Abstract

Objectives: To evaluate the Neisseria gonorrhoeae BD ProbeTec Strand Displacement Assay (SDA) on female endo-cervical swab and male first void urine (FVU) against culture for Neisseria gonorrhoeae (NG) on female endo-cervical and urethral swab and male urethral swab for the diagnosis of Neisseria gonorrhoeae infection (NGI) in genitourinary medicine (GUM) attendees. To determine an algorithm for implementation of NGI screening by SDA in these patients taking account of the desirability of having an NG isolate in people with NGI.

Methods: Initially 1,582 patients attending the GUM clinic were tested for NGI by SDA and routine microscopy and culture. Based on the results a protocol for diagnosis of NGI by SDA, with culture specimens only from patients at high risk of NGI acquisition was devised and implemented. A post implementation audit was done to assess the effectiveness of this protocol for routine service use.

Results: There was good concurrence between the NG SDA and culture results with a NGI prevalence rate of 3.4% by both methods. All men and 85% of the women with NGI had a risk factor for acquisition of infection. Overall 38% men and 60% women attending the GUM clinic had a risk factor for acquisition of NGI. Post implementation audit confirmed the initial findings.

Conclusions: Nucleic Acid Amplification Techniques (NAAT) like the SDA are sensitive and specific for diagnosis of NGI. To obtain timely sensitivity data a culture specimen should be submitted at the same time from patients deemed to be at high risk of NGI acquisition.