(P15) HETEROGENEITY OF CONGENITAL SYPHILIS DIAGNOSIS AND MANAGEMENT AMONG PEDIATRIC PROVIDERS IN CHICAGO, IL

Background:
Congenital syphilis (CS) cases are on the rise nationally and locally. From 2012 to 2022, the number of CS cases in the US increased by 755% & over a 400% increase in the city of Chicago between 2019 to 2022. Despite the 2021 CDC Treatment guidelines on CS case management, there is sparse literature describing the consistency of following the CDC’s recommendations, particularly given the variety of providers who may be caring for these infants. Objectives were: 1) to gauge similarities and differences among pediatricians and neonatologists managing CS cases, and 2) to determine the needs of health care providers citywide related to diagnosis and management of CS cases.

Methods:
A REDcap survey instrument was created and shared with Chicago-based pediatric providers using Health Alert Network (HAN). Case-based questions, based on CDC CS scenario definitions, inquired about diagnostic and management practices.

Results:
Between December 1st, 2023 – February 29th, 2024, in total, 61 providers responded to the survey including neonatologists (n=19, 31.1%),  pediatric hospitalists (n=12, 19.7%), General Pediatricians (n=11, 18%), Pediatric Infectious Diseases Specialists (n=11, 18%), advanced practitioners (n=3, 4.9%) and 5 other (family medicine, n=5, 8.2%). In 2023, 64% of providers reported seeing at least 4 infants with exposure to maternal syphilis. Approximately, 85% worked at an academic/university medical center. For the three different CS case scenario diagnoses, significant differences were observed in utilization for lumbar puncture, long bone radiographs, serum complete blood count (CBC), and serum liver function tests (LFTs)., in addition to the variation in penicillin dosage and administration.

Conclusion:
Based on this survey results among Chicago pediatricians, we demonstrated significant heterogeneity of clinical and resource utilization of CS diagnosis and management compared to CDC treatment recommendations. There is a need to conduct additional assessments locally and nationally and to standardize diagnosis and clinical management practices.