Rising heterosexual syphilis in south London in 2002 prompted Local Enhanced Syphilis Surveillance (LESS) in five of the 10 genitourinary medicine clinics. LESS reported a fall in heterosexual infectious syphilis in 2004 that was corroborated by the National Enhanced Syphilis Surveillance (NESS). However, mandatory clinic Korner Codes 60 (KC60) coding did not support the reported fall; therefore database discrepancies were evaluated. Three databases (KC60, NESS and LESS) were compared in 2004 at selected clinics using clinical notes as the reference. Six clinics participated in NESS. Four clinics participated in both LESS and NESS and three of these clinics were visited. Only 48% (79 of 163) of KC60 infectious syphilis cases were heterosexual, 36% (58 of 163) were men who have sex with men and the rest were incorrectly coded. The NESS and LESS databases captured 80% and 68% of the confirmed heterosexual syphilis cases, respectively. Despite the inaccuracy in mandatory KC60 returns, this surveillance system captured additional heterosexual syphilis cases.

This study shows that most care homes are not fully compliant with current infection prevention and control guidance, and that some unacceptable practices are occurring. In order to reduce potential for transmission of CDI and other diarrhoeal infection in care homes, infection prevention and control practices must be improved, with early diagnosis and control.

No abstract