Patton Monica E, Kirkcaldy Robert D, Chang Douglas C, Markman Stephanie, Yellowman Marilyn, Petrosky Emiko, Adams Laura, Robinson Candice, Gupta Akash, Taylor Melanie M
From the *Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, GA; †Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA, ‡Phoenix Indian Medical Center, Indian Health Service, Phoenix, AZ; §Arizona Department of Health Services, Phoenix, AZ; ¶CDC Experience Fellowship, Centers for Disease Control and Prevention, Atlanta, GA.
Sex Transm Dis. 2016 Jun;43(6):396-401. doi: 10.1097/OLQ.0000000000000457.
Gonorrhea screening is recommended for women at risk and men who have sex with men; expanded screening is encouraged based on local epidemiology. In response to a substantial increase in gonorrhea cases at an urban medical center serving American Indians, gonorrhea screening of all sexually active patients aged 14 to 45 years was initiated in March 2013. We describe gonorrhea screening coverage and case finding before and after implementation of expanded screening.
In March 2013, provider training, electronic health record prompts, and bundled laboratory orders were implemented to facilitate gonorrhea screening of all sexually active patients aged 14 to 45 years. We assessed the proportions of patients screened and testing positive for gonorrhea in the 2 years before (March 2011-February 2012 [indicated as 2011], March 2012-February 2013 [2012]) and 1 year after (March 2013-February 2014 [2013]) expanded screening measures.
Gonorrhea screening coverage increased from 22% (2012) to 38% (2013); coverage increased 50% among females and 202% among males. Screening coverage increased in nearly all clinics. Gonorrhea case finding increased 68% among females in 2013 (n = 104) compared with 2012 (n = 62), primarily among women aged 25 to 29 years. No corresponding increase in gonorrhea case finding occurred among males. Most increased case finding occurred in the emergency department.
After introduction of expanded gonorrhea screening, there was a significant increase in gonorrhea screening coverage and a subsequent increase in gonorrhea case finding among females. Despite increased screening in all clinics, increased case finding only occurred in the emergency department.
建议对有风险的女性和男男性行为者进行淋病筛查；鼓励根据当地流行病学情况扩大筛查范围。为应对一家为美国印第安人服务的城市医疗中心淋病病例大幅增加的情况，2013年3月开始对所有14至45岁性活跃患者进行淋病筛查。我们描述了扩大筛查实施前后的淋病筛查覆盖率和病例发现情况。
2013年3月，开展了提供者培训、电子健康记录提示和捆绑式实验室订单，以促进对所有14至45岁性活跃患者进行淋病筛查。我们评估了在扩大筛查措施实施前两年（2011年3月至2012年2月[记为2011年]、2012年3月至2013年2月[2012年]）和实施后一年（2013年3月至2014年2月[2013年]）接受淋病筛查和检测呈阳性的患者比例。
淋病筛查覆盖率从2012年的22%增至2013年的38%；女性覆盖率增加了50%，男性增加了202%。几乎所有诊所的筛查覆盖率均有所提高。与2012年（n = 62）相比，2013年女性淋病病例发现增加了68%（n = 104），主要是25至29岁的女性。男性淋病病例发现没有相应增加。增加的病例发现大多发生在急诊科。
扩大淋病筛查后，淋病筛查覆盖率显著提高，随后女性淋病病例发现有所增加。尽管所有诊所的筛查都有所增加，但病例发现增加仅发生在急诊科。
