Abstract 742 Poster Session IV, Tuesday, 5/4 (poster 17)

Objectives: to determine the prevalence of treatable bacterial STDs (N.gonorrhea and C trachomatis) in adolescents seeking care at a urban Emergency Department (ED) utilizing opportunistic urine screening and to compare this prevalence with that of the same STDs detected in the context of usual problem oriented ED care. Methods: Patients between 14 and 19 years of age were eligible for study entry upon presentation to the ED regardless of chief complaint. Informed consent was obtained to review medical records and to anonymously test urine samples. Results of medical record review and urine ligase chain reaction (LCR) tests were linked in computer analysis only after identifiers were removed. Urine specimens were tested using the Abbott LCR. Results: 13.5% (n=38) of the 282 study patients were found to be positive for one or both of the STDs. The study group had a even distribution of ages and the racial distribution was reflective of the overall ED population. There was a slight preponderance of females (68%). 42% of the study population had some form of private insurance; 24% medicaid and 34% uninsured. The chief complaints of the patients found to be positive were 39% dysuria/genital DC; 25% suspected child abuse; 19% GI illness; 13% neuropsychiatric complaints (eg syncope, headache, suicide attempt, etc); 9% minor illness (sore throat, fever, cough) and 6% trauma. Prevalence did not vary with age. Only 13% (n=5) were detected in the course of routine problem oriented care. Conclusion: Many treatable bacterial STDs in adolescents are undetected in the course of routine problem oriented care. A high percentage of adolescents in our ED were positive for one or both of these STDs. Acute care providers may be important sites for public health department outreach programs.

No disclosures; no conflict of interest