Detection of Neisseria gonorrhoeae and Chlamydia trachomatis from pooled rectal, pharyngeal and urine specimens in men who have sex with men

2017 ◽  
Vol 94 (4) ◽  
pp. 293-297 ◽  
Author(s):  
David John Speers ◽  
I-Ly Joanna Chua ◽  
Justin Manuel ◽  
Lewis Marshall
Keyword(s):  
Nucleic Acid ◽  
Chlamydia Trachomatis ◽  
Neisseria Gonorrhoeae ◽  
Sexual Health ◽  
Point Of Care ◽  
Standard Of Care ◽  
Urine Samples ◽  
Health Clinic ◽  
Sex With Men ◽  
The Cost

ObjectivesScreening of men who have sex with men (MSM) for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) requires sampling from anorectal and pharyngeal sites in addition to urogenital sampling. Due to the cost of testing multiple anatomical sites individually testing of pooled specimens has potential merit. The Cepheid GeneXpert CT/NG assay (GeneXpert), which also has potential for point-of-care nucleic acid testing in the sexual health clinic, has not been assessed for pooled specimen testing.MethodsWe prospectively compared GeneXpert testing of pooled pharyngeal and rectal swabs with urine samples to standard of care testing of individual specimens from 107 participants using the Roche cobas 4800 CT/NG assay (cobas) for CT and NG in high-risk MSM attending an inner city sexual health clinic.ResultsWe found testing of pooled pharyngeal, rectal and urine samples by the GeneXpert to have 100% agreement for NG and 94% overall agreement for CT when compared with individual specimen testing by cobas. For CT testing, 14 cases were detected for both tests, 4for cobas only, 2 for GeneXpert only and 89 participants were negative for both tests.ConclusionsPooled specimen CT and NG testing by the GeneXpert was accurate when compared with single specimen testing and has potential for screening MSM for CT and NG. The role of pooled specimen testing with the GeneXpert as a point-of-care nucleic acid test in MSM requires further investigation.

scholarly journals Screening for Chlamydia trachomatis and Neisseria gonorrhoeae infection among asymptomatic men who have sex with men in Bangkok, Thailand

2017 ◽  
Vol 29 (6) ◽  
pp. 577-587 ◽  
Author(s):  
Sarika Pattanasin ◽  
Eileen F Dunne ◽  
Punneeporn Wasinrapee ◽  
Jaray Tongtoyai ◽  
Wannee Chonwattana ◽  
...  
Keyword(s):  
Cohort Study ◽  
Nucleic Acid ◽  
Chlamydia Trachomatis ◽  
Neisseria Gonorrhoeae ◽  
Nucleic Acid Amplification ◽  
Anatomic Site ◽  
Number Needed To Screen ◽  
Sex With Men ◽  
Study Participants ◽  
Asymptomatic Men

We report positivity rates of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infection at each anatomic site among asymptomatic men who have sex with men (MSM). We calculated the number needed to screen (NNS) to detect CT and NG infection at each anatomic site. From 2006 to 2010, we enrolled Thai MSM, age ≥ 18 years into the Bangkok MSM Cohort Study. Participants underwent physical examination and had rectal, urethral, and pharyngeal screening for CT and NG infection using nucleic acid amplification tests (NAATs). Of 1744 enrollees, 1696 (97.2%) had no symptoms of CT and NG infection. The positivity rates of CT and NG infection at any site were 14.3% (rectum, urethra, pharynx) and 6.4% (rectum, urethra), respectively. The NNS to detect rectal CT and rectal NG infections was 10 and 16, respectively (p < 0.05). For urethral infection, the NNS of CT was lower than the NNS of NG (22, 121: p < 0.05). The lowest NNS found for rectal CT infection was in HIV-infected MSM (6, 5–8). Asymptomatic CT and NG infection were common among MSM in Bangkok, Thailand and frequently detected in the rectum. In setting where screening in all specimens using NAAT is not feasible, rectal screening should be a priority.

scholarly journals The “3 in 1” Study: Pooling Self-Taken Pharyngeal, Urethral, and Rectal Samples into a Single Sample for Analysis for Detection of Neisseria gonorrhoeae and Chlamydia trachomatis in Men Who Have Sex with Men

2015 ◽  
Vol 54 (3) ◽  
pp. 650-656 ◽  
Author(s):  
B. Sultan ◽  
J. A. White ◽  
R. Fish ◽  
G. Carrick ◽  
N. Brima ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Neisseria Gonorrhoeae ◽  
Standard Of Care ◽  
Nucleic Acid Amplification ◽  
Site Testing ◽  
Predictive Values ◽  
Content Type ◽  
Sexually Transmitted ◽  
Soc Testing ◽  
Sex With Men

