Andrea Sailer

Prevalence of pharyngeal and rectal Chlamydia trachomatis and Neisseria gonorrhoeae infections among men who have sex with men in Germany

Objectives To determine the prevalence of pharyngeal and rectal Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among men who have sex with men (MSM) in Germany and describe associations between these infections, sexual practices and other factors to provide an evidence base for screening recommendations. Methods We conducted a cross-sectional study in 22 sentinel sites of sexually transmitted infections across Germany. Pharyngeal and rectal swabs were collected and tested for CT and NG with a nucleic acid amplification test (NAAT). Information on HIV status, number of sex partners and sexual practices was collected and linked to NAAT results. Results Overall, 2247 MSM were screened for pharyngeal or rectal CT and NG infections; median age was 34 years (range 16–83). Prevalence of CT was 1.5% in pharyngeal and 8.0% in rectal specimens. Prevalence of NG was 5.5% in pharyngeal and 4.6% in rectal specimens. Local symptoms were reported in 5.1% of pharyngeal and 11.9% of rectal infections. Altogether 90.8% of rectal or pharyngeal infections would remain undetected if only symptomatic cases were tested. Rectal infection was significantly more likely in men reporting multiple partners (2–5 partners, OR=1.85; 6–10 partners, OR=2.10; >11 partners, OR=2.95), men diagnosed with HIV (OR=1.60) and men practising receptive anal intercourse without a condom (OR=1.54). Pharyngeal infection was more likely in men reporting multiple partners (6–10 partners, OR=2.88; >11 partners, OR=4.96), and men diagnosed with HIV (OR=1.78). Conclusions Pharyngeal and rectal infections in sexually active MSM can remain undetected and thus transmissible if swabbing is not offered routinely. Screening should be offered particularly to MSM diagnosed with HIV and MSM reporting multiple partners.

Lymphogranuloma Venereum in Men Screened for Pharyngeal and Rectal Infection, Germany

To determine prevalence of lymphogranuloma venereum among men who have sex with men in Germany, we conducted a multicenter study during 2009–2010 and found high rates of rectal and pharyngeal infection in men positive for the causative agent, Chlamydia trachomatis. Many infections were asymptomatic. An adjusted C. trachomatis screening policy is justified in Germany.

Establishment of a voluntary electronic Chlamydia trachomatis laboratory surveillance system in Germany, 2008 to 2014

Chlamydia trachomatis (CT) infections are not reportable in Germany and limited data on prevalence are available. CT screening has been offered free of charge to pregnant women since 1995 and to all women under 25 years since 2008. For symptomatic women and men, diagnostic testing is covered by statutory health insurance. We describe the establishment of a nationwide, laboratory-based, voluntary sentinel that electronically collects information on all performed CT tests with test results, test reason and patient information. The sentinel represents one third of all performed CT tests in Germany. In the period from 2008 to 2014, 3,877,588 CT tests were reported, 93% in women. Women aged 20–24 years and men aged 25–29 years were the most frequently tested age groups. The overall proportion of positive tests (PPT) among women was 3.9% and among men 11.0%. The highest PPT among women was in the age groups 15–19 (6.8%) and 20–24 years (5.9%), and among men in the age groups 20–24 (19.2%), 15–19 (15.4%) and 25–29 years (14.8%). The PPT for CT was high among women and men younger than 25 years. Prevention is urgently needed. Monitoring of CT infection in Germany should be continued.

