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.
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: Duygu Durukan; Tim R H Read; Catriona S Bradshaw; Christopher K Fairley; Deborah A Williamson; Vesna De Petra; Kate Maddaford; Rebecca Wigan; Marcus Y Chen; Anne Tran; Eric P F Chow Journal: J Clin Microbiol Date: 2020-04-23 Impact factor: 5.948
Authors: Alison Footman; Jodie Dionne-Odom; Kristal J Aaron; James L Raper; Barbara Van Der Pol Journal: Sex Transm Dis Date: 2020-03 Impact factor: 2.830
Authors: Lisa A Cosentino; Claire S Danby; Lorna K Rabe; Ingrid Macio; Leslie A Meyn; Harold C Wiesenfeld; Sharon L Hillier Journal: J Clin Microbiol Date: 2017-07-05 Impact factor: 5.948
Authors: Eric P F Chow; Sandra Walker; Jane S Hocking; Catriona S Bradshaw; Marcus Y Chen; Sepehr N Tabrizi; Benjamin P Howden; Matthew G Law; Kate Maddaford; Tim R H Read; David A Lewis; David M Whiley; Lei Zhang; Andrew E Grulich; John M Kaldor; Vincent J Cornelisse; Samuel Phillips; Basil Donovan; Anna M McNulty; David J Templeton; Norman Roth; Richard Moore; Christopher K Fairley Journal: BMC Infect Dis Date: 2017-06-28 Impact factor: 3.090
Authors: Vincent J Cornelisse; Lei Zhang; Matthew Law; Marcus Y Chen; Catriona S Bradshaw; Clare Bellhouse; Christopher K Fairley; Eric P F Chow Journal: BMC Infect Dis Date: 2018-02-27 Impact factor: 3.090
Authors: Vincent J Cornelisse; Christopher K Fairley; Mark Stoove; Jason Asselin; Eric P F Chow; Brian Price; Norman J Roth; Jeff Willcox; B K Tee; Matthew Penn; Christina C Chang; Judith Armishaw; George Forgan-Smith; Edwina J Wright Journal: Clin Infect Dis Date: 2018-11-28 Impact factor: 9.079