Background The countywide sexual health service have recently adopted the roche cobas dual PCR for gonorrhoea testing. The locality has a low prevalence of gonorrhoea compared to national rates.

Aims To assess the performance of the gonococcal (GC) nucleic acid amplification tests (NAAT) against culture and to advise all areas of sexual health.

Methods Female endocervical, vulvovaginal and urine samples were taken for culture and NAAT. Male urethral swabs for culture were taken in parallel with urine samples for NAAT. Throat and rectal samples were also taken.

Results 309 cervical samples for culture, 289 cervical samples for NAAT. 97 vulvovaginal swabs and 93 female urine samples were taken. In males, 246 urethral culture samples and 251 urine samples were taken. 45 throat swabs and 29 rectal samples were taken. In females there was concordance in all results except for 1 throat swab (culture positive, NAAT negative) In males, there was concordance in all results except for two samples (urine NAAT positive, urethral culture negative). Two rectal samples were NAAT positive but culture negative—both were from men having sex with men (MSM) and were gonorrhoea contacts. Six throat samples were positive in NAAT but culture negative—(all MSM), 1 was a contact. 3 were sent for further testing using a different NAAT (aptima combo 2—all these assays were negative).

Conclusion NAAT testing was recommended at all sites except for throat swabs given the lower specificity at this site (88%) in males. The study confirms the need to evaluate GC NAAT testing sampling in low prevalence areas but differs from other studies as regards testing from throat samples.