Increased Detection of Pharyngeal and Rectal Gonorrhea in Men Who Have Sex With Men After Transition From Culture To Nucleic Acid Amplification Testing

Vincent J. Cornelisse, Eric P F Chow, Sarah Huffam, Christopher K. Fairley, Melanie Bissessor, Vesna de Petra, Benjamin P. Howden, Ian Denham, Catriona S. Bradshaw, Deborah Williamson, Marcus Y. Chen

Research output: Contribution to journalArticleResearchpeer-review

Abstract

BACKGROUND: This before-and-after study measured the impact of a change in testing methods from culture to nucleic acid amplification testing (NAAT) on the detection of pharyngeal and rectal gonorrhea in men who have sex with men (MSM) on a sexual health service level, including the effect on subgroups anticipated to have higher rates of gonorrhea. METHODS: In March 2015, Melbourne Sexual Health Centre changed its laboratory method for gonococcal testing from culture to NAAT using the Aptima Combo 2 and Aptima GC tests. We compared the proportion of tests positive for rectal and pharyngeal gonorrhea in MSM using culture in 2014 with those using NAAT in 2015. RESULTS: The proportion of tests positive for rectal gonorrhea by NAAT was double that obtained by culture (8% vs 3.9%; prevalence ratio [PR], 2.0; 95% confidence interval [CI], 1.8–2.4) and 5-fold for pharyngeal gonorrhea (8.3% vs 1.6%; PR, 5.2; 95% CI, 4.2–6.4). Similar increases in test positivity were observed in human immunodeficiency virus (HIV)-positive and HIV-negative men. By NAAT, test positivity for rectal gonorrhea was higher in HIV-positive compared with HIV-negative men (15.4% vs 7.3%; PR, 2.1; 95% CI, 1.7–2.6). Culture and NAAT had similar test positivity for rectal gonorrhea among men who reported contact with gonorrhea (24.9% vs 25.3%, PR 1.0, 95% CI 0.8–1.4) and men who presented with symptoms of proctitis (22.2% vs 27.9%, PR 1.3, 95% CI 0.8–2.0). CONCLUSIONS: A switch from culture to Aptima Combo 2 testing for extragenital gonorrhea in MSM increased detection and was most marked for pharyngeal infections.

Original languageEnglish
Pages (from-to)114-117
Number of pages4
JournalSexually Transmitted Diseases
Volume44
Issue number2
DOIs
Publication statusPublished - 2017

Cite this

@article{f88efa523d1945f7b27a8554a0040197,
title = "Increased Detection of Pharyngeal and Rectal Gonorrhea in Men Who Have Sex With Men After Transition From Culture To Nucleic Acid Amplification Testing",
abstract = "BACKGROUND: This before-and-after study measured the impact of a change in testing methods from culture to nucleic acid amplification testing (NAAT) on the detection of pharyngeal and rectal gonorrhea in men who have sex with men (MSM) on a sexual health service level, including the effect on subgroups anticipated to have higher rates of gonorrhea. METHODS: In March 2015, Melbourne Sexual Health Centre changed its laboratory method for gonococcal testing from culture to NAAT using the Aptima Combo 2 and Aptima GC tests. We compared the proportion of tests positive for rectal and pharyngeal gonorrhea in MSM using culture in 2014 with those using NAAT in 2015. RESULTS: The proportion of tests positive for rectal gonorrhea by NAAT was double that obtained by culture (8{\%} vs 3.9{\%}; prevalence ratio [PR], 2.0; 95{\%} confidence interval [CI], 1.8–2.4) and 5-fold for pharyngeal gonorrhea (8.3{\%} vs 1.6{\%}; PR, 5.2; 95{\%} CI, 4.2–6.4). Similar increases in test positivity were observed in human immunodeficiency virus (HIV)-positive and HIV-negative men. By NAAT, test positivity for rectal gonorrhea was higher in HIV-positive compared with HIV-negative men (15.4{\%} vs 7.3{\%}; PR, 2.1; 95{\%} CI, 1.7–2.6). Culture and NAAT had similar test positivity for rectal gonorrhea among men who reported contact with gonorrhea (24.9{\%} vs 25.3{\%}, PR 1.0, 95{\%} CI 0.8–1.4) and men who presented with symptoms of proctitis (22.2{\%} vs 27.9{\%}, PR 1.3, 95{\%} CI 0.8–2.0). CONCLUSIONS: A switch from culture to Aptima Combo 2 testing for extragenital gonorrhea in MSM increased detection and was most marked for pharyngeal infections.",
author = "Cornelisse, {Vincent J.} and Chow, {Eric P F} and Sarah Huffam and Fairley, {Christopher K.} and Melanie Bissessor and {de Petra}, Vesna and Howden, {Benjamin P.} and Ian Denham and Bradshaw, {Catriona S.} and Deborah Williamson and Chen, {Marcus Y.}",
year = "2017",
doi = "10.1097/OLQ.0000000000000553",
language = "English",
volume = "44",
pages = "114--117",
journal = "Sexually Transmitted Diseases",
issn = "0148-5717",
publisher = "Lippincott Williams & Wilkins",
number = "2",

}

Increased Detection of Pharyngeal and Rectal Gonorrhea in Men Who Have Sex With Men After Transition From Culture To Nucleic Acid Amplification Testing. / Cornelisse, Vincent J.; Chow, Eric P F; Huffam, Sarah; Fairley, Christopher K.; Bissessor, Melanie; de Petra, Vesna; Howden, Benjamin P.; Denham, Ian; Bradshaw, Catriona S.; Williamson, Deborah; Chen, Marcus Y.

