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Successful Combination of Nucleic Acid Amplification Test Diagnostics and Targeted Deferred Neisseria gonorrhoeae Culture
Cluster Infect Dis, STI Outpatient Clin, Publ Hlth Serv, Amsterdam, Netherlands.; Acad Med Ctr, Dept Dermatol, Univ Amsterdam, Amsterdam, Netherlands.
Cluster Infect Dis, STI Outpatient Clin, Publ Hlth Serv, Amsterdam, Netherlands;Acad Med Ctr, Dept Dermatol, Univ Amsterdam, Amsterdam, Netherlands; Acad Med Ctr, Ctr Infect & Immun Amsterdam CINIMA, Univ Amsterdam, Amsterdam, Netherlands.
Acad Med Ctr, Ctr Infect & Immun Amsterdam CINIMA, Univ Amsterdam, Amsterdam, Netherlands; Cluster Infect Dis, Publ Hlth Serv, Amsterdam, Netherlands.
Örebro University Hospital. Dept Lab Med, Natl Reference Lab Pathogen Neisseria, WHO Collaborating Ctr Gonorrhoea & Other STIs, Örebro University Hospital, Örebro, Sweden.
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2015 (English)In: Journal of Clinical Microbiology, ISSN 0095-1137, E-ISSN 1098-660X, Vol. 53, no 6, p. 1884-1890Article in journal (Refereed) Published
Abstract [en]

Nucleic acid amplification tests (NAATs) are recommended for the diagnosis of N. gonorrhoeae infections because of their superior sensitivity. Increasing NAAT use causes a decline in crucial antimicrobial resistance (AMR) surveillance data, which rely on culture. We analyzed the suitability of the ESwab system for NAAT diagnostics and deferred targeted N. gonorrhoeae culture to allow selective and efficient culture based on NAAT results. We included patients visiting the STI Clinic Amsterdam, The Netherlands, in 2013. Patient characteristics and urogenital and rectal samples for direct N. gonorrhoeae culture, standard NAAT, and ESwab were collected. Standard NAAT and NAAT on ESwab samples were performed using the Aptima Combo 2 assay for N. gonorrhoeae and C. trachomatis. Two deferred N. gonorrhoeae cultures were performed on NAAT-positive ESwab samples after storage at 4 degrees C for 1 to 3 days. We included 2,452 samples from 1,893 patients. In the standard NAAT, 107 samples were N. gonorrhoeae positive and 284 were C. trachomatis positive. The sensitivities of NAAT on ESwab samples were 83% (95% confidence interval [CI], 75 to 90%) and 87% (95% CI, 82 to 90%), respectively. ESwab samples were available for 98 of the gonorrhea-positive samples. Of these, 82% were positive in direct culture and 69% and 56% were positive in the 1st and 2nd deferred cultures, respectively (median storage times, 27 and 48 h, respectively). Deferred culture was more often successful in urogenital samples or when the patient had symptoms at the sampling site. Deferred N. gonorrhoeae culture of stored ESwab samples is feasible and enables AMR surveillance. To limit the loss in NAAT sensitivity, we recommend obtaining separate samples for NAAT and deferred culture.

Place, publisher, year, edition, pages
2015. Vol. 53, no 6, p. 1884-1890
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Microbiology
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URN: urn:nbn:se:oru:diva-56679DOI: 10.1128/JCM.00369-15ISI: 000358284600014PubMedID: 25832300OAI: oai:DiVA.org:oru-56679DiVA, id: diva2:1083582
Available from: 2017-03-21 Created: 2017-03-21 Last updated: 2018-07-08Bibliographically approved

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