P013 The introduction of pharyngeal chlamydia and gonorrhoea sampling in a young persons’ clinic to assess for the possibility of pharyngeal only infection that would have otherwise been missed

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IntroductionPrior to April 2016 the policy in the clinic was to ‘Consider taking a pharyngeal Chlamydia and Gonorrhoea swab in conjunction with exposure, history and symptoms’ in heterosexual males and females. However, in practice pharyngeal swabs were almost never taken from heterosexual patients and only routinely taken from men who have sex with men (MSM). Recent studies suggest that gonorrhoea and chlamydia infections are being missed by taking vulvovaginal and urethral samples only. Therefore, it was decided to take throat swabs for chlamydia and gonorrhoea from all patients aged 20 and under that attended the dedicated Young Persons’ Clinic for one year. The findings so far will be presented here.ResultsA total of 225 YPC attendees had a throat swab taken between April 2016 and February 2017. Twenty-five out of 225 patients (11%) were found to have pharyngeal chlamydia or gonorrhoea. Five patients had pharyngeal chlamydia and twenty had pharyngeal gonorrhoea. A significant number, fourteen of the twenty-five (56%), had pharyngeal chlamydia or gonorrhoea only with no genital infection. Gonorrhoea was detected in twenty patients’ throats and chlamydia in five. Pharyngeal cultures were taken from eleven out of the twenty gonorrhoea patients, three of which were macrolide resistant and two macrolide intermediate.DiscussionPrior to the study throat swabs were not routinely being taken from heterosexual patients. More than half of patients with pharyngeal infection had no genital infection and would not have received treatment under the current clinic guidelines. These are significant findings which may lead to a change in practice in the service.

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