In: Sexually Transmitted Diseases, Vol. 44, No. 2, 2017, p. 114-117.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Increased Detection of Pharyngeal and Rectal Gonorrhea in Men Who Have Sex With Men After Transition From Culture To Nucleic Acid Amplification Testing

AU - Cornelisse, Vincent J.

AU - Chow, Eric P F

AU - Huffam, Sarah

AU - Fairley, Christopher K.

AU - Bissessor, Melanie

AU - de Petra, Vesna

AU - Howden, Benjamin P.

AU - Denham, Ian

AU - Bradshaw, Catriona S.

AU - Williamson, Deborah

AU - Chen, Marcus Y.

PY - 2017

Y1 - 2017

N2 - BACKGROUND: This before-and-after study measured the impact of a change in testing methods from culture to nucleic acid amplification testing (NAAT) on the detection of pharyngeal and rectal gonorrhea in men who have sex with men (MSM) on a sexual health service level, including the effect on subgroups anticipated to have higher rates of gonorrhea. METHODS: In March 2015, Melbourne Sexual Health Centre changed its laboratory method for gonococcal testing from culture to NAAT using the Aptima Combo 2 and Aptima GC tests. We compared the proportion of tests positive for rectal and pharyngeal gonorrhea in MSM using culture in 2014 with those using NAAT in 2015. RESULTS: The proportion of tests positive for rectal gonorrhea by NAAT was double that obtained by culture (8% vs 3.9%; prevalence ratio [PR], 2.0; 95% confidence interval [CI], 1.8–2.4) and 5-fold for pharyngeal gonorrhea (8.3% vs 1.6%; PR, 5.2; 95% CI, 4.2–6.4). Similar increases in test positivity were observed in human immunodeficiency virus (HIV)-positive and HIV-negative men. By NAAT, test positivity for rectal gonorrhea was higher in HIV-positive compared with HIV-negative men (15.4% vs 7.3%; PR, 2.1; 95% CI, 1.7–2.6). Culture and NAAT had similar test positivity for rectal gonorrhea among men who reported contact with gonorrhea (24.9% vs 25.3%, PR 1.0, 95% CI 0.8–1.4) and men who presented with symptoms of proctitis (22.2% vs 27.9%, PR 1.3, 95% CI 0.8–2.0). CONCLUSIONS: A switch from culture to Aptima Combo 2 testing for extragenital gonorrhea in MSM increased detection and was most marked for pharyngeal infections.

AB - BACKGROUND: This before-and-after study measured the impact of a change in testing methods from culture to nucleic acid amplification testing (NAAT) on the detection of pharyngeal and rectal gonorrhea in men who have sex with men (MSM) on a sexual health service level, including the effect on subgroups anticipated to have higher rates of gonorrhea. METHODS: In March 2015, Melbourne Sexual Health Centre changed its laboratory method for gonococcal testing from culture to NAAT using the Aptima Combo 2 and Aptima GC tests. We compared the proportion of tests positive for rectal and pharyngeal gonorrhea in MSM using culture in 2014 with those using NAAT in 2015. RESULTS: The proportion of tests positive for rectal gonorrhea by NAAT was double that obtained by culture (8% vs 3.9%; prevalence ratio [PR], 2.0; 95% confidence interval [CI], 1.8–2.4) and 5-fold for pharyngeal gonorrhea (8.3% vs 1.6%; PR, 5.2; 95% CI, 4.2–6.4). Similar increases in test positivity were observed in human immunodeficiency virus (HIV)-positive and HIV-negative men. By NAAT, test positivity for rectal gonorrhea was higher in HIV-positive compared with HIV-negative men (15.4% vs 7.3%; PR, 2.1; 95% CI, 1.7–2.6). Culture and NAAT had similar test positivity for rectal gonorrhea among men who reported contact with gonorrhea (24.9% vs 25.3%, PR 1.0, 95% CI 0.8–1.4) and men who presented with symptoms of proctitis (22.2% vs 27.9%, PR 1.3, 95% CI 0.8–2.0). CONCLUSIONS: A switch from culture to Aptima Combo 2 testing for extragenital gonorrhea in MSM increased detection and was most marked for pharyngeal infections.

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U2 - 10.1097/OLQ.0000000000000553

DO - 10.1097/OLQ.0000000000000553

M3 - Article

VL - 44

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EP - 117

JO - Sexually Transmitted Diseases

JF - Sexually Transmitted Diseases

SN - 0148-5717

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