Die deutsche Laborlandschaft zu Diagnostik und Antibiotikaresistenztestung bei Neisseria gonorrhoeae

Recent years have seen a world-wide increase in antimicrobial resistance (AMR) in cases of infection with Neisseria gonorrhoeae (NG). NG infection is not notifiable in Germany and there is a lack of information available about the spread and AMR of NG infections. The objective of the study was to provide information on diagnostic methods and AMR testing in cases of NG infections in German laboratories. A cross-sectional survey was undertaken in Germany between June and August 2013 using an online questionnaire. Laboratories performing NG diagnostics were identified and described with regard to the diagnostic methods used, the number of tests performed, the antibiotics tested and the AMR observed, in addition to general laboratory information. In total, 188 of the 521 participating laboratories performed NG diagnostics; these were included in the further statistical analysis. 92.6 % of the 188 laboratories performed culture. A median of 60 (IQR 15-270) samples per quarter (SPQ) were tested, with an overall positivity rate of 4.1 and 6.9 % among men. Most (82.1 %) of the 151 laboratories performing NG culture tested for AMR as well. The most frequently tested antibiotics were ciprofloxacin (94.8 %), penicillin (93.1 %), doxycycline (70.0 %) and ceftriaxone (67.2 %). The most frequently observed AMR ever were those against ciprofloxacin (87.1 %), penicillin (78.3 %), doxycycline (56.6 %) and azithromycin (35.1 %; all percentages refer to laboratories). The laboratories used different standards regarding susceptibility criteria. The emergence and spread of AMR shows that it is crucial to assess and monitor the scope and trends of multidrug-resistant gonorrhea. The data collected on diagnostic methods and AMR testing in cases of NG infections in German laboratories constitute an important basis for future monitoring.ZusammenfassungWeltweit sind zunehmende Antibiotikaresistenzen (AMR) bei Infektionen mit Neisseria gonorrhoeae (NG) zu beobachten. Aufgrund der fehlenden Meldepflicht in Deutschland stehen kaum epidemiologische und bevölkerungsbezogene Daten zur Verbreitung von NG-Infektionen und deren AMR zur Verfügung. Ziel der hier vorgestellten Erhebung war die Erfassung der NG-Diagnostikmethoden und AMR-Testungen von Laboren in Deutschland. Zwischen Juni und August 2013 wurde eine Querschnittserhebung in Deutschland über einen Online-Fragebogen durchgeführt. Labore mit NG-Diagnostik wurden identifiziert, um sie hinsichtlich der Diagnostikmethoden, des Probenumfangs, der getesteten Antibiotika, der beobachteten AMR sowie mit Blick auf allgemeine Laborangaben zu charakterisieren. Insgesamt führten 188 von 521 teilnehmenden Laboren eine NG-Diagnostik durch. Ihre Angaben waren somit Grundlage für die weiteren statistischen Auswertungen. 92,6 % der Labore führten einen Kulturnachweis durch. Im Median wurden 60 Proben pro Quartal (PpQ) (IQR 15–270) getestet. Der Positivenanteil unter Männern lag bei 4,1 % sowie 6,9 %. Die Mehrzahl (82,1 %) der 151 Labore mit Kulturnachweis führte eine AMR-Testung durch. Die hier am häufigsten getesteten Antibiotika waren Ciprofloxacin (94,8 %), Penicillin (93,1 %), Doxycyclin (70,0 %) und Ceftriaxon (67,2 %). Die Antibiotika gegen die am häufigsten jemals Resistenzen beobachtet wurden waren Ciprofloxacin (87,1 %), Penicillin (78,3 %), Doxycyclin (56,6 %) und Azithromycin (35,1 %; alle Angaben als Protzentsatz der Labore). Es wurden unterschiedliche AMR-Ablesestandards verwendet. Die weltweite Resistenzentwicklung weist darauf hin, dass eine regelmäßige Überwachung von AMR bei NG-Infektionen erforderlich ist. Die im Rahmen der Studie erhobenen Daten zur deutschen Laborlandschaft bei der NG-Diagnostik bieten hierfür eine wichtige Voraussetzung.AbstractRecent years have seen a world-wide increase in antimicrobial resistance (AMR) in cases of infection with Neisseria gonorrhoeae (NG). NG infection is not notifiable in Germany and there is a lack of information available about the spread and AMR of NG infections. The objective of the study was to provide information on diagnostic methods and AMR testing in cases of NG infections in German laboratories. A cross-sectional survey was undertaken in Germany between June and August 2013 using an online questionnaire. Laboratories performing NG diagnostics were identified and described with regard to the diagnostic methods used, the number of tests performed, the antibiotics tested and the AMR observed, in addition to general laboratory information. In total, 188 of the 521 participating laboratories performed NG diagnostics; these were included in the further statistical analysis. 92.6 % of the 188 laboratories performed culture. A median of 60 (IQR 15–270) samples per quarter (SPQ) were tested, with an overall positivity rate of 4.1 and 6.9 % among men. Most (82.1 %) of the 151 laboratories performing NG culture tested for AMR as well. The most frequently tested antibiotics were ciprofloxacin (94.8 %), penicillin (93.1 %), doxycycline (70.0 %) and ceftriaxone (67.2 %). The most frequently observed AMR ever were those against ciprofloxacin (87.1 %), penicillin (78.3 %), doxycycline (56.6 %) and azithromycin (35.1 %; all percentages refer to laboratories). The laboratories used different standards regarding susceptibility criteria. The emergence and spread of AMR shows that it is crucial to assess and monitor the scope and trends of multidrug-resistant gonorrhea. The data collected on diagnostic methods and AMR testing in cases of NG infections in German laboratories constitute an important basis for future monitoring.

