A year in a sexually-transmitted disease (STD) outpatients clinic in Italy: prevalence and characteristics of chlamydia, gonorrhoea and syphilis infections

Objectives: Bacterial sexually transmitted diseases (STDs) are a public health problem worldwide, but there are marked differences in National Surveillance Systems across the Europe. For example, in Italy chlamydia data are not reported nor any screening programs are available for STDs; syphilis and gonorrhoea should be reported to our national register, but physicians infrequently do. Therefore their diffusion is highly underestimated and the Italian sentinel system can not collect epidemiological data for a full coverage, completeness, and representativeness of national data. In this study we report on prevalence and characteristics of chlamydia (CT), gonorrhoea (GC) and syphilis infections in patients attending a STD Outpatients Clinic in Italy. Methods: In the period between January and December 2011 we collected data of all the patients attending the STD Outpatients Clinic of S. Orsola Hospital, Bologna and being investigated for syphilis, GC and/or CT infections. A blood sample was tested on ARCHITECT Syphilis TP (Abbott) for serological diagnosis of syphilis; positive results were confirmed by TPHA and RPR tests (Randox) and/or a “home made” Western Blot. A urine specimen was collected for DNA detection of Chlamydia trachomatis and Neisseria gonorrhoeae by VERSANT CT/GC DNA 1.0 Assay (Siemens). Results: Total prevalence of antibodies anti-T. pallidum was 21.6% (406/1887). In 173 cases syphilis was diagnosed for the first time, with a prevalence of 9.2%. A total of 1076 patients were investigated for CT/GC infection, with a prevalence of 11.5% (124/1076) for CT and 4.5% (48/1076) for GC: 8 patients were positive for both pathogens. Characteristics of infected patients are reported in table 1. Conclusions: This study highlights the diffusion of STDs in our Country and the need to have clear available data about the real impact on public health. Infection by CT showed the higher prevalence, as expected, on the basis of data reported from other European countries. Moreover, the high number of asymptomatic women underlines the need to implement CT screening programs. In their absence, young people or non-Italian women, for example, rarely seek for medical care. New outbreaks of bacterial STDs seems to be frequent in specific groups of patients (MSM for GC; immigrate women for syphilis), as already reported in other EU Countries. Correct diagnosis for STDs is important to know their real diffusion, to individuate risk factors and to prevent transmission.