Prevalence Of GC Research Articles

Polymerase ζ Activity Is Linked to Replication Timing in Humans: Evidence from Mutational Signatures.

Replication timing is an important determinant of germline mutation patterns, with a higher rate of point mutations in late replicating regions. Mechanisms underlying this association remain elusive. One of the suggested explanations is the activity of error-prone DNA polymerases in late-replicating regions. Polymerase zeta (pol ζ), an essential error-prone polymerase biased toward transversions, also has a tendency to produce dinucleotide mutations (DNMs), complex mutational events that simultaneously affect two adjacent nucleotides. Experimental studies have shown that pol ζ is strongly biased toward GC→AA/TT DNMs. Using primate divergence data, we show that the GC→AA/TT pol ζ mutational signature is the most frequent among DNMs, and its rate exceeds the mean rate of other DNM types by a factor of approximately 10. Unlike the overall rate of DNMs, the pol ζ signature drastically increases with the replication time in the human genome. Finally, the pol ζ signature is enriched in transcribed regions, and there is a strong prevalence of GC→TT over GC→AA DNMs on the nontemplate strand, indicating association with transcription. A recurrently occurring GC→TT DNM in HRAS and SOD1 genes causes the Costello syndrome and amyotrophic lateral sclerosis correspondently; we observe an approximately 1 kb long mutation hotspot enriched by transversions near these DNMs in both cases, suggesting a link between these diseases and pol ζ activity. This study uncovers the genomic preferences of pol ζ, shedding light on a novel cause of mutational heterogeneity along the genome.

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

<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.

006.5 Periodic presumptive treatment for vaginal infections may reduce chlamydia and gonorrhoea incidence: a secondary analysis from the preventing vaginal infections trial

Background Women with bacterial vaginosis (BV) are at increased risk for sexually transmitted infections (STI), including Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC). Among women participating in a randomised trial of periodic presumptive treatment to reduce vaginal infections, we assessed the intervention effect on incident CT and GC infections. Methods Non pregnant, HIV-uninfected women aged 18–45 from the US and Kenya were randomised to receive intravaginal metronidazole 750 mg plus miconazole 200 mg or matching placebo for 5 consecutive nights each month for 12 months. Genital specimens were collected every other month. Baseline specimens were tested for CT/GC during the trial and follow-up specimens were tested after trial completion using the Aptima Combo-2 assay. Baseline STIs were treated according to local guidelines. Poisson regression models were used to assess the intervention effect on the outcomes separately and as a combined endpoint. Results Of 234 women enrolled, 221 (94%) had specimens available for analysis (intervention n = 110; placebo n = 111). Baseline CT and GC prevalence was 7% (n = 16) and 1% (n = 3), respectively, and similar by arm. Among 205 CT- participants, there were 21 incident CT infections during 179.6 person-years (CT incidence = 11.7/100 person-years), with lower CT incidence in the intervention arm versus placebo (7.8/100 person-years versus 15.6/100 person-years; incidence rate ratio [IRR] = 0.50, 95% CI 0.20–1.23). Among 218 GC- participants, GC incidence was 7.2/100 person-years (14 infections during 93.3 person-years) and also lower in the intervention arm (5.2/100 person-years versus 9.3/100 person-years; IRR = 0.56, 95% CI 0.19–1.67). Results were consistent when CT/GC was assessed as combined endpoint (IRR = 0.57; 95% CI 0.27–1.19). Conclusions This intervention, which significantly reduced BV over 12 months, may also reduce women’s STI acquisition risk. The small sample size in this secondary analysis precluded detection of significant associations, but generated point estimates for reductions in STIs that could inform the planning of future STI prevention trials Disclosure of interest statement R. S. M. has received honoraria for invited lectures and consulting as well as donated study product for this trial from Embil Pharmaceutical Company. R. S. M. currently receives research funding from Hologic/Gen-Probe. J. E. B. received honoraria from Symbiomix, Inc for consulting and donated reagents from Hologic/Gen-Probe. J. S. has received consultancy payments from Akesis, Hologic, Symbiomix, and Starpharma, and has grants/pending grants from Akesis, BD Diagnostic, Hologic, Cepheid, Quidel, Symbiomix, Starpharma, and Viamet. All other authors declare that they do not have a commercial or other association that might pose a conflict of interest.

