Schlanger Karen, Black Jamie M, Smith Marguerite, Ridpath Alison, Crause Candi, Holderman Justin L, Henderson Kyle, Hardrick Harold, Pham Cau D, Howard George, Kirkcaldy Robert D
From the Centers for Disease Control and Prevention, Atlanta, GA.
Indiana Department of Health, Indianapolis, IN.
Sex Transm Dis. 2021 Dec 1;48(12S Suppl 2):S174-S179. doi: 10.1097/OLQ.0000000000001536.
Responding effectively to outbreaks of antibiotic-resistant gonorrhea (ARGC) in the future will likely prove challenging. Tabletop exercises (TTXs) may assist local, state, and federal public health officials evaluate existing ARGC outbreak response plans, strengthen preparedness and response effectiveness, and identify critical gaps to address before an outbreak.
In 2018 to 2019, Centers for Disease Control and Prevention (CDC) collaborated with state partners to develop and implement TTXs to simulate a public health emergency involving an ARGC outbreak. Before the TTXs, 2 state-local health department pairs developed ARGC outbreak response plans. During each 1-day exercise (in Indiana and Illinois), participants discussed roles, clinical management, public health response, and communication based on predeveloped response plans. Observers identified outbreak response strengths and gaps, and participants completed feedback forms.
Forty-one (Illinois) and 48 people (Indiana) participated in each TTX, including sexually transmitted disease clinical staff, laboratorians, public health infectious disease program staff, and CDC observers. Strengths and gaps varied by jurisdiction, but identified gaps included: (1) local access to gonorrhea culture and timely antimicrobial susceptibility testing, (2) protocols for clinical management of suspected treatment failures, (3) communication plans, and (4) clarity regarding state and local responsibilities. The CDC observers identified opportunities to provide national-level technical assistance, foster local antimicrobial susceptibility testing, and develop further response guidance. Tabletop exercises summary reports were used to guide modifications to local response plans to address gaps.
The TTXs allowed participants to practice responding to a simulated public health emergency and may have enhanced local response capacity. Centers for Disease Control and Prevention made TTX implementation materials publicly available.
未来有效应对耐抗生素淋病（ARGC）疫情可能具有挑战性。桌面演练（TTXs）可协助地方、州和联邦公共卫生官员评估现有的ARGC疫情应对计划，加强防范和应对效果，并找出疫情发生前需要解决的关键差距。
2018年至2019年，疾病控制与预防中心（CDC）与州合作伙伴合作，制定并实施TTXs，以模拟涉及ARGC疫情的公共卫生紧急情况。在TTXs之前，两对州和地方卫生部门制定了ARGC疫情应对计划。在每次为期1天的演练（分别在印第安纳州和伊利诺伊州）中，参与者根据预先制定的应对计划讨论了各自的角色、临床管理、公共卫生应对和沟通。观察员确定了疫情应对的优势和差距，参与者填写了反馈表。
每次TTXs分别有41人（伊利诺伊州）和48人（印第安纳州）参加，包括性传播疾病临床工作人员、实验室人员、公共卫生传染病项目工作人员和CDC观察员。优势和差距因辖区而异，但发现的差距包括：（1）当地淋病培养和及时的抗菌药物敏感性检测；（2）疑似治疗失败的临床管理方案；（3）沟通计划；（4）州和地方职责的明确性。CDC观察员确定了提供国家级技术援助、促进当地抗菌药物敏感性检测以及制定进一步应对指南的机会。桌面演练总结报告被用于指导修改地方应对计划以弥补差距。
TTXs使参与者能够练习应对模拟的公共卫生紧急情况，并可能增强了地方应对能力。疾病控制与预防中心已将TTX实施材料公开提供。
