Comparison of self-obtained penile-meatal swabs to urine for the detection ofC. trachomatis,N. gonorrhoeaeandT. vaginalis

Abstract

Background Self-obtained penile-meatal swabs and urine specimens have been used for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) for outreach screening in men. Objective To compare the sensitivity of self-collected male penile-meatal swabs and urine for the detection of CT, NG and TV. Methods Matching penile-meatal swabs and urines were collected at home after recruitment to the study; via the internet programme, http://www.iwantthekit.org. The instructions directed the participant to place the tip of a Copan flocked swab at the meatal opening of the urethra to collect the penile-meatal sample. Two ml of urine was collected after the swab onto a Copan sponge-on-a-shaft collection device. Both swab and urine were placed into individual Aptima transport media tubes and mailed to the laboratory for testing. All specimens were tested for CT and NG using the GenProbe Aptima Combo2 Assay and for TV using GenProbe Aptima Analyte Specific Reagents with TV oligonucleotides. Results Of 634 men, 86 (13.6%) were positive for CT, 9 (1.4%) were positive for NG and 56 (9.3%) positive for TV. For CT, swab sensitivity was 81/86 (94.2%), and urine sensitivity was 66/86 (76.7%). For NG, swab sensitivity was 9/9 (100%) and urine sensitivity was 8/9 (88.9%). For TV, swab sensitivity was 45/56 (80.4%) and urine sensitivity was 22/56 (39.3%). Conclusions Self-obtained penile-meatal swabs provided for the detection of more CT, NG and TV, than urine specimens.

2016 United Kingdom national guideline on the sexual health care of men who have sex with men

“…Where possible, prior to treatment, all sites positive for gonorrhoea on NAAT should have a culture performed to monitor antimicrobial susceptibility (112,114). First-void urine is the specimen of choice for genital sampling, but self-taken urethral meatus swabs have recently demonstrated equivalent sensitivity in the detection of both infections, and may be considered (115,116). There is evidence to suggest that self-collected pharyngeal and rectal swabs perform as well as clinician-taken swabs from both sites, although published studies are not powered to exclude a difference in performance.…”

Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence

“…39,40 If first-void urine (FVU) is to be used, studies from Australia 41 and overseas 42 have suggested the sensitivity for chlamydia detection in the male urethra is similar if urine specimens are collected 20 min after the last void, compared with 1 h after the last void.…”

Molecular Diagnostics in the Diagnosis of Parasitic Infection

“…Dize and colleagues have shown selfcollected penile-meatal swabs to provide greater sensitivity than urine (80% vs. 39%, respectively) with the Aptima T. vaginalis assay (Dize et al, 2013). Semen may also be tested (Workowski & Bolan, 2014).…”