Allan-Blitz Lao-Tzu, Chan Karly, Adamson Paul, Klausner Jeffrey D, Hsu Katherine
Brigham and Women's Hospital, Boston, MA, USA.
Massachusetts Department of Public Health, Boston, MA, USA.
J Prim Care Community Health. 2024 Jan-Dec;15:21501319241303609. doi: 10.1177/21501319241303609.
Drug-resistant is an urgent threat to public health. Novel prevention and treatment strategies are emerging, including immunizations, pharmacologic post-exposure prophylaxis, rapid molecular resistance assays, and novel antibiotics. However, where and how such strategies are optimally implemented remains unclear.
We conducted a retrospective interrupted time series analysis of gonorrhea cases reported to the Massachusetts Department of Public Health. We collected names of treating providers from 2011 (n = 100) and 2022 (n = 108), and cross-referenced provider names with publicly available records from the Massachusetts Boards of Registration in Medicine and Nursing to identify provider type, specialty, year of terminal degree or licensure, and clinic type.
Of 208 providers, 111 (53.4%) were advanced care practitioners. Providers treated cases predominantly in community health centers (n = 65, 31.3%) and emergency departments or urgent care centers (n = 60, 28.8%). Only 11 (12.4%) of 89 physicians were trained in either adult or pediatric infectious diseases.
Our results indicate that the majority of gonorrhea cases in the Massachusetts are treated in non-specialty settings. The time is now to plan for implementation of the emerging strategies to avoid underutilization and assure uptake of interventions in settings positioned to reach persons diagnosed with gonorrhea who will benefit most.
耐药性是对公共卫生的紧迫威胁。新的预防和治疗策略不断涌现，包括免疫接种、暴露后药物预防、快速分子耐药性检测以及新型抗生素。然而，这些策略在何处以及如何得到最佳实施仍不明确。
我们对向马萨诸塞州公共卫生部报告的淋病病例进行了回顾性中断时间序列分析。我们收集了2011年（n = 100）和2022年（n = 108）治疗提供者的姓名，并将提供者姓名与马萨诸塞州医学和护理注册委员会的公开记录进行交叉比对，以确定提供者类型、专业、最终学位或执照颁发年份以及诊所类型。
在208名提供者中，111名（53.4%）是高级护理从业者。提供者主要在社区卫生中心（n = 65，31.3%）以及急诊科或紧急护理中心（n = 60，28.8%）治疗病例。在89名医生中，只有11名（12.4%）接受过成人或儿科传染病方面的培训。
我们的结果表明，马萨诸塞州的大多数淋病病例是在非专科环境中治疗的。现在是时候规划实施新出现的策略，以避免利用不足，并确保在能够接触到最能受益的淋病确诊患者的环境中采用干预措施。
