Objective: Although testing for Chlamydia trachomatis is encouraged and increasingly practiced at sexually transmitted disease (STD) and family planning clinics, patterns of testing and follow-up in other settings are not well described. To begin to address these issues, we performed a chart review of patients with a positive laboratory test for C. trachomatis at a major university medical center.
Methods: Chart review of medical records for all patients with positive laboratory tests for C. trachomatis during calendar year 1996.
Results: Of 326 patients with positive tests, 95% were female and 5% were male. Median age was 22 for females and 25 for males. Most positive C. trachomatis test results were from the emergency room (ER)/walk-in clinic (55%) or patients receiving obstetric/gynecologic (OB/GYN) care (31%). While most C. trachomatis tests performed were on patients who had symptoms, patterns of treatment varied between sites. Fifty-seven percent of ER/walk-in patients received empiric antibiotics at the initial visit versus 36% of patients under OB/GYN care. Among patients with positive screening tests seen in the ER/walk-in clinic, 32% of patients had no treatment documented versus 14% of OB/GYN patients. Four percent of women with positive tests who did not receive therapy at the time of their initial evaluation developed pelvic inflammatory disease in the interval between testing and return to the medical center.
Conclusions: Of the patients with positive chlamydial screening tests, the proportion not treated was similar to that found in studies performed in STD clinics.
PIP: A chart review of patients with positive laboratory tests for C. trachomatis at the University of Alabama at Birmingham Hospital and affiliated clinics during 1996 was performed to determine whether the problem of failure to notify patients of positive sexually transmitted disease (STD) test results is generalizable beyond STD clinics. Furthermore, it would review chlamydia testing practices in nonreproductive health setting. Findings revealed that of the 326 patients with positive tests, 95% were females aged 22 years and 5% were males aged 25 years. Most positive C. trachomatis test results were 51% from the emergency room (ER) and 31% from obstetric/gynecologic (OB/GYN). 57% of ER patients and 36% of OB/GYN patients received antibiotics on their initial visits. Among patients with positive screening tests, 32% of ER patients and 14% of OB/GYN patient had no documented treatment. 4% of women with positive tests, who did not receive therapy at the time of their initial evaluation, developed pelvic inflammatory disease in the interval between testing and returning to the medical center. From the findings, a substantial proportion of patients with positive screening tests for C. trachomatis may not receive timely treatment of their infections, which suggests that the problem occurs in settings other than STD and family clinics.