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Cited by 85Reproductive tract infections researchHIV/AIDS Research and InterventionsSyphilis Diagnosis and Treatment

Effect of nucleic acid amplification testing on detection of extragenital gonorrhea and chlamydial infections in men who have sex with men sexually transmitted disease clinic patients.

Barbee, Lindley A., Dombrowski, Julia C., Kerani, Roxanne, Golden, Matthew R.·2014·Sexually Transmitted Diseases
DOI 10.1097/olq.0000000000000093
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Abstract

BACKGROUND: In 2010, the Centers for Disease and Control and Prevention recommended using nucleic acid amplification tests (NAATs) for extragenital gonorrhea (GC) and chlamydia (CT) testing because of NAATs' improved sensitivity compared with culture. METHODS: In 2011, the Public Health-Seattle & King County Sexually Transmitted Disease Clinic introduced NAAT-based testing for extragenital GC and CT infection in men who have sex with men (MSM) using AptimaCombo2. We compared extragenital GC and CT test positivity and infection detection yields in the last year of culture-based testing (2010) to the first year of NAAT testing (2011). RESULTS: Test positivity of GC increased by 8% for rectal infections (9.0%-9.7%) and 12% for pharyngeal infections (5.8%-6.5%) from 2010 to 2011; CT test positivity increased 61% for rectal infections (7.4%-11.9%). Pharyngeal CT was identified in 2.3% of tested persons in 2011 (not tested in 2010). We calculated the ratio of extragenital cases per 100 urethral infections to adjust for a possible decline in GC/CT incidence in 2011; the GC rectal and pharyngeal ratios increased 77% and 66%, respectively, and the CT rectal ratio increased 127%. The proportion of infected persons with isolated extragenital infections (i.e., extragenital infections without urethral infection) increased from 43% in 2010 to 57% in 2011. CONCLUSIONS: Extragenital testing with NAAT substantially increases the number of infected MSM identified with GC or CT infection and should continue to be promoted.

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  • Approximately 70% of gonococcal and chlamydial infections might be missed if urogenital-only testing is performed among MSM because most pharyngeal and rectal infections are asymptomatic.

    “Approximately 70% of gonococcal and chlamydial infections might be missed if urogenital-only testing is performed among MSM (212–216) because most pharyngeal and rectal infections are asymptomatic.”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [215]

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Authors
Barbee, L. A., Dombrowski, J. C., Kerani, R., & Golden, M. R.
Affiliations
Public Health – Seattle & King County (US)
Corresponding author
  • Barbee, Lindley A.
  • Dombrowski, Julia C.
  • Kerani, Roxanne
  • Golden, Matthew R.
ORCID
Venue
Sexually Transmitted Diseases
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2014-03
Volume
41
Issue
3
Pages
168-172
ISSN
0148-5717 (ISSN-L)
DOI
10.1097/olq.0000000000000093
OpenAlex
W2328324241
Cited by
85
References
22
Citations by year
2026: 2 · 2025: 4 · 2024: 8 · 2023: 4 · 2022: 6 · 2021: 14 · 2020: 7 · 2019: 10 · 2018: 6 · 2017: 6 · 2016: 8 · 2015: 7 · 2014: 3
FWCI
6.53
Type
journal article
Language
en
Open access
closed
Locations
  • Sexually Transmitted Diseases (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • U.S. Public Health Service (T32 67-4198)
  • National Institute of Mental Health (K23MH090923)
  • National Institute of Allergy and Infectious Diseases (K01AI095060, P30AI027757)
Topics
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
Keywords
nucleic acid amplification tests, chlamydia, men who have sex with men, rectal infection, pharyngeal infection, sexually transmitted disease clinics, test positivity
MeSH terms
Adult, Chlamydia Infections, Chlamydia trachomatis, Gonorrhea, Humans, Male, Mass Screening, Neisseria gonorrhoeae, Pharyngeal Diseases, Predictive Value of Tests, Rectal Diseases, Sensitivity and Specificity, Sexual Behavior, Urethral Diseases, Prevalence, Homosexuality, Male, Nucleic Acid Amplification Techniques

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