Article Text

other Versions

Download PDFPDF
Rapid accurate point-of-care tests combining diagnostics and antimicrobial resistance prediction for Neisseria gonorrhoeae and Mycoplasma genitalium
  1. Syed Tariq Sadiq1,
  2. Fulvia Mazzaferri2,
  3. Magnus Unemo3
  1. 1Applied Diagnostic Research and Evaluation Unit, St George's, University of London, London, UK
  2. 2Diagnostic and Public Health Department, Infectious Diseases and Tropical Medicine Section, University of Verona, Verona, Italy
  3. 3World Health Organization Collaborating Centre for Gonorrhoea and other STIs, Örebro University, Örebro, Sweden
  1. Correspondence to Dr Tariq Sadiq, Institute for Infection and Immunity, St George's, University of London, London SW17 0RE, UK; ssadiq{at}


In addition to inadequate access to early diagnosis and treatment with antimicrobial agents for patients and sexual contacts, management and control of STIs is significantly challenged by emergence and spread of antimicrobial resistance (AMR), particularly for STIs such as Neisseria gonorrhoeae and Mycoplasma genitalium. This is further compounded by use of nucleic acid amplification techniques for diagnosis, resulting in reduced phenotypic AMR testing for N. gonorrhoeae and absence or suboptimal AMR surveillance for guiding treatment of both STIs in many settings. Rapid accurate point-of-care (POC) tests for diagnosis of all STIs would be valuable but to significantly impact treatment precision and management of N. gonorrhoeae and M. genitalium infections, combinations of rapid POC diagnostic and AMR testing (POC-AMR) will likely be required. This strategy would combat STI burden and AMR emergence and spread by enabling diagnosis and individualised treatment at the first healthcare visit, potentially reducing selection pressure on recommended antimicrobials, reducing transmission of resistant strains and providing means for AMR surveillance. Microfluidic and nanotechnology platforms under development for rapid detection of STIs provide a basis to also develop molecular rapid POC-AMR prediction. A number of prototypic devices are in the pipeline but none as yet approved for routine use. However, particularly for N. gonorrhoeae, more knowledge is required to assess which antimicrobials lend themselves to a genotypic POC-AMR approach, in relation to genotypic–phenotypic associations and potential impact clinically and epidemiologically. Key for successful deployment will include also understanding cost-effectiveness, cost-consequences and acceptability for key stakeholders.


Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors All authors contributed to the manuscript.

  • Funding National Institute for Health Research, 10.13039/501100000272, grant number II-LB-0214-20005.

  • Competing interests STS is grant holder for the National Institute for Health Research (NIHR) i4i Programme (grant number II-LB-0214-20005). The views expressed are those of the authors and not necessarily those of the NIHR, the NHS or the UK Department of Health. STS has also received funding from Atlas Genetics to conduct performance evaluations of its io POC system. None for MU and FM.

  • Provenance and peer review Commissioned; externally peer reviewed.