P165 Rates of isolated extragenital chlamydia trachomatis and neisseria gonorrhoeae in heterosexual patients attending a sexual health clinic

• Published in: Sexually transmitted infections Vol. 99; no. Suppl 1; p. A107
• Main Authors: Ahmed, Arslan, Okecha, Elizabeth, Fishwick, Louise, Thomson-Glover, Rebecca
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 20.06.2023; BMJ Publishing Group LTD
• Subjects: Chlamydia; Condoms; Gonorrhea; Heterosexuality; Infections; Males; Sexual health
• ISSN: 1368-4973; 1472-3263
• DOI: 10.1136/sextrans-BASHH-2023.202

IntroductionBASHH guidance advises offering testing at extra genital sites for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) dependant on sexual history in heterosexual males and females. We examined the roll out of offering routine additional extragenital testing in heterosexual patients attending the sexual health clinic.MethodsGenitourinary Medicine Clinic Activity Dataset (GUMCAD) codes were used to obtain data on screening for a 6 month period from 01/08/21 to 01/02/22. MSM and patients for whom sexual preference was undocumented were excluded.ResultsCT/NG Nucleic Acid Amplification Tests (NAAT) swabs were used to screen 2025 patients of whom 71.8% (1061/1477) female and 80.5% (441/548) male accepted extragenital testing (rectal and pharyngeal tests for females and pharyngeal tests for males). Isolated CT pharyngeal infection was found in 2.5% (4/157) of positive CT tests in females and 1.5% (1/66) in males. Isolated CT rectal infection in 8.9% (14/157) and 1.5% (1/66) respectively. Isolated NG pharyngeal infection was found in 12.2% (5/41) of positive NG tests in females and 19.2% (5/26) of males. Isolated rectal infection in 2.4% (1/41) of females only. 78.6% (11/14) of females with isolated rectal CT had not reported anal intercourse as their last sexual intercourse (LSI). 80% (4/5) of males with isolated pharyngeal NG had not reported oral intercourse as their LSI.DiscussionExtragenital testing for CT/NG was acceptable to heterosexual patients and isolated extragenital infection was found regardless of sexual history. The clinical impact and transmission risk of extragenital infection is unclear but significant numbers of CT/NG would have been missed with genital only testing.