MEMO: Shortage of Bicillin and Chlamydia/Gonorrhea Specimen Collection Kits

TO:  Health care providers in the Niagara region

FROM: Sexual Health program

REFERENCE: Shortage of Bicillin and Chlamydia/Gonorrhea Specimen Collection Kits

DATE:  December 2020

Shortage of Bicillin

• The Ministry of Health has notified us of a Bicillin shortage used for treatment of syphilis
• There is currently no timeline for when this shortage will end
• Please continue to order Bicillin as per usual practice from Niagara Region Public Health (NRPH) as needed using the Sexually Transmitted Infections Medications and Condoms Order Form
• NRPH will provide future recommendations for practice if necessary

Global Demand Affects Supply of Chlamydia/Gonorrhea Collection Kits

• Public Health Ontario (PHO) has identified a shortage of Hologic Aptima® collection kits for chlamydia trachomatis and Neisseria gonorrhea nucleic acid amplification testing (NAAT)
  • PHO will review all requests for collection kits based on your historical specimen submissions to PHO for this testing and adjust based on the current available stock

Recommendations for Practice

NAAT is the recommended method for initial screening or testing of chlamydia and gonorrhea collected from the following specimen sources: urethral, penile meatal, clinician and patient collected vaginal, endocervical, rectal and pharyngeal. PHO is recommending that specimen collection be prioritized based on physician assessment and routine screening selecting restricted based on clinical indications and risk factors for testing.

• The Centres for Disease Control and Prevention (CDC) has clinical advice prioritizing for STI testing in the context of limited test kit availability. However, when treating patients for STI’s, please refer to NRPH’s STI Treatment Reference Guide.
• Please monitor the expiration of kits to prioritize the use of those with shorter expiry dates first.  The use of expired kits is generally not recommended; however, in light of the global shortage, PHO’s laboratory will accept specimens collected with expired kits.  These specimens will be tested and the result will be reported with a disclaimer.

More Information

• The PHO laboratory webpage will be updated when the supply of collection kits improves
• See PHO memos:
  • Specimen collection kit requests for Chlamydia trachomatis and Neisseria gonorrhoeae Nucleic Acid Amplification testing
  • Expired Specimen collection kits for Chlamydia trachomatis and Neisseria gonorrhoeae Nucleic Acid Amplification testing