[Laboratory practices: diagnostics and antibiotics resistance testing of Neisseria gonorrhoeae in Germany].

Recent years have seen a world-wide increase in antimicrobial resistance (AMR) in cases of infection with Neisseria gonorrhoeae (NG). NG infection is not notifiable in Germany and there is a lack of information available about the spread and AMR of NG infections. The objective of the study was to provide information on diagnostic methods and AMR testing in cases of NG infections in German laboratories. A cross-sectional survey was undertaken in Germany between June and August 2013 using an online questionnaire. Laboratories performing NG diagnostics were identified and described with regard to the diagnostic methods used, the number of tests performed, the antibiotics tested and the AMR observed, in addition to general laboratory information. In total, 188 of the 521 participating laboratories performed NG diagnostics; these were included in the further statistical analysis. 92.6 % of the 188 laboratories performed culture. A median of 60 (IQR 15-270) samples per quarter (SPQ) were tested, with an overall positivity rate of 4.1 and 6.9 % among men. Most (82.1 %) of the 151 laboratories performing NG culture tested for AMR as well. The most frequently tested antibiotics were ciprofloxacin (94.8 %), penicillin (93.1 %), doxycycline (70.0 %) and ceftriaxone (67.2 %). The most frequently observed AMR ever were those against ciprofloxacin (87.1 %), penicillin (78.3 %), doxycycline (56.6 %) and azithromycin (35.1 %; all percentages refer to laboratories). The laboratories used different standards regarding susceptibility criteria. The emergence and spread of AMR shows that it is crucial to assess and monitor the scope and trends of multidrug-resistant gonorrhea. The data collected on diagnostic methods and AMR testing in cases of NG infections in German laboratories constitute an important basis for future monitoring.ZusammenfassungWeltweit sind zunehmende Antibiotikaresistenzen (AMR) bei Infektionen mit Neisseria gonorrhoeae (NG) zu beobachten. Aufgrund der fehlenden Meldepflicht in Deutschland stehen kaum epidemiologische und bevölkerungsbezogene Daten zur Verbreitung von NG-Infektionen und deren AMR zur Verfügung. Ziel der hier vorgestellten Erhebung war die Erfassung der NG-Diagnostikmethoden und AMR-Testungen von Laboren in Deutschland. Zwischen Juni und August 2013 wurde eine Querschnittserhebung in Deutschland über einen Online-Fragebogen durchgeführt. Labore mit NG-Diagnostik wurden identifiziert, um sie hinsichtlich der Diagnostikmethoden, des Probenumfangs, der getesteten Antibiotika, der beobachteten AMR sowie mit Blick auf allgemeine Laborangaben zu charakterisieren. Insgesamt führten 188 von 521 teilnehmenden Laboren eine NG-Diagnostik durch. Ihre Angaben waren somit Grundlage für die weiteren statistischen Auswertungen. 92,6 % der Labore führten einen Kulturnachweis durch. Im Median wurden 60 Proben pro Quartal (PpQ) (IQR 15–270) getestet. Der Positivenanteil unter Männern lag bei 4,1 % sowie 6,9 %. Die Mehrzahl (82,1 %) der 151 Labore mit Kulturnachweis führte eine AMR-Testung durch. Die hier am häufigsten getesteten Antibiotika waren Ciprofloxacin (94,8 %), Penicillin (93,1 %), Doxycyclin (70,0 %) und Ceftriaxon (67,2 %). Die Antibiotika gegen die am häufigsten jemals Resistenzen beobachtet wurden waren Ciprofloxacin (87,1 %), Penicillin (78,3 %), Doxycyclin (56,6 %) und Azithromycin (35,1 %; alle Angaben als Protzentsatz der Labore). Es wurden unterschiedliche AMR-Ablesestandards verwendet. Die weltweite Resistenzentwicklung weist darauf hin, dass eine regelmäßige Überwachung von AMR bei NG-Infektionen erforderlich ist. Die im Rahmen der Studie erhobenen Daten zur deutschen Laborlandschaft bei der