P228 Evaluating the use of extra-genital Chlamydia trachomatis (CT) and Neisseria gonorrhoea (GC) nucleic acid amplification tests (NAATs) in non-MSM populations

Abstract

Background/introduction Our clinic performs routine oral and anal CT and GC NAATs following disclosure during sexual history of oral or receptive anal sex. Specimens are analysed using the Abbott M2000 assay, costing £4.50 per dual NAAT. Aim(s)/objectives We report the findings of this practice, focusing on clinical and partner notification outcomes, and the cost per diagnosis. Methods We included all non-MSM patients with isolated extra-genital CT or GC infection from 1/8/14 to 31/7/15. We excluded contacts of either infection, plus those without GC confirmed by culture or second NAAT platform. Retrospective case note review was performed for identified cases. Results In total 8796 NAATs were processed in non-MSM patients, of which 3813 (43%) were extra-genital. In heterosexual men we identified 3 pharyngeal GC cases and one contact, and one pharyngeal CT case with one contact. In women there were 2 pharyngeal GC cases, one pharyngeal CT case and one rectal CT case with no additional contacts. The spend per pharyngeal diagnosis was £1519 in males and £3138 in women. The spend per rectal diagnosis in women was £1665. Discussion/conclusion Our screening practice has picked up only a small number of cases which would otherwise have been missed. 25% (2/8) of those cases had verified contacts identified. The cost implication of such screening is high, meaning that ongoing routine screening is not viable. In our relatively low-prevalence setting we now intend to target our screening in line with BASHH CEG guidance which will provide significant cost savings.