Chlamydia trachomatis screening in Switzerland: the experience of the Geneva University Hospitals
ESC Congress Library. Catarino R. May 10, 2018; 208192; ESC298
Dr. Rosa Catarino
Dr. Rosa Catarino
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Abstract
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Objective: Chlamydia trachomatis (CT) is the most frequent cause of bacterial sexually transmitted infection (STI) worldwide and may negatively affect young women's reproductive health. Although usually asymptomatic, CT infection may lead to pelvic inflammatory disease, ectopic pregnancy, chronic pelvic pain, and tubal factor infertility. Systematic screening for CT in asymptomatic patients is yet not recommended in most developed countries. Our aim was to determine the CT positivity in different wards of a University Hospital. Design and methods: We have analyzed data provided by the Bacteriology Laboratory of the Geneva University Hospitals (HUG) between 2014 and 2016, comprising 43'621 samples testing for CT and Neisseria gonorrhoeae (NG) using real-time PCR amplification. We determined the rate of CT and NG co-infection and the distribution of these STI by age group and gender. Statistical analyses were conducted using Stata. Results: The overall positivity rates were 3.7% (1221/33261) and 1.8% (185/10360) for CT and NG, respectively, which remained stable from 2014 through 2016. CT was detected in 3.3% of female samples (941/28193) and in 4.7% of male samples (233/4970) (p value Considering the distribution of CT infection in the different wards of the HUG, the highest positivity rate was found in the general emergency department (8.0%, 86/1069), followed by the Youth Health Unit (5.3%, 57/1070), then by the abortion consultation (4.5%, 117/2599) and the general gynecological consultation (3.6%, 103/2846). Conclusions: We believed that CT screening should be offered to young adults consulting in high risk settings, such as the general emergency department and gynecological consultations. Due to the high rate of co-infection of CT with NG, in the presence of a positive test, screening for the other STI should be systematically performed. Further case-control studies are needed to establish the real impact of CT infection and consequent complications, so that cost-effectiveness studies will establish more clearly the necessity for CT screening as a public health intervention.
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