(P33) TRENDS IN SYPHILIS CONSULTS FROM THE NNPTC'S STD CLINICAL CONSULTATION NETWORK (STDCCN), 2020- 2023

Background:
The National Network of STD Clinical Prevention Training Centers (NNPTC) assists clinicians in the United States with skills, knowledge, and experience to treat and prevent STIs. The NNPTC provides clinical decision support to healthcare professionals through the Clinical Consultation Network (STDCCN). We evaluated STDCCN consults for syphilis support, identifying emerging challenges in case management and opportunities to create resources and provide training/technical assistance.

Methods:
From April 1, 2020, through September 30, 2023, consults were extracted from the STDCCN database. Variables abstracted included year, syphilis- subcategory [serology interpretation, advanced clinical management (neuro/ocular syphilis, alternative treatment/penicillin allergy), and congenital syphilis], occupational setting, requestor-type (clinical versus program), and clinical question. Consults were examined for trends and stratified by requestor-type and syphilis-subcategory.

Results:
Syphilis requests accounted for most consults (54.7%, n= 1833), and increased over time by 70.5% from 285 (47.3% of consults in 2020) to 486 (47.7% of consults in 2023). Most syphilis consults were from clinical staff (76.9%, n=1409), but there was a 146% increase in requests from non-clinical public health program staff (43 [15.1%] in 2020 to 106 [21.8%] in 2023). Most syphilis consults were for serology interpretation (41.7%, n=756), followed by advanced clinical management (37.1%, n=672) and congenital syphilis (21.1%, n=383). While there were increases in total syphilis consults, the largest increases from 2020 to 2023 were for advanced clinical management (153%) and congenital syphilis (72%).

Conclusion:
Syphilis consults accounted for the majority of STDCCN inquiries, with increases over time in multiple syphilis- subcategories. Increases in consults mirror the epidemiology of syphilis in the U.S. and highlights need for greater clinical training to help address the complexities of case management and congenital syphilis. As more non-clinical program staff request consultation, further investigation is warranted to ensure appropriate syphilis trainings, technical assistance, and resources are available to clinical and public health professionals.