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Trends in gonorrhoea positivity by nucleic acid amplification test versus culture among Australian heterosexual men with a low prevalence of gonorrhoea, 2007-2014.
Sex Transm Infect. 2016 Dec; 92(8):625-628.ST

Abstract

BACKGROUND

Testing for gonorrhoea with nucleic acid amplification tests (NAATs) is not recommended in low-prevalence populations as it results in high numbers of false positive results. The aim of this study was to examine temporal trends of gonorrhoea positivity by NAAT and culture in heterosexual men in Victoria, Australia following recent increases in gonorrhoea notifications.

METHODS

Three data sources between 2007 and 2014 were used in this study: notification data from the Victorian Department of Health, Medicare testing numbers of single chlamydia and dual NAATs performed, and electronic records on heterosexual men attending Melbourne Sexual Health Centre (MSHC).

RESULTS

Notifications of gonorrhoea by NAAT (with/without culture) in heterosexual men in Victoria rose threefold from 74 in 2007 to 238 in 2014, while the number of dual NAATs ordered over the same period underwent a fivefold increase from 14 061 to 71 860. The overall proportion of NAATs that were positive for gonorrhoea in Victoria was low and fell from 0.53% in 2007 to 0.33% in 2014 (Ptrend=0.002). Of the 28014 new heterosexual men attending MSHC, the gonorrhoea positivity by culture was 0.9%, and chlamydia positivity by NAAT was 8.5%. The positivity of both infections did not change over time.

CONCLUSIONS

These data suggest that gonorrhoea prevalence in heterosexual men is low and stable, despite annual increases in notifications. Guidelines in most countries recommend restricting testing to groups or populations with prevalence over 1%, symptomatic individuals or those at increased epidemiological risk. These data indicate gonorrhoea testing should not automatically accompany chlamydia screening in low-risk heterosexual men.

Authors+Show Affiliations

Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia. Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Victoria, Australia.Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia. Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Victoria, Australia.Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Parkville, Victoria, Australia. Murdoch Childrens Research Institute, Parkville, Victoria, Australia. Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia.Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia. National Skin Centre, Singapore, Singapore.Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia. Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Victoria, Australia.Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia. Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Victoria, Australia.Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia. Faculty of Medicine, Nursing and Health Sciences, Central Clinical School, Monash University, Melbourne, Victoria, Australia.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

26888660

Citation

Mannion, Patrick K., et al. "Trends in Gonorrhoea Positivity By Nucleic Acid Amplification Test Versus Culture Among Australian Heterosexual Men With a Low Prevalence of Gonorrhoea, 2007-2014." Sexually Transmitted Infections, vol. 92, no. 8, 2016, pp. 625-628.
Mannion PK, Fairley CK, Fehler G, et al. Trends in gonorrhoea positivity by nucleic acid amplification test versus culture among Australian heterosexual men with a low prevalence of gonorrhoea, 2007-2014. Sex Transm Infect. 2016;92(8):625-628.
Mannion, P. K., Fairley, C. K., Fehler, G., Tabrizi, S. N., Tan, W. S., Chen, M. Y., Bradshaw, C. S., & Chow, E. P. (2016). Trends in gonorrhoea positivity by nucleic acid amplification test versus culture among Australian heterosexual men with a low prevalence of gonorrhoea, 2007-2014. Sexually Transmitted Infections, 92(8), 625-628. https://doi.org/10.1136/sextrans-2015-052246
Mannion PK, et al. Trends in Gonorrhoea Positivity By Nucleic Acid Amplification Test Versus Culture Among Australian Heterosexual Men With a Low Prevalence of Gonorrhoea, 2007-2014. Sex Transm Infect. 2016;92(8):625-628. PubMed PMID: 26888660.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trends in gonorrhoea positivity by nucleic acid amplification test versus culture among Australian heterosexual men with a low prevalence of gonorrhoea, 2007-2014. AU - Mannion,Patrick K, AU - Fairley,Christopher K, AU - Fehler,Glenda, AU - Tabrizi,Sepehr N, AU - Tan,Wei Sheng, AU - Chen,Marcus Y, AU - Bradshaw,Catriona S, AU - Chow,Eric P F, Y1 - 2016/02/17/ PY - 2015/07/02/received PY - 2015/12/08/revised PY - 2016/01/23/accepted PY - 2016/2/19/pubmed PY - 2017/6/2/medline PY - 2016/2/19/entrez KW - CHLAMYDIA TRACHOMATIS KW - EPIDEMIOLOGY (GENERAL) KW - GONORRHOEA KW - MEN SP - 625 EP - 628 JF - Sexually transmitted infections JO - Sex Transm Infect VL - 92 IS - 8 N2 - BACKGROUND: Testing for gonorrhoea with nucleic acid amplification tests (NAATs) is not recommended in low-prevalence populations as it results in high numbers of false positive results. The aim of this study was to examine temporal trends of gonorrhoea positivity by NAAT and culture in heterosexual men in Victoria, Australia following recent increases in gonorrhoea notifications. METHODS: Three data sources between 2007 and 2014 were used in this study: notification data from the Victorian Department of Health, Medicare testing numbers of single chlamydia and dual NAATs performed, and electronic records on heterosexual men attending Melbourne Sexual Health Centre (MSHC). RESULTS: Notifications of gonorrhoea by NAAT (with/without culture) in heterosexual men in Victoria rose threefold from 74 in 2007 to 238 in 2014, while the number of dual NAATs ordered over the same period underwent a fivefold increase from 14 061 to 71 860. The overall proportion of NAATs that were positive for gonorrhoea in Victoria was low and fell from 0.53% in 2007 to 0.33% in 2014 (Ptrend=0.002). Of the 28014 new heterosexual men attending MSHC, the gonorrhoea positivity by culture was 0.9%, and chlamydia positivity by NAAT was 8.5%. The positivity of both infections did not change over time. CONCLUSIONS: These data suggest that gonorrhoea prevalence in heterosexual men is low and stable, despite annual increases in notifications. Guidelines in most countries recommend restricting testing to groups or populations with prevalence over 1%, symptomatic individuals or those at increased epidemiological risk. These data indicate gonorrhoea testing should not automatically accompany chlamydia screening in low-risk heterosexual men. SN - 1472-3263 UR - https://www.unboundmedicine.com/medline/citation/26888660/Trends_in_gonorrhoea_positivity_by_nucleic_acid_amplification_test_versus_culture_among_Australian_heterosexual_men_with_a_low_prevalence_of_gonorrhoea_2007_2014_ L2 - http://sti.bmj.com/cgi/pmidlookup?view=long&pmid=26888660 DB - PRIME DP - Unbound Medicine ER -