P09.43 Sexually tramsmitted infection screening and follow-up in a high-risk urban obstetric clinic

Introduction The objective of this study was to determine the screening rate and prevalence of Chlamydia (CT), gonorrhoea (GC), Treponema pallidum (TP), human immunodeficiency virus (HIV) and hepatitis B (HBV) infections among our presumed high-risk obstetric population. We also report treatment and follow-up of patients and their partners. Methods We conducted a retrospective chart review of 1000 obstetrics patients seen between 2008 and 2014 at our clinic. 854 met criteria for inclusion in the study; included were patients who received most or all prenatal care at our clinic. Demographic data were collected to understand risk factor prevalence in this population. Test results, patients, partner management and follow-up data were extracted from electronic medical records. All descriptive analyses were done using STATA. Results The mean age of patients was 29.2 ± 7.5 (range 14–48). Twenty seven percent reported a prior history of STI, 90% were screened for CT and GC at least once, 98.9% for TP, 97.8% for HBV and 84% for HIV. Prevalence of CT, GC, CT&GC, HBV, TP and HIV were 3.7%, 0.3%, 0.4%, 0.2%, 0.1% and 1%, respectively. All patients with positive screening were treated and 97% of them had a subsequent test of cure. Only 18.2% of partners were reportedly treated. Thirty nine percent of partners were untreated and management unknown for 42.4% of partners. Conclusion Compared to national screening rates, our centre holds very high screening rates but is still not yet optimal. Our HIV screening rate was lowest compared to the other infections. Pregnancy presents a unique opportunity for screening so continuing counselling is indispensable to educate expecting mothers who decline screening on the importance of STIs testing. To address the lack of partners’ screening, providing prescription for both patients and their partners should be implemented. Disclosure of interest statement No funding. No pharmaceutical grants were received in the development of this study.

P09.14 Implementation of oral and self-collected rectal swabs forn. gonorrhoeaeandc. trachomatisdetection as a component of local health department outreach testing

Introduction The availability of extra-genital nucleic acid amplification testing (NAAT) for gonorrhoea (GC) and chlamydia (CT) is limited in many clinical and outreach settings. A recent initiative in Forsyth County, NC funded NAAT testing at oropharyngeal and rectal sites in both of these settings. Methods A retrospective chart review was conducted for all males and females aged 12–80 who reported to an outreach site or STD clinic (MSM only) January 1, 2014 to February 28, 2015. Results Clinic: 131 rectal, 163 pharyngeal, and 176 urethral NAAT tests were performed on 181 males. Twenty-five rectal (19.1%), 22 pharyngeal (13.5%), and 22 (12.5%) urethral specimens were GC positive. 24 rectal (18.3%) and 7 urethral (4.0%) were CT positive. 5 rectal GC (20.0%), 8 pharyngeal GC (36.4%), and 13 rectal CT (54.2%) infections would have been missed in the absence of extra-genital testing. Outreach 47 rectal, 157 pharyngeal, and 162 urogenital NAATs were collected. For GC, 3 rectal (6.4%), 3 pharyngeal (1.9%), and 2 urogenital (1.2%) specimens were positive. Six (12.8%) and 9 (5.6%) individuals were positive for rectal and urogenital CT, respectively. 2 rectal GC (66.7%), 3 pharyngeal GC (100%), and 4 rectal CT (66.7%) infections would have been missed without extra-genital NAAT. When NAAT and bacterial culture for GC were run on the same samples from clinic patients, culture detected 48% (12/25) of the rectal and 45.2% (10/22) of the pharyngeal infections detected by NAAT. Conclusion A significant prevalence of extra-genital GC and CT infections were noted in both the clinic and outreach populations. In the absence of NAAT-based extra-genital testing approximately half of rectal and pharyngeal GC infections would have been missed with culture and more than half of the rectal CT infections would have been missed. Assurance of access of NAAT-based extra-genital testing is critical for STI control efforts.

