Abstract：
UNASSIGNED: Sexually transmitted infection (STI) diagnosis is complicated as these infections can present with lower genitourinary tract symptoms (LGUTS) that overlap with other disorders, i.e. urinary tract infections (UTIs). The study\'s objective was to determine potential missed STI diagnoses from patients presenting with LGUTS in the US between January 2010 and December 2019.
UNASSIGNED: The de-identified insurance claims data from the IBM® MarketScan® Research Databases were collected from patients (14-64 years old) who presented with LGUTS, which could be caused by an STI. A \'GAP\' cohort was created, consisting of episodes with potentially delayed STI (Chlamydia trachomatis [CT]/Neisseria gonorrhoeae [NG]) treatment. The intention was to capture episodes where an STI was not initially suspected. Four subgroups were defined depending on the treatment received (fluoroquinolone; azithromycin and/or doxycycline; cephalosporins; gentamicin and azithromycin).
UNASSIGNED: The GAP cohort consisted of 833,574 LGUTS episodes from the original cohort (23,537,812 episodes). Post-index CT/NG testing was carried out for 4.6% and 5.4% of the episodes from men and women, respectively. There were ≥2 return visits for 16.1% and 15.8% of the episodes from men and women, respectively. A substantial percentage of episodes from men (52.1%) and women (68.3%) were diagnosed with a UTI and/or acute cystitis at the index prior to receiving post-index STI treatment. Other top conditions diagnosed at index for men were dysuria (25.8% of the episodes), orchitis/epididymitis (14.3% of the episodes), and acute prostatitis (10.1% of the episodes), and for women were dysuria (24.2% of the episodes), vaginitis/vulvitis/vulvovaginitis (11.7% of the episodes), and cervicitis (3.3% of the episodes).
UNASSIGNED: These findings highlight delayed STI antibiotic treatment and low rates of CT/NG testing, suggesting late STI consideration and suboptimal diagnosis. Additionally, our study illustrates the importance of accurately diagnosing and treating STIs in patients with LGUTS and associated conditions, to avoid antibiotic misuse and complications from delayed administration of appropriate treatment.
UNASSIGNED: The de-identified insurance claims data from the IBM® MarketScan® Research Databases were collected from patients (14-64 years old) who presented with LGUTS, which could be caused by an STI. A \'GAP\' cohort was created, consisting of episodes with potentially delayed STI (Chlamydia trachomatis [CT]/Neisseria gonorrhoeae [NG]) treatment. The intention was to capture episodes where an STI was not initially suspected. Four subgroups were defined depending on the treatment received (fluoroquinolone; azithromycin and/or doxycycline; cephalosporins; gentamicin and azithromycin).
UNASSIGNED: The GAP cohort consisted of 833,574 LGUTS episodes from the original cohort (23,537,812 episodes). Post-index CT/NG testing was carried out for 4.6% and 5.4% of the episodes from men and women, respectively. There were ≥2 return visits for 16.1% and 15.8% of the episodes from men and women, respectively. A substantial percentage of episodes from men (52.1%) and women (68.3%) were diagnosed with a UTI and/or acute cystitis at the index prior to receiving post-index STI treatment. Other top conditions diagnosed at index for men were dysuria (25.8% of the episodes), orchitis/epididymitis (14.3% of the episodes), and acute prostatitis (10.1% of the episodes), and for women were dysuria (24.2% of the episodes), vaginitis/vulvitis/vulvovaginitis (11.7% of the episodes), and cervicitis (3.3% of the episodes).
UNASSIGNED: These findings highlight delayed STI antibiotic treatment and low rates of CT/NG testing, suggesting late STI consideration and suboptimal diagnosis. Additionally, our study illustrates the importance of accurately diagnosing and treating STIs in patients with LGUTS and associated conditions, to avoid antibiotic misuse and complications from delayed administration of appropriate treatment.
摘要：
■性传播感染（STI）的诊断很复杂，因为这些感染可以表现为与其他疾病重叠的下泌尿生殖道症状（LGUTS）。即尿路感染（UTI）。该研究的目的是确定2010年1月至2019年12月期间在美国患有LGUTS的患者可能错过的STI诊断。
来自IBM®MarketScan®ResearchDatabases的去识别保险索赔数据是从患者（14-64岁）中收集的，这些患者出现了可能由STI引起的LGUTS。创建了一个“GAP”队列,包括潜在延迟性性传播感染（沙眼衣原体[CT]/淋病奈瑟菌[NG]）治疗的发作。目的是捕捉最初没有怀疑STI的情节。根据接受的治疗定义了四个亚组（氟喹诺酮；阿奇霉素和/或强力霉素；头孢菌素；庆大霉素和阿奇霉素）。
■GAP队列包括原始队列的833,574例LGUTS发作（23,537,812例）。对男女发作的4.6%和5.4%进行了指数后CT/NG检测，分别。有≥2次回诊的16.1％和15.8％的事件来自男性和女性，分别。在接受索引后STI治疗之前，男性（52.1％）和女性（68.3％）的相当大比例的发作被诊断为UTI和/或急性膀胱炎。其他诊断为男性指数的主要疾病是排尿困难（占发作的25.8％），睾丸炎/附睾炎（14.3％的发作），和急性前列腺炎（10.1％的发作），女性为排尿困难（24.2％的发作），阴道炎/外阴炎/外阴阴道炎（11.7％的发作），和宫颈炎（3.3%的发作）。
■这些发现突出了性传播感染抗生素治疗的延迟和CT/NG检测的低比率，提示晚期性传播感染考虑和次优诊断。此外,我们的研究说明了在患有LGUTS和相关疾病的患者中准确诊断和治疗性传播感染的重要性，以避免抗生素滥用和因延迟给予适当治疗而引起的并发症。
来自IBM®MarketScan®ResearchDatabases的去识别保险索赔数据是从患者（14-64岁）中收集的，这些患者出现了可能由STI引起的LGUTS。创建了一个“GAP”队列,包括潜在延迟性性传播感染（沙眼衣原体[CT]/淋病奈瑟菌[NG]）治疗的发作。目的是捕捉最初没有怀疑STI的情节。根据接受的治疗定义了四个亚组（氟喹诺酮；阿奇霉素和/或强力霉素；头孢菌素；庆大霉素和阿奇霉素）。
■GAP队列包括原始队列的833,574例LGUTS发作（23,537,812例）。对男女发作的4.6%和5.4%进行了指数后CT/NG检测，分别。有≥2次回诊的16.1％和15.8％的事件来自男性和女性，分别。在接受索引后STI治疗之前，男性（52.1％）和女性（68.3％）的相当大比例的发作被诊断为UTI和/或急性膀胱炎。其他诊断为男性指数的主要疾病是排尿困难（占发作的25.8％），睾丸炎/附睾炎（14.3％的发作），和急性前列腺炎（10.1％的发作），女性为排尿困难（24.2％的发作），阴道炎/外阴炎/外阴阴道炎（11.7％的发作），和宫颈炎（3.3%的发作）。
■这些发现突出了性传播感染抗生素治疗的延迟和CT/NG检测的低比率，提示晚期性传播感染考虑和次优诊断。此外,我们的研究说明了在患有LGUTS和相关疾病的患者中准确诊断和治疗性传播感染的重要性，以避免抗生素滥用和因延迟给予适当治疗而引起的并发症。
