P09.29 High prevalence ofneisseria gonorrhoeaeamong emergency department “super-users” in a large urban medical centre

Abstract

<h3>Introduction</h3> Sexually Transmitted Infections (STIs) remain prevalent in urban populations and are often diagnosed in emergency departments (ED). However, the burden of STI-care on urban EDs is not well characterised. <h3>Methods</h3> We conducted a retrospective study of patients seeking acute care for STI-related complaints at a large urban academic ED in the Midwestern US from July, 2012 to June, 2014. All ED patients evaluated for <i>Neisseria gonorrhoeae</i> (GC) and <i>Chlamydia trachomatis</i> (Ct) infection by nucleic acid amplification testing were examined for demographic characteristics, testing rates, and STI prevalence. <h3>Results</h3> Approximately 183,000 ED patient visits occurred during the study period. Of these, 6,518 visits (3.6%) resulted in STI testing for 5,431 patients. For tested patients, 77% were female, 83% African-American, and median age was 26.3(IQR 22.1–34.5). Overall prevalence was 6.8% for GC and 11.8% for Ct among patients tested. Among patients positive for GC, Ct, or both, 55.04–74.5% were female and 60.5–72.2% were ≤24 years. A total of 758 patients (14%) were tested more than once in the ED during the study period and defined as “super-users”. These super-users made up 28% of the total visits during the study period. Super-users were more likely to be female, African American and older adolescents (age 20–24) (p &lt; 0.001). Super-users were more likely than non-super-users to have a positive test for GC (p &lt; 0.001) and Ct (p &lt; 0.001)], and had GC prevalence more than twice that of non-super-users (13.1% vs 5.7%, p &lt; 0.001). <h3>Conclusion</h3> Our study revealed a significant burden of STI-related diagnoses, especially GC, in the urban ED setting. ED super-users were more likely to have a positive test than those tested patients only once, and may represent a higher risk population. Additional research is needed to understand the unique patient population presenting to urban EDs for STI care and inform tailored intervention strategies. <h3>Disclosure of interest</h3> All authors report no disclosures.