P116 An audit of gonorrhoea management in a UK sexual health clinic

<h3>Background/introduction</h3> Gonorrhoea (GC) is a prevalent sexually-transmitted infection in the UK. The British Society for Sexual Health and HIV (BASHH) published guidelines in 2011 for the management of GC. <h3>Aim(s)/objectives</h3> To audit the management of all patients who tested positive for GC at our centre between 1 May 2013 and 1 May 2014 against BASHH guidelines. <h3>Methods</h3> A proforma was developed and a retrospective notes review performed for all patients who tested positive for GC from 1 May 2013 to 1 May 2014. <h3>Results</h3> 115 patients tested positive for GC during the audit period. The prevalence of GC in this cohort was 0.9%. 46% of patients had symptom (s), 54% were truly asymptomatic, 18% of patients presented as contacts. Microscopy was performed on 80% of symptomatic patients and intracellular gram-negative diplococci were seen in 66% of these. 97% of patients were diagnosed by PCR testing and one by culture. 2 patients were diagnosed elsewhere with negative testing at our clinic. 83% had GC cultures prior to treatment. The sensitivity of culture compared to PCR testing was 59%. 93% of patients were treated as per BASHH guidelines. 65% were documented to have received written information about their diagnosis. All patients were offered test of cure, of which 61% attended within 2 weeks. 92% of patients saw health advisers for partner notification. <h3>Discussion/conclusion</h3> Management of GC was largely in line with BASHH guidance. However, this study highlighted a need to increase written information offer and to encourage attendance for test of cure.

Neisseria gonorrhoeae and Chlamydia trachomatis among women reporting extragenital exposures.

The Centers for Disease Control and Prevention recommends pharyngeal screening of Neisseria gonorrhoeae (GC) and rectal screening of GC and Chlamydia trachomatis (CT) in HIV-infected and at-risk men who have sex with men (MSM). There are currently no recommendations to routinely screen women at extragenital sites. We define the prevalence of extragenital GC and CT in women attending 2 urban sexually transmitted disease clinics in Baltimore City and compare it with the prevalence of extragenital infections in MSM and men who have sex with women. All patients who reported extragenital exposures in the preceding 3 months, who presented for care between June 1, 2011, and May 31, 2013, and who were tested for GC and CT using nucleic acid amplification tests at all sites of exposure were included in the analyses. We used logistic regression models to identify risk factors for extragenital infections. A total of 10,389 patients were included in this analysis (88% African American; mean age, 29 years; 42% women; 7% MSM; 2.5% HIV infected). The prevalence estimates of any extragenital GC and CT were as follows: 2.4% GC and 3.7% CT in women, 2.6% GC and 1.6% CT in men who have sex with women, and 18.9% GC and 11.8% CT in MSM. Among women, 30.3% of GC infections and 13.8% of CT infections would have been missed with urogenital-only testing. Unlike MSM, age ≤ 18 years was the strongest predictor of extragenital infections in women. Although the prevalence of extragenital gonorrhea and chlamydia is highest in MSM, a significant number of GC and CT infections in young women would be missed with genital-only testing. Cost-effectiveness analyses are needed to help inform national guidelines on extragenital screening in young women.

High prevalence of rectal gonorrhea and Chlamydia infection in women attending a sexually transmitted disease clinic.

Testing women for urogenital Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) is common in sexually transmitted disease (STD) clinics. However, women may not be routinely tested for rectal GC/CT. This may lead to missed infections in women reporting anal intercourse (AI). This was a retrospective review of all women who underwent rectal GC/CT testing from August 2012 to June 2013 at an STD clinic in Columbus, Ohio. All women who reported AI in the last year had a rectal swab collected for GC/CT nucleic acid amplification testing (n=331). Using log-binomial regression models, we computed unadjusted and adjusted associations for demographic and behavioral factors associated with rectal GC/CT infection. Participants (n=331) were 47% African-American, with median age of 29 years. Prevalence of rectal GC was 6%, rectal CT was 13%, and either rectal infection was 19%. Prevalence of urogenital GC and CT was 7% and 13% respectively. Among women with rectal GC, 14% tested negative for urogenital GC. Similarly, 14% of women with rectal CT tested negative for urogenital CT. In unadjusted analyses, there was increased rectal GC prevalence among women reporting sex in the last year with an injection drug user, with a person exchanging sex for drugs or money, with anonymous partners, and while intoxicated/high on alcohol or illicit drugs. After multivariable adjustment, no significant associations persisted, but a trend of increased rectal GC prevalence was observed for women <26 years of age (p=0.06) and those reporting sex while intoxicated/high on alcohol or drugs (p=0.05). For rectal CT, only age <26 years was associated with prevalent infection in unadjusted models; this association strengthened after multivariable adjustment (prevalence ratio: 6.03; 95% confidence interval: 2.29-15.90). Nearly one in five women who reported AI in the last year had rectal GC or CT infection. Urogenital testing alone would have missed 14% of rectal infections. Standardized guidelines would increase rectal GC/CT testing in women and help detect missed infections.

