The CSTE position statements for chlamydia and gonorrhea outline criteria sufficient for reporting a case to public health. It is important to not conflate case reporting criteria with case classification criteria. The latter is a distinct function of a public health agency. The case reporting criteria are listed below.

Chlamydia case reporting criteria

  1. Health care record contains a diagnosis of infection caused by C. trachomatis.
  2. Isolation of C. trachomatis by culture of a clinical specimen.
  3. Detection of C. trachomatis antigen by direct fluorescent antibody staining in a clinical specimen.
  4. Detection of C. trachomatis antigen by enzyme-linked immunosorbent assay in a clinical specimen.
  5. Detection of C. trachomatis nucleic acid by hybridization with a nucleic acid probe in a clinical specimen.
  6. Detection of C. trachomatis by nucleic acid amplification (e.g., polymerase chain reaction) in a clinical specimen.

Gonorrhea case reporting criteria

  1. Health care record contains a diagnosis of infection or illness caused by N. gonorrhoeae (from the 2009 Position Statement only).
  2. Isolation of N. gonorrhoeae by culture of a clinical specimen.
  3. Microscopic visualization of N. gonorrhoeae (gram-negative intracellular diplococci of typical morphology associated with neutrophils) in a urethral specimen from men.
  4. Detection of N. gonorrhoeae by nucleic acid amplification (e.g., polymerase chain reaction) in a clinical specimen. Detection of N. gonorrhoeae nucleic acid by hybridization with a nucleic acid probe in a clinical specimen.
  5. Detection of N. gonorrhoeae antigens in a clinical specimen.
  6. Microscopic visualization of N. gonorrhoeae (gram-negative intracellular diplococci of typical morphology associated with neutrophils) in an endocervical specimen from a woman.

The above criteria are set by CSTE.

The expert panel understood that the term diagnosis in the 2009 CSTE position statements was meant to indicate that laboratory evidence of the disease existed. Although the latest statement on gonorrhea does not include a diagnosis alone as sufficient for reporting, their consensus was that a clinical diagnosis of infection due to C. trachomatis or N. gonorrhoeae (as evidenced by a SNOMED or ICD-10 code in the EHR) should trigger a case report being sent to public health, even when a laboratory result is unavailable in the EHR. The public health agency is then responsible for classifying the case (e.g., confirmed, probable, suspect, not a case).

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