Adolescent Women with Sexually Transmitted Infections: Who Gets Lost to Follow-Up?

Abstract Background Adolescent patients comprise the highest rate of Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) in the United States. These patients often initially present to the emergency department (ED) with vague symptoms. Objectives 1) Quantify the frequency of underrecognized GC...

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Bibliographic Details
Published in:The Journal of emergency medicine 2014-11, Vol.47 (5), p.507-512
Main Authors: Krivochenitser, Roman, MD, Bicker, Erica, MD, Whalen, David, MD, Gardiner, Cynthia, RN, Jones, Jeffrey S., MD
Format: Article
Language:English
Subjects:
Abdominal Pain - microbiology
Adolescent
Anti-Bacterial Agents - therapeutic use
Chlamydia Infections - diagnosis
Chlamydia Infections - drug therapy
Chlamydia Infections - microbiology
Chlamydia trachomatis - isolation & purification
DNA, Bacterial - analysis
Emergency
Emergency Service, Hospital - statistics & numerical data
Female
Gonorrhea - diagnosis
Gonorrhea - drug therapy
Humans
Lost to Follow-Up
Neisseria gonorrhoeae - isolation & purification
Pregnancy
Retrospective Studies
Time Factors
Time-to-Treatment - statistics & numerical data
United States
Urinary Tract Infections - diagnosis
Urinary Tract Infections - microbiology
Uterine Hemorrhage - microbiology
Vaginitis - diagnosis
Vaginitis - microbiology
Young Adult
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Summary:Abstract Background Adolescent patients comprise the highest rate of Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) in the United States. These patients often initially present to the emergency department (ED) with vague symptoms. Objectives 1) Quantify the frequency of underrecognized GC and CT cervical infections in adolescent women tested in the ED; 2) describe and compare the characteristics of those treated and not treated during the initial visit; and 3) quantify the delay interval until treatment was provided. Methods This was a retrospective, cohort analysis of consecutive females (ages 13–19 years) seen at four academic medical centers over a 36-month period with positive results for GC/CT. Our key outcome measures were the proportion of adolescent females being untreated in the ED, the time to subsequent treatment, and the proportion lost to follow-up. Results During the study period, 382 female adolescents had positive polymerase chain reaction studies for GC or CT or both; 266 (70%) were not treated in the ED. Untreated patients were significantly more likely to have a discharge diagnosis of urinary tract infection (23% vs. 11%, p  
ISSN:0736-4679
DOI:10.1016/j.jemermed.2014.06.022