Differences in Sexual Health, Risk Behaviors, and Substance Use Among Women by Sexual Identity

Lesbian women may perceive themselves to be at lower risk for sexually transmitted infections (STIs) and use reproductive health care at lower rates compared with heterosexual women. Therefore, STIs in sexual minority women may go undetected. The prevalence and risk factors of urogenital STIs in women of different sexual orientations were investigated. This is a cross-sectional study of women attending the STI clinic of Howard Brown Health Center in Chicago, Illinois. Women were eligible for inclusion in this study if they reported a sexual identity and were screened for urogenital gonorrhea (GC)/chlamydia (CT) in the clinic between January 2008 and December 2011. Among the 669 women studied, the urogenital prevalence of GC was 1.5% and that of CT was 5.2%. Gonorrhea and CT were only diagnosed in women with recent male sex partners, but sexual identity was not necessarily consistent with sexual partner sex, and women of all sexual orientations were diagnosed as having STIs. Bisexual and heterosexual women had similar diagnosis and STI history rates, whereas lesbian women had a significantly lower history of STIs. Bisexual women had more sex partners than heterosexual or lesbian women, and their partners were less likely to be monogamous. Compared with heterosexual women, sexual minority women had twice the odds of drug use in the last year. Chlamydia and GC were diagnosed in sexual minority women, and several cases would have been missed if lesbian women were not tested for STIs. High rates of substance use among sexual minority women highlight the need for targeted interventions.

P3.071 Overutilization of Chlamydia and Gonorrhea Tests in Older Women

BackgroundBaltimore City ranks in the top half among major US cities for rates of chlamydia infections, 80% of which were from women < 26 years of age. Research has shown...

HIV, rectal chlamydia, and rectal gonorrhea in men who have sex with men attending a sexually transmitted disease clinic in a midwestern US city.

Men who have sex with men (MSM) who report receptive anal intercourse (RAI) are currently recommended to undergo at least annual screening for rectal Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) infection. Using standard culture methods, we assessed the prevalence of rectal GC/CT among MSM who reported RAI in the last year (n = 326) at an urban sexually transmitted disease (STD) clinic in a midwestern US city. A subset (n = 125) also underwent rectal GC/CT screening via nucleic acid amplification testing. We examined the associations between HIV status and prevalence of rectal GC and rectal CT using unadjusted and adjusted logistic regression models. The prevalence of rectal GC, rectal CT, and either rectal infection was 9%, 9%, and 15% by culture and 24%, 23%, and 38% by nucleic acid amplification testing, respectively. HIV was not associated with rectal GC prevalence in unadjusted or adjusted analyses. HIV-positive status was significantly associated with increased rectal CT prevalence in unadjusted models (odds ratio, 2.18; 95% confidence interval, 1.04-4.60); this association increased after multivariable adjustment (odds ratio, 3.14; 95% confidence interval, 1.37-7.19). Men who have sex with men reporting RAI had a high prevalence of rectal GC and rectal CT. HIV-positive status was significantly associated with prevalent rectal CT but not with prevalent rectal GC.

Pharyngeal Gonorrhea and Chlamydial Infections in Men who have Sex with Men, a Hidden Threat to the HIV Epidemic

