Bradley Heather, Gruber DeAnn, Introcaso Camille E, Foxhood Joseph, Wendell Debbie, Rahman Mohammad, Ewell Joy, Kirkcaldy Robert D, Weinstock Hillard S
From the *Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA; and †Louisiana Office of Public Health STD/HIV Program, New Orleans, LA.
Sex Transm Dis. 2014 Sep;41(9):560-3. doi: 10.1097/OLQ.0000000000000167.
Congenital syphilis (CS) is a potentially life-threatening yet preventable infection. State and local public health jurisdictions conduct investigations of possible CS cases to determine case status and to inform public health prevention efforts. These investigations occur when jurisdictions receive positive syphilis test results from pregnant women or from infants.
We extracted data from Louisiana's electronic case management system for 328 infants investigated as possible CS cases in 2010 to 2011. Using date stamps from the case management system, we described CS investigations in terms of processes and timing.
Eighty-seven investigations were prompted by positive test results from women who were known to be pregnant by the health jurisdiction, and 241 investigations were prompted by positive syphilis test results from infants. Overall, investigations required a median of 101 days to complete, although 25% were complete within 36 days. Investigations prompted by positive test results from infants required a median of 135 days to complete, and those prompted by positive test results from pregnant women required a median of 41 days.
Three times as many CS investigations began with reported positive syphilis test results from infants as from pregnant women, and these investigations required more time to complete. When CS investigations begin after an infant's birth, the opportunity to ensure that women are treated during pregnancy is missed, and surveillance data cannot inform prevention efforts on a timely basis. Consistently ascertaining pregnancy status among women whose positive syphilis test results are reported to public health jurisdictions could help to assure timely CS prevention efforts.
先天性梅毒（CS）是一种可能危及生命但可预防的感染。州和地方公共卫生部门对可能的先天性梅毒病例进行调查，以确定病例状况并为公共卫生预防工作提供信息。当部门收到孕妇或婴儿梅毒检测呈阳性的结果时，就会展开这些调查。
我们从路易斯安那州的电子病例管理系统中提取了2010年至2011年期间作为可能的先天性梅毒病例接受调查的328名婴儿的数据。利用病例管理系统中的时间戳，我们从流程和时间方面描述了先天性梅毒调查情况。
87项调查是由卫生部门已知怀孕的女性检测呈阳性结果引发的，241项调查是由婴儿梅毒检测呈阳性结果引发的。总体而言，调查完成的中位时间为101天，不过25%的调查在36天内完成。由婴儿检测呈阳性结果引发的调查完成的中位时间为135天，由孕妇检测呈阳性结果引发的调查完成的中位时间为41天。
先天性梅毒调查中，因婴儿梅毒检测呈阳性结果而展开的调查数量是因孕妇检测呈阳性结果而展开的调查数量的三倍，且这些调查需要更多时间才能完成。当先天性梅毒调查在婴儿出生后才开始时，就会错过确保孕妇在孕期接受治疗的机会，而且监测数据无法及时为预防工作提供信息。持续确定那些梅毒检测呈阳性结果已报告给公共卫生部门的女性的怀孕状况，有助于确保及时开展先天性梅毒预防工作。