NG-Diagnostik bieten hierfür eine wichtige Voraussetzung.AbstractRecent years have seen a world-wide increase in antimicrobial resistance (AMR) in cases of infection with Neisseria gonorrhoeae (NG). NG infection is not notifiable in Germany and there is a lack of information available about the spread and AMR of NG infections. The objective of the study was to provide information on diagnostic methods and AMR testing in cases of NG infections in German laboratories. A cross-sectional survey was undertaken in Germany between June and August 2013 using an online questionnaire. Laboratories performing NG diagnostics were identified and described with regard to the diagnostic methods used, the number of tests performed, the antibiotics tested and the AMR observed, in addition to general laboratory information. In total, 188 of the 521 participating laboratories performed NG diagnostics; these were included in the further statistical analysis. 92.6 % of the 188 laboratories performed culture. A median of 60 (IQR 15–270) samples per quarter (SPQ) were tested, with an overall positivity rate of 4.1 and 6.9 % among men. Most (82.1 %) of the 151 laboratories performing NG culture tested for AMR as well. The most frequently tested antibiotics were ciprofloxacin (94.8 %), penicillin (93.1 %), doxycycline (70.0 %) and ceftriaxone (67.2 %). The most frequently observed AMR ever were those against ciprofloxacin (87.1 %), penicillin (78.3 %), doxycycline (56.6 %) and azithromycin (35.1 %; all percentages refer to laboratories). The laboratories used different standards regarding susceptibility criteria. The emergence and spread of AMR shows that it is crucial to assess and monitor the scope and trends of multidrug-resistant gonorrhea. The data collected on diagnostic methods and AMR testing in cases of NG infections in German laboratories constitute an important basis for future monitoring.

An assessment of the current Chlamydia trachomatis laboratory practices in Germany.

BACKGROUND AND OBJECTIVES Currently, no information is available about the number of Chlamydia trachomatis (CT) tests performed, testing facilities available or diagnostic methods used in Germany. This study aimed to map CT diagnostic facilities so that representative laboratories can be recruited for CT sentinel surveillance. METHODS Using a questionnaire, we collected information about population coverage, the number of tests performed, accreditation and current testing methods and systems for German facilities that potentially offer CT diagnostics. RESULTS Overall, 725/1,504 (48%) facilities responded; of the respondents, 143 reported that they perform CT diagnostics. Of the laboratories performing diagnostics, 45% were privately owned, and 42% were located in a hospital. Of the laboratories that provided information about their catchment area, 61% received samples from at least one federal state and therefore covered more than their surrounding area. The median length of time that CT diagnostics had been performed was 11.5 years. Over half (54%) of the laboratories that provided information on their accreditation status were accredited, for a median duration of 6 years. In accordance with national guidelines, 77% used nucleic acid amplification tests (NAAT) for acute CT infections. CONCLUSIONS The long duration since Ct diagnostics have been performed and laboratories have been accredited can be seen as an indication of the high diagnostic quality of German laboratories. Additionally, laboratories mostly serviced doctors and patients from a large region and are not representative for people living in the area where the lab is located. This has to be considered when sampling representative labs for CT sentinel surveillance and further epidemiological studies.

