P025 Accurate cultures for gonorrhoea. how do community services and secondary care compare?

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IntroductionBASHH guidelines emphasise the importance of accurate cultures in the diagnosis and management of gonorrhoea. This audit’s aim was to establish if there was a measurable difference in the positive culture yield between community and secondary care services in the months following a change in contract which has moved a proportion of walk in patients from secondary care to the community setting.MethodsRelevant databases were searched for gonorrhoea patients after 1st October 2017 when the service was changed. A retrospective audit of the notes was then carried out to establish the rates of positive NAATS tests and positive culture yield and compared the two services.ResultsIn secondary care 25 patients (20 men & 5 women) were treated for gonorrhoea over two months. In these patients 22 had a positive NAATs test, of these 17 had a positive culture giving a positive culture yield of 77.2%.In comparison the community service identified 10 patients in the first month of the new contract with a positive NAATs test, of these 9 had a culture. 1 culture was positive giving a NAATs/culture concordance rate of 11.1%; this is to be re-audited by the community service.DiscussionAccurate cultures are vital for the treatment of gonorrhoea, particularly in areas where antibiotic resistance is high. Appropriate storage and prompt processing is important to ensure the viability of these tests. This audit raises a question about viability of Neisseria gonorrhoeae during transfer from community settings to the central hospital laboratory.

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