Sampling technique and detection rates of oropharyngeal and anorectal gonorrhoea using nucleic acid amplification tests in men who have sex with men

Yang, Tim Z T; Chen, Marcus Y; Read, Tim; Needleman, Robert; Bradshaw, Catriona; Fortune, Ria; Fairley, Christopher K.; Chow, Eric P F

doi:10.1136/sextrans-2017-053339

Cited by 6 publications

(3 citation statements)

References 19 publications

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“…Third, we have previously shown that use of mouthwash reduced the detection of N. gonorrrhoeae at the tonsillar fossea, but does not reduce the detection of N.gonorrhoeae at the posterior oropharyngeal wall even after gargling 31. Clinicians at the MSHC routinely sample both the tonsils and oropharynx when taking a swab for oropharyngeal gonorrhoea,32 using a single swab, so our data do not permit us to differentiate between gonorrhoea of the oropharynx and tonsils. Fourth, we do not know how the participants used mouthwash, the typical duration of use or whether they gargled or rinsed.…”

Section: Discussionmentioning

confidence: 71%

Risk factors for oropharyngeal gonorrhoea in men who have sex with men: an age-matched case–control study

et al. 2018

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Section: Discussionmentioning

confidence: 71%

Risk factors for oropharyngeal gonorrhoea in men who have sex with men: an age-matched case–control study

et al. 2018

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“…The two physicians checked each other's technique and then instructed, and initially observed, the non-medical staff in the techniques to be used. Consistent techniques are important as differences in sampling had been shown to affect the isolation rates of gonorrhea by culture [32] but, more recently, probably not by NAAT [33].…”

Section: Discussionmentioning

confidence: 99%

Swab-yourself Trial With Economic Monitoring and Testing for Infections Collectively (SYSTEMATIC): Part 1. A Diagnostic Accuracy and Cost-effectiveness Study Comparing Clinician-taken vs Self-taken Rectal and Pharyngeal Samples for the Diagnosis of Gonorrhea and Chlamydia

Wilson

Wallace

Loftus-Keeling

et al. 2020

Clinical Infectious Diseases

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Background Urogenital testing misses extragenital Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT). Extragenital self-sampling is frequently undertaken despite no robust RCT evidence of efficacy. We compared clinician-taken rectal and pharyngeal samples with self-taken samples for diagnostic accuracy and cost in MSM and females. Methods Prospective, convenience, sample in UK sexual health clinic. Randomised order of clinician and self-samples from pharynx and rectum, plus first catch urine (MSM) and vulvovaginal swabs (females), for NG/CT detection. Results Of 1793 participants (1284 females, 509 MSM), 116 had NG detected (75 urogenital site, 83 rectum, 72 pharynx); 9.4% infected females and 67.3% MSM were urogenital negative. 276 had CT detected (217 urogenital site, 249 rectum, 63 pharynx); 13.1% infected females and 71.8% MSM were urogenital negative. Sexual history did not identify those with rectal infections. Clinician-rectal and self-rectal positive percent agreements (PPA) for NG detection were 92.8% and 97.6%; clinician-rectal, and self-rectal PPA for CT detection were 95.6% and 97.2%. There was no difference in diagnostic accuracy between clinician and self-taken samples. Clinicians performed swabs quicker than participants so costs were lower. However, in asymptomatic people, non-qualified clinicians would oversee self-swabbing and these costs would be lower than clinician’s. Conclusions There was no difference in diagnostic accuracy of clinician compared with self-taken extragenital samples. Sexual history did not identify those with rectal infections so individuals should have extragenital clinician, or self-taken, samples. Clinician swabs cost less than self-swabs but in asymptomatic people, or doing home testing, their costs would be lower than clinician swabs. Trial Registration ClinicalTrials.gov NCT02371109

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“…The detection of chlamydia and gonorrhoea is another theme this month, with a study by Chow et al 10 of sampling techniques and another of pooled samples 11. Together with Tisla-Sala’s report on non-compliant prescribing12 these reflections provide perspective on growing concerns about antimicrobial resistance (AMR).…”

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confidence: 99%

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2018

Sex Transm Infect

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Sampling technique and detection rates of oropharyngeal and anorectal gonorrhoea using nucleic acid amplification tests in men who have sex with men

Abstract: This study shows that differences in clinicians' self-reported sampling technique did not result in measurable differences in the detection rate for oropharyngeal or anorectal gonorrhoea when using NAAT.

Cited by 6 publications

References 19 publications

Risk factors for oropharyngeal gonorrhoea in men who have sex with men: an age-matched case–control study

Risk factors for oropharyngeal gonorrhoea in men who have sex with men: an age-matched case–control study

Swab-yourself Trial With Economic Monitoring and Testing for Infections Collectively (SYSTEMATIC): Part 1. A Diagnostic Accuracy and Cost-effectiveness Study Comparing Clinician-taken vs Self-taken Rectal and Pharyngeal Samples for the Diagnosis of Gonorrhea and Chlamydia

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