Pooling Rectal, Pharyngeal, and Urine Samples to Detect Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium Using Multiplex Polymerase Chain Reaction Is as Effective as Single-Site Testing for Men Who Have Sex With Men

Abstract

Background Screening for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) at pharyngeal, urogenital, and anorectal sites is recommended for men who have sex with men (MSM). Pooling samples is a promising technique, but no data are available when pooled screening also includes Mycoplasma genitalium (MG). The main objective of this study was to examine the sensitivity of pooled samples for detecting CT, NG, and MG in MSM using nucleic acid amplification versus single-site testing. Methods In this multicenter study, MSM with a positive result for CT, NG, or MG were recalled to the clinic for treatment and were asked to participate in this study. Separate samples were sent to a central virological department that proceeded to form the pooled samples. Testing was performed using the multiplex real-time polymerase chain reaction Allplex STI Essential Assay (Seegene, Seoul, Korea), which can simultaneously detect 7 pathogens. Results A total of 130 MSM with at least 1 positive test for CT, NG, or MG were included. A total of 25.4% had a coinfection. The sensitivities of pooled-sample testing were 94.8% for CT, 97.0% for NG, and 92.3% for MG. Pooling failed to detect 8 infections, but pooled-sample analysis missed detecting only samples with a low bacterial load (cycle threshold >35). Conclusions Pooling samples from MSM to detect CT, NG, and MG is as sensitive as individual-site testing for these 3 pathogens using the Allplex assay. Missed infections with a very low bacterial load could have a low impact on further transmission. Clinical Trials Registration. NCT03568695.

Sexually transmitted infections and clinical features in monkeypox (mpox) patients in Madrid, Spain

“…Regarding the pathogens detected, HSV-I/II was the most frequent followed by Neisseria gonorrhoeae and Chlamydia trachomatis reflecting the usual epidemiology of STI in MSM patients [ 9 ]. The sexually transmitted infections are often by pathogens mixed in MSM population [ 10 , 11 ]. The behavior of mpox infection as a new STI is not yet fully understood, so differential diagnosis with other STI is necessary mainly in patients with non-frequent mpox presentations like discharge, proctitis, urethritis or cutaneous rash.…”

A retrospective evaluation of the Euroarray STI-11 multiplex system for the detection of eight STI causing agents

“…However, this elaborate technique needs well-equipped laboratories and skilled personnel, and there are significant costs for supply like reagents for high quality DNA preparation. This is all the more true since STIs often present as coinfection with more than one agent, with coinfection rates of 25% and higher in high-risk populations like men who have sex with men 10 , 11 . This makes it necessary to test for different organisms.…”

Pooling Triple Site Samples to Detect Sexually Transmitted Infections Can Also Be Implemented in Cuba by Using the Sacace Neisseria gonorrhoeae/Chlamydia trachomatis/Mycoplasma genitalium/Trichomonas vaginalis Real-TM Kit

“…To The Editor —We read with interest the recent publication by Prazuck et al concerning the effectiveness of a pooled methodology to detect Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG) in the 3 anatomical sites among men who have sex with men (MSM) using the Allplex STI Essential Assay (Seegene, Seoul, South Korea) [ 1 ]. Due to the increasing evidence that pooling of samples to detect sexually transmitted infections (STIs) is cost-effective with limited reduction in performance characteristics, we decided to validate a similar pooling method in Cuba.…”

“…Prazuck et al described the first multiplex PCR pooling method that also included MG [ 1 ]. Although the need to test for MG is discussed, a pooling methodology using the Multiplex real-time PCR Allplex STI Essential Assay (Seegene, Korea) or the Sacace kit may be used in future surveillance studies.…”