Triple-site testing (using pharyngeal, rectal, and urethral/first-void urine samples) forNeisseria gonorrhoeaeandChlamydia trachomatisusing nucleic acid amplification tests detects greater numbers of infections among men who have sex with men (MSM). However, triple-site testing represents a cost pressure for services. MSM over 18 years of age were eligible if they requested testing for sexually transmitted infections (STIs), reported recent sexual contact with eitherC. trachomatisorN. gonorrhoeae, or had symptoms of an STI. Each patient underwent standard-of-care (SOC) triple-site testing, and swabs were taken to form a pooled sample (PS) (pharyngeal, rectal, and urine specimens). The PS was created using two methods during different periods at one clinic, but we analyzed the data in combination because the sensitivity of the two methods did not differ significantly forC. trachomatis(P= 0.774) orN. gonorrhoeae(P= 0.163). The sensitivity of PS testing (92%) was slightly lower than that of SOC testing (96%) for detectingC. trachomatis(P= 0.167). ForN. gonorrhoeae, the sensitivity of PS testing (90%) was significantly lower than that of SOC testing (99%) (P< 0.001). When pharynx-only infections were excluded, the sensitivity of PS testing to detectN. gonorrhoeaeinfections increased to 94%. Our findings show that pooling of self-taken samples could be an effective and cost-saving method, with high negative predictive values. (Interim results of this study were presented at the BASHH 2013 summer meeting.)

Prevalence and predictors of lymphogranuloma venereum among men who have sex with men at a Sydney metropolitan sexual health clinic

Sexual Health ◽  
2013 ◽  
Vol 10 (2) ◽  
pp. 190 ◽  
Author(s):  
David J. Templeton ◽  
Nicola Sharp ◽  
Sophie Gryllis ◽  
Catherine C. O'Connor ◽  
Sally M. Dubedat
Keyword(s):  
Chlamydia Trachomatis ◽  
Confidence Interval ◽  
Sexual Health ◽  
Lymphogranuloma Venereum ◽  
Health Clinic ◽  
Hiv Positive ◽  
Sex With Men

During an 18-month period to June 2012, 1732 anal chlamydia (Chlamydia trachomatis) tests were performed among men who have sex with men (MSM) at RPA Sexual Health in Sydney’s inner west. Positive anal chlamydia samples were subsequently tested for lymphogranuloma venereum (LGV). Seventy-five (4.3%) anal samples were positive for chlamydia among 67 men during the study period. Anal symptoms were reported for 16 out of 75 (21.3%) of anal chlamydia episodes overall. Three episodes of LGV (all serovar L2b) were identified, all three of whom reported anal symptoms (100%, 95% confidence interval (CI): 29.2–100%). In contrast, only 13/72 (18.1%, 95% CI: 10.0–28.9%) of those with non-LGV anal chlamydia reported anal symptoms. LGV was not identified in any of 59 episodes of asymptomatic anal chlamydia (0%, 95% CI: 0–6.1%). Of those with LGV, two were known to be HIV-positive and one subsequently seroconverted to HIV within a year of the LGV diagnosis. Our findings suggest that routine LGV testing among MSM is not warranted, except among those with anal symptoms.

scholarly journals 1751High Prevalence of Rectal Neisseria gonorrhoeae and Chlamydia trachomatis Infection in Women Attending an Urban Sexual Health Clinic

2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S471-S471
Author(s):  
Jose Bazan ◽  
Patricia Reese ◽  
Allahna Esber ◽  
Samantha Lahey ◽  
Melissa Ervin ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Neisseria Gonorrhoeae ◽  
Sexual Health ◽  
Health Clinic ◽  
Chlamydia Trachomatis Infection

Auditing the use and assessing the clinical utility of microscopy as a point-of-care test for Neisseria gonorrhoeae in a Sexual Health clinic

2017 ◽  
Vol 29 (2) ◽  
pp. 157-163 ◽  
Author(s):  
Sarah Mensforth ◽  
Nicola Thorley ◽  
Keith Radcliffe
Keyword(s):  
Neisseria Gonorrhoeae ◽  
Clinical Utility ◽  
Point Of Care ◽  
Nucleic Acid Amplification ◽  
Contact Tracing ◽  
Health Clinic ◽  
Exact Test ◽  
Point Of Care Test ◽  
Sex With Men ◽  
Prompt Diagnosis

We assessed whether urethral microscopy was performed as per clinic protocol for male clinic attendees reporting contact with Neisseria gonorrhoeae (GC), urethral symptoms or given a diagnosis of epididymo-orchitis (EO) over a 12-month period (9732 patients). Prevalence of gonorrhoea in the contacts, urethral symptoms and EO groups was 50, 12.7 and 1.6%, respectively. Microscopy was performed reliably for contacts (96%), those with discharge/dysuria with evidence of urethritis on examination (98%), but not those with EO (43%). We explored the clinical utility of microscopy as a point-of-care test for identifying urethral GC in each subgroup, using the APTIMA Combo 2 CT/GC nucleic acid amplification test as the comparator (1710 patients). Sensitivity of microscopy for each subgroup was good; there was no statistical difference between subgroup sensitivity using Fisher’s exact test. Microscopy is valuable to ensure prompt diagnosis and contact tracing. All GC contacts were treated ‘epidemiologically’; however, half of GC contacts did not have GC. Microscopy identified the majority of GC cases, including amongst contacts (71% of heterosexual contacts, 66% of contacts reporting sex with men). We propose that epidemiological treatment for GC contacts should be reconsidered on the grounds of antibiotic stewardship, favouring use of microscopy to guide treatment decisions.

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