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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.
J Clin Microbiol. 2016 Mar; 54(3):650-6.JC

Abstract

Triple-site testing (using pharyngeal, rectal, and urethral/first-void urine samples) for Neisseria gonorrhoeae and Chlamydia trachomatis using 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 either C. trachomatis or N. 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 for C. trachomatis (P = 0.774) or N. gonorrhoeae (P = 0.163). The sensitivity of PS testing (92%) was slightly lower than that of SOC testing (96%) for detecting C. trachomatis (P = 0.167). For N. 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 detect N. gonorrhoeae infections 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.).

Authors+Show Affiliations

Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, United Kingdom Research Department of Infection and Population Health, University College London, London, United Kingdom b.sultan@ucl.ac.uk.Department of Genitourinary Medicine, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, United Kingdom.Research Department of Infection and Population Health, University College London, London, United Kingdom.Research Department of Infection and Population Health, University College London, London, United Kingdom.Research Department of Infection and Population Health, University College London, London, United Kingdom.Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, United Kingdom.Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, United Kingdom Research Department of Infection and Population Health, University College London, London, United Kingdom.Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, United Kingdom Research Department of Infection and Population Health, University College London, London, United Kingdom.Mortimer Market Centre, Central and North West London NHS Foundation Trust, London, United Kingdom.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26719439

Citation

Sultan, B, et al. "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." Journal of Clinical Microbiology, vol. 54, no. 3, 2016, pp. 650-6.
Sultan B, White JA, Fish R, et al. 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. J Clin Microbiol. 2016;54(3):650-6.
Sultan, B., White, J. A., Fish, R., Carrick, G., Brima, N., Copas, A., Robinson, A., Gilson, R., Mercey, D., & Benn, P. (2016). 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. Journal of Clinical Microbiology, 54(3), 650-6. https://doi.org/10.1128/JCM.02460-15
Sultan B, et al. 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. J Clin Microbiol. 2016;54(3):650-6. PubMed PMID: 26719439.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Sultan,B, AU - White,J A, AU - Fish,R, AU - Carrick,G, AU - Brima,N, AU - Copas,A, AU - Robinson,A, AU - Gilson,R, AU - Mercey,D, AU - Benn,P, Y1 - 2015/12/30/ PY - 2015/09/10/received PY - 2015/12/22/accepted PY - 2016/1/1/entrez PY - 2016/1/1/pubmed PY - 2016/12/15/medline SP - 650 EP - 6 JF - Journal of clinical microbiology JO - J Clin Microbiol VL - 54 IS - 3 N2 - Triple-site testing (using pharyngeal, rectal, and urethral/first-void urine samples) for Neisseria gonorrhoeae and Chlamydia trachomatis using 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 either C. trachomatis or N. 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 for C. trachomatis (P = 0.774) or N. gonorrhoeae (P = 0.163). The sensitivity of PS testing (92%) was slightly lower than that of SOC testing (96%) for detecting C. trachomatis (P = 0.167). For N. 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 detect N. gonorrhoeae infections 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.). SN - 1098-660X UR - https://www.unboundmedicine.com/medline/citation/26719439/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_ L2 - http://jcm.asm.org/cgi/pmidlookup?view=long&amp;pmid=26719439 DB - PRIME DP - Unbound Medicine ER -