Detection of Pelvic Inflammatory Disease: Development of an Automated Case-Finding Algorithm Using Administrative Data

ICD-9 codes are conventionally used to identify pelvic inflammatory disease (PID) from administrative data for surveillance purposes. This approach may include non-PID cases. To refine PID case identification among women with ICD-9 codes suggestive of PID, a case-finding algorithm was developed using additional variables. Potential PID cases were identified among women aged 15–44 years at Group Health (GH) and Kaiser Permanente Colorado (KPCO) and verified by medical record review. A classification and regression tree analysis was used to develop the algorithm at GH; validation occurred at KPCO. The positive predictive value (PPV) for using ICD-9 codes alone to identify clinical PID cases was 79%. The algorithm identified PID appropriate treatment and age 15–25 years as predictors. Algorithm sensitivity (GH = 96.4%; KPCO = 90.3%) and PPV (GH = 86.9%; KPCO = 84.5%) were high, but specificity was poor (GH = 45.9%; KPCO = 37.0%). In GH, the algorithm offered a practical alternative to medical record review to further improve PID case identification

Antimicrobial Susceptibility of Urogenital and Extragenital Neisseria gonorrhoeae Isolates Among Men Who Have Sex With Men: Strengthening the US Response to Resistant Gonorrhea and Enhanced Gonococcal Isolate Surveillance Project, 2018 to 2019.

BACKGROUND: We investigated differences in gonococcal antimicrobial susceptibility by anatomic site among cisgender men who have sex with men (MSM) using specimens collected through the Centers for Disease Control and Preventions enhanced Gonococcal Isolate Surveillance Project and Strengthening the US Response to Resistant Gonorrhea. METHODS: During the period January 1, 2018-December 31, 2019, 12 enhanced Gonococcal Isolate Surveillance Project and 8 Strengthening the US Response to Resistant Gonorrhea sites collected urogenital, pharyngeal, and rectal isolates from cisgender MSM in sexually transmitted disease clinics. Gonococcal isolates were sent to regional laboratories for antimicrobial susceptibility testing by agar dilution. To account for correlated observations, linear mixed-effects models were used to calculate geometric mean minimum inhibitory concentrations (MICs), and mixed-effects logistic regression models were used to calculate the proportion of isolates with elevated or resistant MICs; comparisons were made across anatomic sites. RESULTS: Participating clinics collected 3974 urethral, 1553 rectal, and 1049 pharyngeal isolates from 5456 unique cisgender MSM. There were no significant differences in the geometric mean MICs for azithromycin, ciprofloxacin, penicillin, and tetracycline by anatomic site. For cefixime and ceftriaxone, geometric mean MICs for pharyngeal isolates were higher compared with anogenital isolates (P < 0.05). The proportion of isolates with elevated ceftriaxone MICs (≥0.125 μg/mL) at the pharynx (0.67%) was higher than at rectal (0.13%) and urethral (0.18%) sites (P < 0.05). CONCLUSIONS: Based on data collected from multijurisdictional sentinel surveillance projects, antimicrobial susceptibility patterns of Neisseria gonorrhoeae isolates may differ among MSM at extragenital sites, particularly at the pharynx. Continued investigation into gonococcal susceptibility patterns by anatomic site may be an important strategy to monitor and detect the emergence of antimicrobial resistant gonorrhea over time

WHO global research priorities for antimicrobial resistance in human health

The WHO research agenda for antimicrobial resistance (AMR) in human health has identified 40 research priorities to be addressed by the year 2030. These priorities focus on bacterial and fungal pathogens of crucial importance in addressing AMR, including drug-resistant pathogens causing tuberculosis. These research priorities encompass the entire people-centred journey, covering prevention, diagnosis, and treatment of antimicrobial-resistant infections, in addition to addressing the overarching knowledge gaps in AMR epidemiology, burden and drivers, policies and regulations, and awareness and education. The research priorities were identified through a multistage process, starting with a comprehensive scoping review of knowledge gaps, with expert inputs gathered through a survey and open call. The priority setting involved a rigorous modified Child Health and Nutrition Research Initiative approach, ensuring global representation and applicability of the findings. The ultimate goal of this research agenda is to encourage research and investment in the generation of evidence to better understand AMR dynamics and facilitate policy translation for reducing the burden and consequences of AMR

Use of Administrative Health Care Data for Sexually Transmitted Disease Surveillance

We evaluated the usefulness of 3 administrative health care databases for sexually transmitted disease (STD) surveillance. Strengths include availability of diagnosis and procedure codes for large numbers of records. All data sources offer standardized data values. However, none of the sources include laboratory test results or inpatient medications, although several contain outpatient prescription claims. Despite limitations, administrative health care data provide new opportunities for STD surveillance among large numbers of health care consumers. These data may be particularly useful for non-reportable STD and STD clinical sequelae, but delayed availability may limit their utility for public health response.

Evaluation of Chlamydia Case Report Data: Completeness of Key Variables - United States, 2012

Chlamydia, a sexually transmitted infection, is the most commonly reported nationally notifable disease in the United States We assessed the completeness of key variables included in chlamydia case report data submitted to the Centers for Disease Control and Prevention (CDC) during 2012. Most of the reviewed demographic and geographic variables provided to CDC on 2012 chlamydia case reports had complete values. Diagnosis-related variables provided on case reports were less complete, in particular anatomic specimen site. Further investigation is needed to identify barriers to submitting complete data. Additional evaluation of validity (e.g., accuracy) of data provided is needed to fully evaluate chlamydia case report data

Evaluation of Chlamydia Case Report Data: Completeness of Key Variables - United States, 2012

Chlamydia, a sexually transmitted infection, is the most commonly reported nationally notifable disease in the United States We assessed the completeness of key variables included in chlamydia case report data submitted to the Centers for Disease Control and Prevention (CDC) during 2012. Most of the reviewed demographic and geographic variables provided to CDC on 2012 chlamydia case reports had complete values. Diagnosis-related variables provided on case reports were less complete, in particular anatomic specimen site. Further investigation is needed to identify barriers to submitting complete data. Additional evaluation of validity (e.g., accuracy) of data provided is needed to fully evaluate chlamydia case report data