Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae Infection in Pediatric Private Practice

Background. Universal screening of sexually active adolescents for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) has been recommended in settings in which prevalence is 2% or greater. Although believed to be above 2%, the prevalence of CT and GC infection in private practice settings has not been clearly established and may affect screening practices. Objectives. To determine CT and GC infection prevalence in 2 pediatric private practices. Design. Cross-sectional study. Setting. Two pediatric private practices in suburban North Carolina. Patients. Convenience sample of patients aged 15 to 24 years who were seen from August 1998 through June 1999. Main Outcome Measures. Prevalence of CT and GC infection. Results. Of 1114 eligible patients, 803 (72%) completed questionnaires and provided urine specimens tested for CT and GC infection using ligase chain reaction assays. Mean age was 17.1 years (standard deviation: 1.8). Most participants were female (63%), white (87%), and from highly educated families (64% of their mothers graduated from college). Sexual activity was reported by 41%. Prevalence of CT infection in all participants was 0.9% (confidence interval [CI]: 0.4%–1.8%); in sexually active participants, 2.1% (CI: 0.9%–4.3%); in sexually active females, 2.7% (CI: 1.0%–5.7%); and in sexually active males, 0.9% (CI: 0.0%–5.1%). One case of GC infection was found. Conclusions. The prevalence of CT and GC infection in this private practice population was much lower than reported in other settings. Screening recommendations may need to be reassessed if other low prevalence populations are found.