Background: Pharyngeal infections with gonorrhea (GC) and chlamydia (CT) can be missed if screened only by routine methods of urethral or urine specimens and may increase the risk of sexually transmitted infections and HIV acquisition and transmission. The prevalence of pharyngeal GC and CT in men who have sex with men (MSM) has been reported as 5.3-9.2% and 1.4-1.9% respectively. The objective of this study is to determine the rates of pharyngeal GC and CT infections in MSM in the Miami Dade Health Department (MDHD) STD clinic. Methods: Routine screening for pharyngeal GC and CT infections in MSM was implemented in the MDHD STD clinic in October 2011 using APTIMA Combo 2 Assay®. Validation studies were performed in the Florida Department of Health Laboratories prior to implementation of the test. Retrospective review of medical records of individuals tested for pharyngeal GC/CT from October 2011 to March 2012 was performed. Results from urine and rectal GC/CT testing done at the same time from the same individuals were also reviewed. Results: A total of 475 pharyngeal swabs were performed. Fifty-two (10.9%) were positive for GC and 13 (2.7%) were positive for CT. Among the individuals with GC pharyngeal infection, 21 (52.5%) had a positive GC rectal test and 14 (28%) a positive urine test. Among the individuals with CT pharyngeal infection, 3 (30%) had a positive CT rectal test and 1 (7.7%) a positive urine test. Conclusions: The prevalence of pharyngeal GC/CT in MSM in the MDHD STD clinic is higher than what has been previously reported in other centers. The discrepancy between pharyngeal, rectal, and urine tests emphasizes the importance of extragenital testing in the MSM population. Keywords: Chlamydia Trachomatis, Neisseria Gonorrhea, Men who have Sex with Men, Sexually Transmitted Infections, Pharyngeal infections, Screening, HIV. Read more →

514P - Gastric Cancer in Portuguese Families with BRCA2 Gene Mutations

ABSTRACT Background and objective BRCA 1/2 are tumor suppressor genes responsible for a high number of hereditary breast and ovarian cancers. BRCA 2 mutations are also associated with higher risk of other cancers: prostate, melanoma, pancreatic, gastric and bile duct cancer. BRCA2 mutations are more frequent than BRCA1 mutations in Portugal and GC has, historically, a high incidence in this country. Our objective was to analyze the frequency and characteristics of GC in confirmed BRCA2 Portuguese families. Methods Retrospective analysis of all BRCA2 families registered in our Clinic. All cases of GC, on the mutated side of the family, for 3 consecutive generations, were registered. The control group consisted of breast cancer families with standard risk of breast cancer (FSRBC) (with probability Results Of 119 families with BRCA 2 mutation analyzed, 35 families (29.4%) had reported cases of GC. Of these 35 families, 24 had one case of GC, 10 had two cases and one family had seven cases. A total of 51 GC cases were found: 20 females (39%) and 31 males (61%) with a median age at diagnosis of 60 years (28–80 yrs). Pathological confirmation was available in 5 cases (4 adenocarcinoma, 1 neuroendocrine). Two cases of GC were diagnosed in BRCA2 pts who were breast cancer survivors and 1 in a healthy woman previously submitted to prophylactic adnexectomy. These 35 families had 19 different BRCA2 mutations, 15 C.156_157insAlu (Portuguese founder mutation). No difference between the frequency of GC in families with C.156_157insAlu mutation and in other BRCA2 families was observed. In the control group of 163 families, only 19 (12%) had cases of GC (1 case in 18 families and 2 cases in 1 family). The median age was 61 years (range 52–76). The frequency of GC in BRCA 2 families was higher compared with the frequency in FSRBC, odds ratio 3.0 CI (1.7–5.3), p Conclusion(s) BRCA2 mutations are associated with a higher risk of GC compared with FSRBC. The Portuguese founder mutation was not associated with higher prevalence of GC compared to the other BRCA 2 mutations. Since GC has already a high incidence in our country, we believe this data supports the need for GC screening in BRCA2 pts. Disclosure All authors have declared no conflicts of interest.

Sentinel Surveillance for Pharyngeal Chlamydia and Gonorrhea Among Men Who Have Sex With Men—San Francisco, 2010

Although a potentially important route for transmission, limited data exist on the burden of pharyngeal chlamydia (CT) and gonorrhea (GC) among men who have sex with men (MSM). We examined pharyngeal CT and GC among MSM screened in San Francisco in 2010. MSM seeking services in a variety of clinical settings provided clinician-collected pharyngeal specimens that were tested using the APTIMA Combo 2 platform. The prevalence of pharyngeal CT and GC was estimated at 5 sentinel sites: the municipal STD clinic, a gay men's health clinic, an HIV care clinic, an HIV testing site, and primary care clinics supported by the San Francisco Department of Public Health. Positivity for each infection was calculated as the number of positive tests divided by the number of testers with corresponding confidence intervals (CI). In 2010, a total of 12,454 pharyngeal CT specimens and 12,457 pharyngeal GC specimens were tested for an overall CT positivity of 1.69% (95% CI: 1.47-1.93) and GC positivity of 5.76% (95% CI: 5.36-6.19). At the 5 sentinel sites, pharyngeal CT positivity ranged from 1.10% (HIV testing site) to 2.28% (STD clinic); pharyngeal GC positivity ranged from 3.4% (HIV testing site) to 7.01% (STD clinic). Sentinel surveillance data indicate that there is a substantial burden of pharyngeal CT and GC infections among MSM in San Francisco. Identification and treatment of pharyngeal infections could prevent ongoing transmission of these bacteria. Increasing access to nucleic acid amplification tests-based pharyngeal screening should be a public health priority.

