Gonococcal NAATs: what is the current state of play in England and Wales?

Abstract

The aim of this study was to determine how widespread the use is of dual nucleic acid amplification tests (NAATs) for the diagnosis of both Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) in England and Wales. A structured telephone questionnaire was used to collect information on the method of dual testing used by laboratories, the patient groups tested, the types of specimens obtained and the use of GC culture. Of the 108 laboratories participating, 29% performed dual CT and GC NAAT assays. The platforms used included: (i) BD Probetec (19/31), (ii) Aptima Combo 2 (9/31) and (iii) COBAS AMPLICOR (2/31). GC-positive specimens were either repeated using the same test (21) or an alternative target (9). Most laboratories confirmed positive GC NAATs by performing culture (26/31). Laboratories performed dual NAAT testing on specimens sourced from both community and genitourinary medicine clinic settings, and on a wide variety of different specimen types. This survey highlights a lack of consistency in the current use of dual NAAT platforms in the UK and the need for national guidelines.

Estimating the prevalence of gonococcal resistance to antimicrobials in England and Wales

“…However, owing to their high sensitivity, reduced cost, use of non-invasive samples and simplicity, nucleic acid amplification tests (NAATs) are now routinely used to diagnose gonococcal infection. Increasingly, they are also being used to confirm the diagnosis in preference to culture 16. As the national data include all cases regardless of how confirmation was achieved, they will better reflect trends in underlying incidence and distribution of gonococcal infection in England and Wales.…”

Evaluation of strategies for confirming Neisseria gonorrhoeae nucleic acid amplification tests

“…platform and confirmatory testing is required if these laboratories are to comply with national N. gonorrhoeae NAAT guidelines (Benzie et al, 2010;Health Protection Agency, 2010;Dave & Eastaway, 2007). It was determined that independent in-house real-time PCR assays, combined with appropriate DNA extraction facilities, are suitable confirmation tests for SDA assay specimens as high rates of correlation can be achieved.…”

“…An increasing number of laboratories in England and Wales are using dual nucleic acid amplification tests (NAATs) for the combined detection of both chlamydia and Neisseria gonorrhoeae infections (Benzie et al, 2010). N. gonorrhoeae NAATs offer a number of advantages over traditional culture methods, including improved patient flow, faster turnaround times and non-invasive sampling.…”

Survey of the laboratory diagnosis of gonorrhoea and chlamydial infection in the UK

“…In 2007, 29% of laboratories were using dual NAATs3 but there are no data on current usage to inform testing guidelines. We used an internet-based Public Health England survey tool comprised of 26 questions emailed to UK microbiology laboratories from May to June 2013 to assess usage.…”