue. CDC guidelines suggest repeat testing 3–12 months after a positive test result (Workowski et al. MMWR 2010 and 2015). We investigated national trends and repeat testing practices for patients with GC and CT infection in VA.MethodsGC and CT cases were identified from January 1, 2013–December 31, 2017 using molecular laboratory testing results from VA data sources. Patients were reviewed for positive results, repeat testing and demographic characteristics.Results10,587 of 641,535 (1.7%) GC results were positive; 27,306 of 648,320 (4.2%) CT results were positive. Coinfection (GC+CT) was documented in 1,935 tests (1,804 unique patients). Repeat testing after a positive result ranged from 26 to 31% for GC, CT and GC+CT, respectively (table). Number of positive cases and tests performed for GC and CT increased over the last 5 years, however percent positive has been stable for CT but increasing for GC (figure). States with the highest total number of positive GC tests were California (1,363), Texas (1,219), and Florida (815), while for CT were Illinois (4,509), California (3,370), and Texas (2,805).Table.Demographic Factors and Repeat Testing in Gonorrhea (GC) and Chlamydia (CT) Infections in VA, January 1, 2013–December 31, 2017.GC N = 641,535CT N = 648,320GC+CT N = 638,361Unique patients tested414,316417,641407,708Total positive results10,58727,3061,935Unique positive patients9,14924,2571,804 Female:malea1,109:8,0407,600:16,657291:1,513Average age (range)40 (17–87)31 (13–88)36 (17–84)Repeat testing performed (% of total positive results)b2,702 (26)7,906 (29)593 (31) aOverall, VA population is 10% female (www.womenshealth.va.gov). bAny GC/CT test 3–12 months after a positive result.Figure:Five-Year Trend in Gonorrhea (GC) and Chlamydia (CT) Test Results in VA, January 1, 2013–December 31, 2017.ConclusionGC and CT infections increased between 2013 and 2017 in VA. Although females comprise 10% of the VA population, they proportionally had increased GC and CT positive Results. VA providers could improve retesting practices 3–12 months post-infection for patients with GC and/or CT.Disclosures All authors: No reported disclosures.