O2 Who should have gonorrhoea cultures in addition to gonorrhoea and chlamydia nucleic acid amplification tests? Cost effectiveness study

BackgroundNucleic acid amplification tests (NAATs) can now detect chlamydia (CT) and gonorrhoea (GC) but cultures are needed in GC NAAT positive people prior to treatment. This necessitates re-evaluation, examination and...

P64 High rates of rectal Chlamydia trachomatis in women reporting anal sex in the GUM clinic

BackgroundNucleic acid amplification (NAAT) testing for Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) is now widely available but not licensed for use at non-genital sites. Despite this, high rates of...

P48 Yearly trends for the internet recruitment program, http://www.iwantthekit.org—what happened to the STI prevalence?

BackgroundThe iwantthekit (IWTK) internet recruitment screening program began in 2004 and offered an opportunity to determine trends in prevalence for women and men were screened for STIs.ObjectivesTo determine significance in...

Laboratory-confirmed gonorrhea and/or chlamydia rates in clinically diagnosed pelvic inflammatory disease and cervicitis

ObjectiveThe aim of this study was to determine the rates of laboratory confirmed gonorrhea (GC) and chlamydia (CT) in emergency department (ED) patients with pelvic inflammatory disease (PID) and cervicitis who were diagnosed clinically and treated empirically. A secondary goal examines which clinical criteria were present in patients with PID testing positive for GC/CT. MethodsWe conducted a retrospective chart review of all ED patents diagnosed with PID or cervicitis during a 40-month period (January 2007–March 2010). Charts were reviewed for laboratory-confirmed GC or CT. For patients with positive GC or CT studies, the presence of key clinical criteria used in the diagnosis of PID was tallied. ResultsA total of 1469 patients were diagnosed with cervicitis and 343 with PID. Of these patients, 27 (1.8%) of 1469 and 15 (4.4%) of 343 were GC positive, and 136 (9.3%) of 1469 and 34 (10%) of 343 were CT positive. Twenty-six cervicitis (1.8%) and 9 PID (2.6%) patients were positive for both infections. One hundred eighty-nine cervicitis (13%) and 58 PID (17%) patients were positive for at least 1 sexually transmitted infection. Of the 58 patients with PID with laboratory-confirmed GC/CT, the following clinical criteria were present: abdominal pain, 58 of 58; abdominal tenderness, 50 of 58; cervical discharge, 47 of 58; cervical motion tenderness, 46 of 58; adnexal tenderness, 32 of 58; vaginal bleeding, 8 of 58; and fever, 2 of 58. Ultrasound was preformed in 27 (47%) of 58 GC/CT-positive patients with PID, with findings suggestive of PID in 12 (44%) of 27 ultrasounds. One hundred percent of abnormal ultrasounds were associated with positive GC and/or CT results. ConclusionThere is a generally low prevalence of GC and CT in this patient population diagnosed with cervicitis or PID. There is a very low prevalence of coinfection.

P3-S1.20 Aetiology of urethral discharge syndrome and its association with sexual practices among males attending STI clinics in India

BackgroundStudies to validate the aetiology of urethral discharge (UD) syndrome are limited in India. The objectives of the study were to determine etiological agents of UD syndrome among males attending...

P3-S1.11 Per cent additional test positive following positive Combo 2 Chlamydia (CT) and gonorrhoea (GC) specimens: assessing the impact of prevalence

BackgroundThe positive predictive value (PPV) of a screening test (ST) is a function of prevalence and ST specificity and is expected to decrease with decreasing prevalence unless ST specificity approaches...