P47 Systematic recall vs standard care, addressing the increased risk of re-infection in patients presenting with gonorrhoea

Abstract

BackgroundGonorrhoea is of increasing concern in UK, with the gonococcal resistance to antimicrobials surveillance programme reporting high levels of resistance to antibiotics. Prior history of gonorrhoea is a strong predictor of current infection, supporting the concept of a group of “core transmitters.” The US Center for Disease Control advises retesting of patients with gonorrhoea 3 months after treatment to identify repeat infections. Current UK guidelines only recommend a test of cure at 2–4 weeks.AimTo assess the feasibility, acceptability and effectiveness of routine retesting at a 3-month interval, in UK sexual health clinic attendees diagnosed with gonorrhoea.MethodsAttendees between November 2010 and June 2011 diagnosed with gonorrhoea were offered retesting 3–6 months after treatment, with a subsequent reminder to attend (recall arm). Re-attendance rates and frequency of gonorrhoea diagnosis were compared to a historic group who attended between October 2006 and April 2007, controlling for age, sex, sexual orientation and history of STI (control arm).Results242 patients were assessed in the recall arm. 95 (39%) re-attended within 6 months of initial attendance and 15 (6%) were positive for gonorrhoea. Of 202 controls, 44 (22%) re-attended within 6 months and 12 (6%) tested positive for gonorrhoea. Being actively recalled increased re-attendance at the clinic (β=2.2, p=0.001) but did not detect additional cases of gonorrhoea (β=1.2, p=0.9).ConclusionThese results strongly suggest that the CDC recommendation for re-testing for infection after 3 months is not an effective approach for unselected patients with gonorrhoea in the UK.