POSITIVE SCREENING-TESTS FOR GONORRHEA AND CHLAMYDIAL INFECTION FAIL TO LEAD CONSISTENTLY TO TREATMENT OF PATIENTS ATTENDING A SEXUALLY-TRANSMITTED DISEASE CLINIC

Background artd Objectives: Patients attending sexually transmitted di sease (STD) clinics are frequently screened for gonorrhea and chlamydi al infection, To determine the efficiency of these screening efforts a s a component of STD control, we evaluated treatment outcomes of patie nts with positive cultures who had not received presumptive treatment at their initial visit. Goals: To determine the treatment outcomes of patients screened for STDs who have positive test results. Study Desig n: Retrospective chart review of the computerized medical record, Resu lts: Between January 1, 1994 and June 30, 1995, 24,823 patients were t ested for gonorrhea, of whom 19.3% (4791) had positive cultures, Of pa tients with positive gonorrhea cultures, 564 (11.8%) had positive scre ening cultures and did not receive therapy at the time of evaluation. Similarly, screening chlamydial cultures were positive in 1539 (10.9%) of 14,162 patients screened for chlamydial infection. Forty-four perc ent (677) of these did not receive presumptive treatment for chlamydia l infection at their initial visit, Overall, 20% of patients with posi tive cultures failed to return to the clinic for treatment within 30 d ays of screening, Of those who did return, 30% did so only after at le ast 2 weeks had elapsed. Conclusions: A substantial proportion of pati ents with positive screening tests for gonorrhea and chlamydial infect ion fail to comply with follow-up recommendations and thus are likely to remain infectious, Methods must be sought to enhance patient compli ance with follow-up of test results and treatment if indicated.