Introduction Urethral swabs are used for culture of gonorrhoea (NG) in males and for detection of chlamydia (CT) and NG by nucleic acid amplification tests (NAATs). We hypothesised self-collected penile swabs would perform as well as urethral swabs for detection of CT, NG, trichomonas (TV) and mycoplasma (MG).
Methods Men having urethral swabs obtained for NG culture in the STD clinic volunteered to collect penile swabs. Urethral swabs were placed into NAAT transport media; then self-collected penile swabs were placed in transport media. NAATs were performed for CT, NG, TV, and MG for urethral and penile swabs. Acceptability questionnaires were given.
Results For 203 urethral/penile pairs, there were 32 penile positive for CT (15.8%), 31 urethral positive for CT (15.3%); [sensitivity 96.8% and specificity 98.8% compared to urethral swabs]. There were 29 penile positives for NG (14.3%) and 27 urethral positives for NG (13.3%); [sensitivity 100%, specificity 98.9%]. 25 were Gram stain positive; 21 by culture. For TV, there were 23 penile positives (11.3%), 20 urethral positives (9.9%); [sensitivity 85.0%, specificity 96.7%]. For MG, 24 penile swabs were positive (11.8%); and 29 urethral were positive (14.3%); [sensitivity 79.3%, specificity 99.4%]. CT: 2 samples were penile+/urethral-, 1 was penile-/urethral+. NG: 2 samples were penile+/urethral-. TV: 6 samples were penile+/urethral-, 3 were penile-/urethral+. MG: 1 pair was penile+/urethral-, 6 were penile-/urethral+. There were no significant differences between self-collected penile swabs and clinician-collected urethral swabs for NAATs (p = 0.625 for CT; p = 0.248 for NG; p = 0.344 for TV; and P = 0.070 for MG). 100% of men preferred penile swabs for diagnosis.
Conclusions Self-collected penile swabs were as accurate as urethral swabs for the detection of sexually transmitted infections for NAAT assays and could expedite express visits in a busy STD clinic. Penile swabs show promise as a method of utilising one sample for multiple STIs.
Disclosure of interest statement The research group has previously received research funding from GenProbe/Hologic. No pharmaceutical grants were received in the development of this study.
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