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Self-taken pharyngeal and rectal swabs are appropriate for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in asymptomatic men who have sex with men.
Sex Transm Infect. 2008 Nov; 84(6):488-92.ST

Abstract

INTRODUCTION

Self-taken specimens from men who have sex with men (MSM) could be important in reducing high levels of demand on sexual health services. The performance of self-taken specimens for the detection of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) from both pharyngeal and rectal sites in asymptomatic MSM was assessed.

METHODS

MSM were examined according to clinic protocol: a rectal and pharyngeal swab for GC culture and a rectal swab for the CT strand displacement assay. An extra set of nurse-taken and self-taken pharyngeal and rectal specimens were also requested and were tested using the Aptima Combo 2 assay and the result compared with the routine clinic result, which was considered the gold standard.

RESULTS

A total of 272 MSM was recruited and the sensitivity and specificity of nurse-taken and patient-taken swabs, respectively, was as follows: rectal GC: 94.9% and 90.1% (nurse); 92.3% and 87.9% (patient); pharyngeal GC: 88.2% and 91.8% (nurse); 100% and 87.8% (patient); rectal CT: 80.0% and 99.6% (nurse); 91.4% and 98.2% (patient). No significant difference in sensitivity or specificity was observed between the nurse-taken and the patient-taken rectal swabs for either GC or CT. For the detection of GC from the pharynx, comparable sensitivities were achieved between nurse-taken and patient-taken swabs (p = 0.5); however, a significant difference in specificity was observed (p = 0.006). This was due to a higher number of false GC-positive self-taken pharyngeal swabs from patients with high rates (90.9%; 10/11) of confirmed concurrent GC infection in different anatomical sites.

CONCLUSIONS

MSM are able to collect self-taken rectal and pharyngeal swabs that are comparable to those taken by clinicians.

Authors+Show Affiliations

Sexually Transmitted Bacteria Reference Laboratory, Health Protection Agency, 61 Colindale Avenue, London NW95HT, UK. sarah.alexander@hpa.org.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19028953

Citation

Alexander, S, et al. "Self-taken Pharyngeal and Rectal Swabs Are Appropriate for the Detection of Chlamydia Trachomatis and Neisseria Gonorrhoeae in Asymptomatic Men Who Have Sex With Men." Sexually Transmitted Infections, vol. 84, no. 6, 2008, pp. 488-92.
Alexander S, Ison C, Parry J, et al. Self-taken pharyngeal and rectal swabs are appropriate for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in asymptomatic men who have sex with men. Sex Transm Infect. 2008;84(6):488-92.
Alexander, S., Ison, C., Parry, J., Llewellyn, C., Wayal, S., Richardson, D., Phillips, A., Smith, H., & Fisher, M. (2008). Self-taken pharyngeal and rectal swabs are appropriate for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in asymptomatic men who have sex with men. Sexually Transmitted Infections, 84(6), 488-92. https://doi.org/10.1136/sti.2008.031443
Alexander S, et al. Self-taken Pharyngeal and Rectal Swabs Are Appropriate for the Detection of Chlamydia Trachomatis and Neisseria Gonorrhoeae in Asymptomatic Men Who Have Sex With Men. Sex Transm Infect. 2008;84(6):488-92. PubMed PMID: 19028953.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Self-taken pharyngeal and rectal swabs are appropriate for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in asymptomatic men who have sex with men. AU - Alexander,S, AU - Ison,C, AU - Parry,J, AU - Llewellyn,C, AU - Wayal,S, AU - Richardson,D, AU - Phillips,A, AU - Smith,H, AU - Fisher,M, AU - ,, PY - 2008/11/26/pubmed PY - 2009/2/5/medline PY - 2008/11/26/entrez SP - 488 EP - 92 JF - Sexually transmitted infections JO - Sex Transm Infect VL - 84 IS - 6 N2 - INTRODUCTION: Self-taken specimens from men who have sex with men (MSM) could be important in reducing high levels of demand on sexual health services. The performance of self-taken specimens for the detection of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) from both pharyngeal and rectal sites in asymptomatic MSM was assessed. METHODS: MSM were examined according to clinic protocol: a rectal and pharyngeal swab for GC culture and a rectal swab for the CT strand displacement assay. An extra set of nurse-taken and self-taken pharyngeal and rectal specimens were also requested and were tested using the Aptima Combo 2 assay and the result compared with the routine clinic result, which was considered the gold standard. RESULTS: A total of 272 MSM was recruited and the sensitivity and specificity of nurse-taken and patient-taken swabs, respectively, was as follows: rectal GC: 94.9% and 90.1% (nurse); 92.3% and 87.9% (patient); pharyngeal GC: 88.2% and 91.8% (nurse); 100% and 87.8% (patient); rectal CT: 80.0% and 99.6% (nurse); 91.4% and 98.2% (patient). No significant difference in sensitivity or specificity was observed between the nurse-taken and the patient-taken rectal swabs for either GC or CT. For the detection of GC from the pharynx, comparable sensitivities were achieved between nurse-taken and patient-taken swabs (p = 0.5); however, a significant difference in specificity was observed (p = 0.006). This was due to a higher number of false GC-positive self-taken pharyngeal swabs from patients with high rates (90.9%; 10/11) of confirmed concurrent GC infection in different anatomical sites. CONCLUSIONS: MSM are able to collect self-taken rectal and pharyngeal swabs that are comparable to those taken by clinicians. SN - 1472-3263 UR - https://www.unboundmedicine.com/medline/citation/19028953/Self_taken_pharyngeal_and_rectal_swabs_are_appropriate_for_the_detection_of_Chlamydia_trachomatis_and_Neisseria_gonorrhoeae_in_asymptomatic_men_who_have_sex_with_men_ L2 - https://sti.bmj.com/lookup/pmidlookup?view=long&pmid=19028953 DB - PRIME DP - Unbound Medicine ER -