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Use of nucleic acid amplification testing for diagnosis of anorectal sexually transmitted infections.

Abstract

Nucleic acid amplification testing (NAAT) has become the preferred method to detect Chlamydia trachomatis and Neisseria gonorrhoeae, but no commercial tests are cleared by the U.S. Food and Drug Administration for use with rectal swab samples. This study evaluated the performance of strand displacement amplification (SDA) and transcription-mediated amplification (TMA) to detect C. trachomatis and N. gonorrhoeae and to determine if TMA could also detect Mycoplasma genitalium and Trichomonas vaginalis in men and women reporting a history of receptive anal intercourse. Discordant results between the NAATs were reevaluated using the Aptima CT or Aptima GC assay, each of which targets primers other than those targeted by the Aptima Combo 2 (AC2) assay, as the confirmatory test. Of 497 evaluable participants, 41 (8.2%) were positive for C. trachomatis, 21 (4.2%) were positive for N. gonorrhoeae, 26 (5.2%) were positive for T. vaginalis, and 47 (9.5%) were positive for M. genitalium. The sensitivity and specificity of the C. trachomatis test were 100% and 99.8% for AC2 and 56.1% and 100% for SDA, respectively. The sensitivity and specificity of the N. gonorrhoeae test were 100% and 100% for AC2 and 76.2% and 100% for SDA, respectively, while culture was only 23.8% sensitive. Of the 114 participants who had a positive result for any of the four infectious agents, 16 were positive for two pathogens and 3 were positive for three pathogens. These data suggest that rectal infection is common and that the AC2 is superior to SDA for the detection of C. trachomatis and N. gonorrhoeae from rectal swab samples.

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    • Authors

    Cosentino LA, Campbell T, Jett A, Macio I, Zamborsky T, Cranston RD, Hillier SL

    Institution

    Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

    Source

    Journal of clinical microbiology 50:6 2012 Jun pg 2005-8

    MeSH

    Adolescent
    Adult
    Chlamydia trachomatis
    Female
    Humans
    Male
    Middle Aged
    Molecular Diagnostic Techniques
    Mycoplasma genitalium
    Neisseria gonorrhoeae
    Nucleic Acid Amplification Techniques
    Rectum
    Sensitivity and Specificity
    Sexual Behavior
    Sexually Transmitted Diseases
    Trichomonas vaginalis
    United States
    Young Adult

    Pub Type(s)

    Evaluation Studies
    Journal Article
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    22493338