P1-S2.07 STI rates and risk factors among female sex workers attending STI testing sites in Germany, January–December 2010

Background Epidemiological studies on female sex workers (FSW) in Europe are limited. Since January 2010, selected German local health departments (LHD) offering STI testing services, have collected test results and behavioural data among FSW attendees. Using the data collected from January to December 2010, we asses STI positivity rates and identify risk factors for acquiring STIs among FSW tested at LHDs in Germany. Methods 30 LHDs throughout Germany voluntary submit quarterly reports with the number of FSW tested and found positive for any of the following STIs—HIV, Chlamydia (CT), Gonorrhoea (GC), Syphilis, Trichomoniasis (Tvag) and bacterial vaginosis (BV). Physicians provide basic demographic data, medical history relating to STI and information on where the FSW meet clients. In a separate questionnaire FSW provide information on for example, number of clients per week, sexual practices and drug use. Data for the in total 123 variables is consolidated and validated at the Robert Koch Institute. Uni- and multi-variable logistic regressions were used to identify relevant risk factors for being infected with CT, GC, Syphilis and/or Tvag (STI positive) and OR with 95% CIs were calculated. Results In 2010, 6675 FSW were seen and a total of 19 557 STI tests were performed. Physicians provided background data for 1142 (17%) of all FSW seen and of these 399 provided additional behavioural data. Median age was 30 (range—15–77 years), 72% were born outside Germany. Overall 7% of all tests were positive. The most common diagnoses were—BV (32.1% of 2770 tests), CT (6.8% of 3807), Tvag (3.3% of 2529) and GC (3.0% of 4223). 1.3% (of 3191) were positive for Syphilis and 0.2% (of 3037) HIV positive. Risk factors associated with a higher chance of testing STI positive included—poor knowledge of German language, OR=3.6 (2.5 to 5.0), meeting clients on the street, OR=3.5 (2.3 to 5.3) and increased number of clients per week. The risk of STI decreased with year of age, OR=0.95 (0.93 to 0.97), and was lower among FSW meeting clients on the internet, OR=0.5 (0.3 to 0.7) and FSW with health insurance, OR=0.4 (0.3 to 0.5) see Abstract P1-S2.07 Table 1. Abstract P1-S2.07 Table 1 Association between selected risk factors and being “STI positive” (testing positive for Chlamydia, Gonorrhoea, Syphilis and/or Trichomoniasis) among female sex workers attending STI testing sites in Germany, 2010 (N=1142) STI positive (Chlamydia, Gonorrhoea, Syphilis and/or Trichomoniasis), N=233 NTotal NPositive OR (95% CI) p Value German language  Fluent (R) 437 59 1  Medium 301 34 0.82 (0.52 to 1.30) 0.376  Very poor / None 375 135 3.60 (2.55 to 5.10) 0.000 Age  Range 15–77 years 1142 233 0.95 (0.93 to 0.97) 0.000 Health insurance  No (R) 450 138 1  Yes 648 87 0.35 (0.26 to 0.47) 0.000 Meet clients on the street  No (R) 995 173 1  Yes 101 43 3.52 (2.30 to 5.40) 0.000 Meet clients through internet or adds  No (R) 908 195 1 0.002  Yes 188 21 0.46 (0.28 to 0.74) Number of clients per week  Range 1–75 270 37 1.02 (1.00 to 1.04) 0.028 Explanatory factor included as continuous variable in logistic regression. (R), Reference group. Conclusions STI positivity rates, especially for HIV and syphilis seem relatively low among the FSW attending STI testing sites in Germany in 2010. FSW are a heterogeneous group and public health efforts should target those most at risk such as the young, migrant, uninsured and street-based women who sell sex.

