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Increased Detection of Pharyngeal and Rectal Gonorrhea in Men Who Have Sex With Men After Transition From Culture To Nucleic Acid Amplification Testing.
Sex Transm Dis. 2017 02; 44(2):114-117.ST

Abstract

BACKGROUND

This before-and-after study measured the impact of a change in testing methods from culture to nucleic acid amplification testing (NAAT) on the detection of pharyngeal and rectal gonorrhea in men who have sex with men (MSM) on a sexual health service level, including the effect on subgroups anticipated to have higher rates of gonorrhea.

METHODS

In March 2015, Melbourne Sexual Health Centre changed its laboratory method for gonococcal testing from culture to NAAT using the Aptima Combo 2 and Aptima GC tests. We compared the proportion of tests positive for rectal and pharyngeal gonorrhea in MSM using culture in 2014 with those using NAAT in 2015.

RESULTS

The proportion of tests positive for rectal gonorrhea by NAAT was double that obtained by culture (8% vs 3.9%; prevalence ratio [PR], 2.0; 95% confidence interval [CI], 1.8-2.4) and 5-fold for pharyngeal gonorrhea (8.3% vs 1.6%; PR, 5.2; 95% CI, 4.2-6.4). Similar increases in test positivity were observed in human immunodeficiency virus (HIV)-positive and HIV-negative men. By NAAT, test positivity for rectal gonorrhea was higher in HIV-positive compared with HIV-negative men (15.4% vs 7.3%; PR, 2.1; 95% CI, 1.7-2.6). Culture and NAAT had similar test positivity for rectal gonorrhea among men who reported contact with gonorrhea (24.9% vs 25.3%, PR 1.0, 95% CI 0.8-1.4) and men who presented with symptoms of proctitis (22.2% vs 27.9%, PR 1.3, 95% CI 0.8-2.0).

CONCLUSIONS

A switch from culture to Aptima Combo 2 testing for extragenital gonorrhea in MSM increased detection and was most marked for pharyngeal infections.

Authors+Show Affiliations

From the *Melbourne Sexual Health Centre, Alfred Health; †Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University; and ‡Microbiological Diagnostic Unit, Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.No 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 availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27984552

Citation

Cornelisse, Vincent J., et al. "Increased Detection of Pharyngeal and Rectal Gonorrhea in Men Who Have Sex With Men After Transition From Culture to Nucleic Acid Amplification Testing." Sexually Transmitted Diseases, vol. 44, no. 2, 2017, pp. 114-117.
Cornelisse VJ, Chow EP, Huffam S, et al. Increased Detection of Pharyngeal and Rectal Gonorrhea in Men Who Have Sex With Men After Transition From Culture To Nucleic Acid Amplification Testing. Sex Transm Dis. 2017;44(2):114-117.
Cornelisse, V. J., Chow, E. P., Huffam, S., Fairley, C. K., Bissessor, M., De Petra, V., Howden, B. P., Denham, I., Bradshaw, C. S., Williamson, D., & Chen, M. Y. (2017). Increased Detection of Pharyngeal and Rectal Gonorrhea in Men Who Have Sex With Men After Transition From Culture To Nucleic Acid Amplification Testing. Sexually Transmitted Diseases, 44(2), 114-117. https://doi.org/10.1097/OLQ.0000000000000553
Cornelisse VJ, et al. Increased Detection of Pharyngeal and Rectal Gonorrhea in Men Who Have Sex With Men After Transition From Culture to Nucleic Acid Amplification Testing. Sex Transm Dis. 2017;44(2):114-117. PubMed PMID: 27984552.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased Detection of Pharyngeal and Rectal Gonorrhea in Men Who Have Sex With Men After Transition From Culture To Nucleic Acid Amplification Testing. AU - Cornelisse,Vincent J, AU - Chow,Eric P F, AU - Huffam,Sarah, AU - Fairley,Christopher K, AU - Bissessor,Melanie, AU - De Petra,Vesna, AU - Howden,Benjamin P, AU - Denham,Ian, AU - Bradshaw,Catriona S, AU - Williamson,Deborah, AU - Chen,Marcus Y, PY - 2016/12/17/pubmed PY - 2017/12/8/medline PY - 2016/12/17/entrez SP - 114 EP - 117 JF - Sexually transmitted diseases JO - Sex Transm Dis VL - 44 IS - 2 N2 - BACKGROUND: This before-and-after study measured the impact of a change in testing methods from culture to nucleic acid amplification testing (NAAT) on the detection of pharyngeal and rectal gonorrhea in men who have sex with men (MSM) on a sexual health service level, including the effect on subgroups anticipated to have higher rates of gonorrhea. METHODS: In March 2015, Melbourne Sexual Health Centre changed its laboratory method for gonococcal testing from culture to NAAT using the Aptima Combo 2 and Aptima GC tests. We compared the proportion of tests positive for rectal and pharyngeal gonorrhea in MSM using culture in 2014 with those using NAAT in 2015. RESULTS: The proportion of tests positive for rectal gonorrhea by NAAT was double that obtained by culture (8% vs 3.9%; prevalence ratio [PR], 2.0; 95% confidence interval [CI], 1.8-2.4) and 5-fold for pharyngeal gonorrhea (8.3% vs 1.6%; PR, 5.2; 95% CI, 4.2-6.4). Similar increases in test positivity were observed in human immunodeficiency virus (HIV)-positive and HIV-negative men. By NAAT, test positivity for rectal gonorrhea was higher in HIV-positive compared with HIV-negative men (15.4% vs 7.3%; PR, 2.1; 95% CI, 1.7-2.6). Culture and NAAT had similar test positivity for rectal gonorrhea among men who reported contact with gonorrhea (24.9% vs 25.3%, PR 1.0, 95% CI 0.8-1.4) and men who presented with symptoms of proctitis (22.2% vs 27.9%, PR 1.3, 95% CI 0.8-2.0). CONCLUSIONS: A switch from culture to Aptima Combo 2 testing for extragenital gonorrhea in MSM increased detection and was most marked for pharyngeal infections. SN - 1537-4521 UR - https://www.unboundmedicine.com/medline/citation/27984552/Increased_Detection_of_Pharyngeal_and_Rectal_Gonorrhea_in_Men_Who_Have_Sex_With_Men_After_Transition_From_Culture_To_Nucleic_Acid_Amplification_Testing_ L2 - https://doi.org/10.1097/OLQ.0000000000000553 DB - PRIME DP - Unbound Medicine ER -