P24 Outbreak or illusion: consequences of "improved" diagnostics for gonorrhoea. (18th May 2015) - Bennett, Amy
Abstract : Background/introduction: The service introduced gonorrhoea nucleic acid testing (NAATs) using the BD Viper LT™ System in August 2012. Since then rates of gonorrhoea have increased threefold (Table 1). Concerns were raised by Public Health England in 2014 that this increase represented an outbreak. Aim(s)/objectives: To ascertain if there was an outbreak. Methods: We reviewed all 153 gonorrhoea (GC) cases seen from January to June 2014. Results: Of 45 female cases, 16 (36%) were not known GC contacts, and were culture negative: all were NAATS positive at the cervix. Of 43 cases in heterosexual men, 4 were positive by NAATs only and not known contacts of GC: one had a single partner who tested negative for GC. There were 65 cases in MSM. Of 36 (55%) NAATS positive only who were asymptomatic and not a known GC contact, 32 had isolated pharyngeal infection, 3 rectal infections only and 1 dual rectal and pharynx infection. Discussion/conclusion: At an incident control meeting with the local authority, PHE and local GUM service, it was agreed there was insufficient evidence to confirm a cluster of cases and that at least some of the increase could be attributable to the introduction of NAATs testing. It was agreed to prospectively audit GC cases, until March 2015 and to send NAAT positive/culture negative samples to reference laboratory for confirmatory testing. Initial results from the first 2 months suggest that a significant number of cases are not confirmed. The full data will be presented and the implications for GC testing in our clinic population discussed.