Die deutsche Laborlandschaft zu Diagnostik und Antibiotikaresistenztestung bei Neisseria gonorrhoeaeLaboratory practices: diagnostics and antibiotics resistance testing of Neisseria gonorrhoeae in Germany

Recent years have seen a world-wide increase in antimicrobial resistance (AMR) in cases of infection with Neisseria gonorrhoeae (NG). NG infection is not notifiable in Germany and there is a lack of information available about the spread and AMR of NG infections. The objective of the study was to provide information on diagnostic methods and AMR testing in cases of NG infections in German laboratories. A cross-sectional survey was undertaken in Germany between June and August 2013 using an online questionnaire. Laboratories performing NG diagnostics were identified and described with regard to the diagnostic methods used, the number of tests performed, the antibiotics tested and the AMR observed, in addition to general laboratory information. In total, 188 of the 521 participating laboratories performed NG diagnostics; these were included in the further statistical analysis. 92.6 % of the 188 laboratories performed culture. A median of 60 (IQR 15-270) samples per quarter (SPQ) were tested, with an overall positivity rate of 4.1 and 6.9 % among men. Most (82.1 %) of the 151 laboratories performing NG culture tested for AMR as well. The most frequently tested antibiotics were ciprofloxacin (94.8 %), penicillin (93.1 %), doxycycline (70.0 %) and ceftriaxone (67.2 %). The most frequently observed AMR ever were those against ciprofloxacin (87.1 %), penicillin (78.3 %), doxycycline (56.6 %) and azithromycin (35.1 %; all percentages refer to laboratories). The laboratories used different standards regarding susceptibility criteria. The emergence and spread of AMR shows that it is crucial to assess and monitor the scope and trends of multidrug-resistant gonorrhea. The data collected on diagnostic methods and AMR testing in cases of NG infections in German laboratories constitute an important basis for future monitoring.ZusammenfassungWeltweit sind zunehmende Antibiotikaresistenzen (AMR) bei Infektionen mit Neisseria gonorrhoeae (NG) zu beobachten. Aufgrund der fehlenden Meldepflicht in Deutschland stehen kaum epidemiologische und bevölkerungsbezogene Daten zur Verbreitung von NG-Infektionen und deren AMR zur Verfügung. Ziel der hier vorgestellten Erhebung war die Erfassung der NG-Diagnostikmethoden und AMR-Testungen von Laboren in Deutschland. Zwischen Juni und August 2013 wurde eine Querschnittserhebung in Deutschland über einen Online-Fragebogen durchgeführt. Labore mit NG-Diagnostik wurden identifiziert, um sie hinsichtlich der Diagnostikmethoden, des Probenumfangs, der getesteten Antibiotika, der beobachteten AMR sowie mit Blick auf allgemeine Laborangaben zu charakterisieren. Insgesamt führten 188 von 521 teilnehmenden Laboren eine NG-Diagnostik durch. Ihre Angaben waren somit Grundlage für die weiteren statistischen Auswertungen. 92,6 % der Labore führten einen Kulturnachweis durch. Im Median wurden 60 Proben pro Quartal (PpQ) (IQR 15–270) getestet. Der Positivenanteil unter Männern lag bei 4,1 % sowie 6,9 %. Die Mehrzahl (82,1 %) der 151 Labore mit Kulturnachweis führte eine AMR-Testung durch. Die hier am häufigsten getesteten Antibiotika waren Ciprofloxacin (94,8 %), Penicillin (93,1 %), Doxycyclin (70,0 %) und Ceftriaxon (67,2 %). Die Antibiotika gegen die am häufigsten jemals Resistenzen beobachtet wurden waren Ciprofloxacin (87,1 %), Penicillin (78,3 %), Doxycyclin (56,6 %) und Azithromycin (35,1 %; alle Angaben als Protzentsatz der Labore). Es wurden unterschiedliche AMR-Ablesestandards verwendet. Die weltweite Resistenzentwicklung weist darauf hin, dass eine regelmäßige Überwachung von AMR bei NG-Infektionen erforderlich ist. Die im Rahmen der Studie erhobenen Daten zur deutschen Laborlandschaft bei der NG-Diagnostik bieten hierfür eine wichtige Voraussetzung.AbstractRecent years have seen a world-wide increase in antimicrobial resistance (AMR) in cases of infection with Neisseria gonorrhoeae (NG). NG infection is not notifiable in Germany and there is a lack of information available about the spread and AMR of NG infections. The objective of the study was to provide information on diagnostic methods and AMR testing in cases of NG infections in German laboratories. A cross-sectional survey was undertaken in Germany between June and August 2013 using an online questionnaire. Laboratories performing NG diagnostics were identified and described with regard to the diagnostic methods used, the number of tests performed, the antibiotics tested and the AMR observed, in addition to general laboratory information. In total, 188 of the 521 participating laboratories performed NG diagnostics; these were included in the further statistical analysis. 92.6 % of the 188 laboratories performed culture. A median of 60 (IQR 15–270) samples per quarter (SPQ) were tested, with an overall positivity rate of 4.1 and 6.9 % among men. Most (82.1 %) of the 151 laboratories performing NG culture tested for AMR as well. The most frequently tested antibiotics were ciprofloxacin (94.8 %), penicillin (93.1 %), doxycycline (70.0 %) and ceftriaxone (67.2 %). The most frequently observed AMR ever were those against ciprofloxacin (87.1 %), penicillin (78.3 %), doxycycline (56.6 %) and azithromycin (35.1 %; all percentages refer to laboratories). The laboratories used different standards regarding susceptibility criteria. The emergence and spread of AMR shows that it is crucial to assess and monitor the scope and trends of multidrug-resistant gonorrhea. The data collected on diagnostic methods and AMR testing in cases of NG infections in German laboratories constitute an important basis for future monitoring.

