(P362) Co-infection Rate of Sexually Transmitted Infections from a United States Cohort

Background: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the 2 most common nationally notifiable conditions (except SARS-CoV-2) in the US. Despite emerging interest in Trichomonas vaginalis (TV) and Mycoplasma genitalium (MG), true prevalence rates are unknown as many medical centers do not routinely test for these pathogens. Here we assessed the overall STI prevalence detection across different sample types as well as the co-infection rates for CT, NG, TV and MG.



Methods: Specimens were collected from subjects 14 years of age or older at 33 sites throughout the US that included, but were not limited to STI clinics, primary care offices, and gynecology practices. A total of 7,099 male and female, asymptomatic and symptomatic participants were enrolled. Specimens were tested with the Alinity m STI Assay and comparator assays for CT, NG, TV, and MG. Only specimens which were identified positive or negative by the patient infection status were included in the analysis.

Results: Positivity for urogenital CT specimens ranged from 6.5% to 8.4%, NG specimens from 1.3% to 3.1%, TV specimens from 3.0% to 12.6% and MG specimens from 7.5% to 9.7%. 27.2% (135/497) of all CT positives, 40.4% (59/146) of all NG positives, 22.2% (89/401) of all TV positives and 28.7% (138/481) of all MG positives had co-infection with at least one other pathogen. Of these, dual infections account for the majority: 91.9% (124/135) for CT, 79.7% (47/59) for NG, 88.8% (79/89) for TV and 90.6% (125/138) for MG. Triple infection rate 7.4% (10/135) for CT, 18.6% (11/59) for NG, 10.1% (9/89) for TV and 8.7% (12/138) for MG. Only one specimen was positive for all 4 analytes. TV co-infection rate with CT was 18.5% (35/189), 7.2% (10/138) with NG and 32.0% (55/172) for MG. MG co-infection rate with CT was 37.9% (75/198), 12.6% (22/175) with NG.

Conclusion: This study underscores the importance of understanding the prevalence of these pathogens and the importance of multiple pathogen testing. Alinity m STI assay can detect and identify CT, NG, TV and MG from a single sample with a single test thus improving the time to accurate diagnosis and treatment initiation.