In the UK, despite its low sensitivity, wet mount microscopy is often the only method of detecting Trichomonas vaginalis infection. A study was conducted in symptomatic women to compare the performance of five methods for detecting T. vaginalis: an in-house polymerase chain reaction (PCR); Aptima T. vaginalis kit; OSOM ®Trichomonas Rapid Test; culture and microscopy. Symptomatic women underwent routine testing; microscopy and further swabs were taken for molecular testing, OSOM and culture. A true positive was defined as a sample that was positive for T. vaginalis by two or more different methods. Two hundred and forty-six women were recruited: 24 patients were positive for T. vaginalis by two or more different methods. Of these 24 patients, 21 patients were detected by real-time PCR (sensitivity 88%); 22 patients were detected by the Aptima T. vaginalis kit (sensitivity 92%); 22 patients were detected by OSOM (sensitivity 92%); nine were detected by wet mount microscopy (sensitivity 38%); and 21 were detected by culture (sensitivity 88%). Two patients were positive by just one method and were not considered true positives. All the other detection methods had a sensitivity to detect T. vaginalis that was significantly greater than wet mount microscopy, highlighting the number of cases that are routinely missed even in symptomatic women if microscopy is the only diagnostic method available.

Youth and young adults (19–24 years of age) shoulder the burden of sexually transmitted infections accounting for nearly half of all new infections annually. Mobile technology is one way that we have reached this population with safer sex information but challenges exist with the delivery process. The literature between 2010 and 2015 was reviewed for data on safe sex and sexual health information delivered using mobile cell phone devices. A search for relevant databases revealed that 17 articles met our inclusion criteria. Findings suggest that mobile cell phone interventions are an effective mode for delivering safe sex and sexual health information to youth; those at the highest risk may not be able to access cell phones based on availability and cost of the text messages or data plans.

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Pipelle, and the tissue was split for microbiological and histological assessment. Cultivated microorganisms were identified using phenotypic and genotypic characteristics. Fisher's exact tests were used to assess the association between microorganisms and endometritis (plasma cells ± neutrophils). Results Of 136 women with clinical PID, 55 (40%) had histologic evidence of endometritis, and endometrial GC and/or CT was associated with endometritis (29% vs. 6%, P < 0.001). In addition to STIs, a broad range of bacteria representing 63 different species were recovered from 53 (39%) of the endometrial biopsy samples, including 8 novel species. The recovery of any non-GC/non-CT organisms from the endometrium was associated with histologic endometritis (53% vs. 30%, P = 0.008). Both G. vaginalis (35% vs. 16%, P = 0.01) and A. vaginae (22% vs. 3%, P < 0.001) were associated with histologic endometritis. Other anaerobic bacteria associated with bacterial vaginosis including Prevotella timonensis, P. amnii and Peptoniphilus harei were also more frequent in the endometrium of women having endometritis (11% vs. 3%, P = 0.06) but this did not reach statistical significance. After excluding women having GC and/or CT, A. vaginae was still independently associated with endometritis (17% vs. 3%, P = 0.03). Conclusions Health Protection Agency, London, UKBackground TV is the most common non-viral STI in the world. Despite this, TV infection in UK Genitourinary clinics is mainly (and often exclusively) diagnosed by wet mount microscopy alone. Microscopy is known to have a low and variable sensitivity and therefore greatly underestimates the true prevalence of TV infection. Objectives A clinical trial was conducted to evaluate the performance of five methods for detecting TV: an in-house PCR; the Aptima TV kit; the OSOM Trichomonas Rapid Test (POCT); culture and microscopy to diagnose infection in symptomatic women. The results of the study were used to power a financial model for clinical implementation of a molecular test. Methods Symptomatic women were recruited for testing. Results and resource costs from the study were extrapolated to calculate the cost of implementing POCT and in house PCR compared to wet mount microscopy in the clinic. Results A composite reference standard of 2 more or more positives was used. 246 women were recruited of which 24 had a positive test by 2 or more of the 5 methods. Aptima TV kit, POCT, Real-time PCR and culture (sensitivities 92, 92, 88 and 88%) all out performed wet-mount microscopy (sensitivity 38%). The prevalence based on two tests as reference standard was 9.75%. Conclusions Cost modelling showed although initial outlay costs for PCR and POCT were high, savings were made in labour costs. PCR and POCT would improve the rate of TV diagnosis in this group and therefore reduce repeat visits due to false positive results. PCR requires additional clinical time for recalling the patient for a further visit to give a positive result, treatment and contact tracing. Implementation of newer test...

Conclusions Equivocal reports introduce delays to patient management while the risk of unnecessary antibiotic therapy appears acceptable to most patients. The cobas 4800 CT/NG PCR screening assay can achieve UK testing standards (PPV >90%) in extragenital swabs and low prevalence gonorrhoea population without supplementary tests. A patient-led confirmation algorithm is proposed. Background Ocular syphilis can affect most eye structures and can be the result of congenital and acquired infection. Many ocular signs are not specific to syphilis and it can be difficult to make the diagnosis. Aim This study aims to investigate the epidemiology of ocular syphilis presenting to an oculogenital clinic. Method Retrospective case notes review of ocular syphilis cases seen between 1965 and 2011. Of 307 cases with ocular signs and positive treponemal serology, 85 cases with a history of yaws were excluded, leaving 222. Results Of the 222 cases, 93 (42%) were late congenital (CS), and 129 (58%) were acquired (AS). Of the CS cases, the mean age was 47.5 (range 7e86), 37 (40%) were male, of whom 1 was MSM. 55 (59%) were from the UK, 19 (20%) from the Caribbean, 9 (10%) from Europe. Eye signs were as follows: interstitial keratitis 73, anterior uveitis 23, posterior uveitis 10, panuveitis 3, ArgyllRobertson pupils (ARP) 1 and optic neuritis (ON) 1. Of the AS cases, the mean age was 50.9 (range 17e85), 99 (77%) were male, of whom 15 were MSM. 31 (24%) were from the UK, 15 (12%) from Europe, 51 (40%) from the Caribbean and 16 (12%) from Africa. 17 (13%) were early syphilis (secondary/early latent) and 112 (87%) were late latent or tertiary syphilis. Eye signs were as follows: anterior uveitis 63, posterior uveitis 21, panuveitis 13, optic atrophy 9, ON 8 and ARP 5. 35 (38%) of CS cases and 8 (6%) of the AS cases had extra-ocular signs of syphilis. Treatment was with a neurosyphilis regimen. STI screen were offered to all patients. Concomitant STIs are shown in the abstract P54 table 1. P54