P3.028 Positivity Rate of Chlamydia Trachomatis and Status Quo of Opportunistic Screening in Germany

Background Chlamydia trachomatis (CT) infections are not reportable in Germany and limited data on CT-prevalence among women is available. In 2008 an opportunistic CT screening programme for women < 25 years (OCS) was introduced. We assessed positivity rate of CT-infection and evaluated the OCS in order to develop recommendations to improve OCS. Methods In September 2010 voluntary laboratory-based sentinel surveillance system was implemented and is collecting retrospective (from 2008) and prospective data on performed CT-tests together with results and information on age and test reason (TR). We calculated positivity rates (PR) by age and TR and compared them with Chi2 test. We described data by time and estimated the proportion of the target population reached by OCS. Results As of 27.11.2012 data from 14 laboratories were available for analysis. These data cover approximately 25% of all CT-tests performed in Germany. Overall 90.6% (643,332) of all tests (710,021) were among women. Among those 19.1% (122,650) were attributable to OCS, 31.3% (201,322) to screening in pregnancy (CSP), 30.6% (197,013) to diagnostic test (DT), and in 19.0% (122,347) the TR was not known. The number of OCS-tests increased by 114% in 2009, 15% in 2010, and 7% in 2011 compared to the previous year. Extrapolating, OCS covered 10% of the target population. OCS PR was 5.3%, higher than for other TR (2.6% among CSP, and 3.9% among DT, p-value < 0.001). OCS PR was highest in women aged 15–19 years (7.1%) and 20–24 (6.5%) compared to other age-groups (p-value < 0.001). Conclusion The proportion of young women testing positive for CT was high. OCS coverage in Germany is insufficient and did not increase substantially in the last years. OCS should be promoted among the target population and physicians. Awareness campaigns for young women should be implemented. Respective regulations should be expanded and remuneration to physicians for OCS offered.