Swabs for nucleic acid amplification test and culture

The rise of gonococcal resistance (particularly to extended-spectrum cephalosporins) poses an increasing problem. Wind et al1 look at the use of ESwab swabs for gonorrhoea testing. They highlight that a nucleic acid amplification test (NAAT) to diagnose gonorrhoea combined with a way to defer culture of positive samples would be useful, but a specialised collection medium to enable Neisseria gonorrhoea to survive, that also maintains diagnostic sensitivity would be essential. The ESwab system is known to prolong survival of many bacterial species. The authors hypothesised that ESwab could be used for deferred gonorrhoea culture and aimed to determine if culture was possible up to 3 days after storing samples and if ESwab NAAT testing resulted in any loss of diagnostic sensitivity. A total of 2452 samples were taken from 1893 high-risk patients (symptomatic, men who have sex with men (MSM) or sexually transmitted infection contacts) attending a sexual health clinic. In men, direct GC culture and first void urine or rectal NAAT (in MSM) …