Self-taken pharyngeal and rectal swabs are appropriate for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in asymptomatic men who have sex with men
INTRODUCTION: Self-taken specimens from men who have sex with men (MSM) could be important in reducing high levels of demand on sexual health services. The performance of self-taken specimens for the detection of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) from both pharyngeal and rectal sites in asymptomatic MSM was assessed. METHODS: MSM were examined according to clinic protocol: a rectal and pharyngeal swab for GC culture and a rectal swab for the CT strand displacement assay. An extra set of nurse-taken and self-taken pharyngeal and rectal specimens were also requested and were tested using the Aptima Combo 2 assay and the result compared with the routine clinic result, which was considered the gold standard. RESULTS: A total of 272 MSM was recruited and the sensitivity and specificity of nurse-taken and patient-taken swabs, respectively, was as follows: rectal GC: 94.9\% and 90.1\% (nurse); 92.3\% and 87.9\% (patient); pharyngeal GC: 88.2\% and 91.8\% (nurse); 100\% and 87.8\% (patient); rectal CT: 80.0\% and 99.6\% (nurse); 91.4\% and 98.2\% (patient). No significant difference in sensitivity or specificity was observed between the nurse-taken and the patient-taken rectal swabs for either GC or CT. For the detection of GC from the pharynx, comparable sensitivities were achieved between nurse-taken and patient-taken swabs (p = 0.5); however, a significant difference in specificity was observed (p = 0.006). This was due to a higher number of false GC-positive self-taken pharyngeal swabs from patients with high rates (90.9\%; 10/11) of confirmed concurrent GC infection in different anatomical sites. CONCLUSIONS: MSM are able to collect self-taken rectal and pharyngeal swabs that are comparable to those taken by clinicians.
%0 Journal Article
%1 alexander_self-taken_2008
%A Alexander, S
%A Ison, C
%A Parry, J
%A Llewellyn, C
%A Wayal, S
%A Richardson, D
%A Phillips, A
%A Smith, H
%A Fisher, M
%D 2008
%J Sexually Transmitted Infections
%K Acid Amplification Care, Chlamydia Diseases, Gonorrhea, Handling Homosexuality, Humans, Infections, Male, Neisseria Nucleic Observer Pharyngeal Pharynx, Rectal Rectum, Self Sensitivity Specificity, Specimen Techniques, Variation, and gonorrhoeae, trachomatis,
%N 6
%P 488--492
%R 10.1136/sti.2008.031443
%T Self-taken pharyngeal and rectal swabs are appropriate for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in asymptomatic men who have sex with men
%U http://www.ncbi.nlm.nih.gov/pubmed/19028953
%V 84
%X INTRODUCTION: Self-taken specimens from men who have sex with men (MSM) could be important in reducing high levels of demand on sexual health services. The performance of self-taken specimens for the detection of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) from both pharyngeal and rectal sites in asymptomatic MSM was assessed. METHODS: MSM were examined according to clinic protocol: a rectal and pharyngeal swab for GC culture and a rectal swab for the CT strand displacement assay. An extra set of nurse-taken and self-taken pharyngeal and rectal specimens were also requested and were tested using the Aptima Combo 2 assay and the result compared with the routine clinic result, which was considered the gold standard. RESULTS: A total of 272 MSM was recruited and the sensitivity and specificity of nurse-taken and patient-taken swabs, respectively, was as follows: rectal GC: 94.9\% and 90.1\% (nurse); 92.3\% and 87.9\% (patient); pharyngeal GC: 88.2\% and 91.8\% (nurse); 100\% and 87.8\% (patient); rectal CT: 80.0\% and 99.6\% (nurse); 91.4\% and 98.2\% (patient). No significant difference in sensitivity or specificity was observed between the nurse-taken and the patient-taken rectal swabs for either GC or CT. For the detection of GC from the pharynx, comparable sensitivities were achieved between nurse-taken and patient-taken swabs (p = 0.5); however, a significant difference in specificity was observed (p = 0.006). This was due to a higher number of false GC-positive self-taken pharyngeal swabs from patients with high rates (90.9\%; 10/11) of confirmed concurrent GC infection in different anatomical sites. CONCLUSIONS: MSM are able to collect self-taken rectal and pharyngeal swabs that are comparable to those taken by clinicians.
@article{alexander_self-taken_2008,
abstract = {{INTRODUCTION:} Self-taken specimens from men who have sex with men {(MSM)} could be important in reducing high levels of demand on sexual health services. The performance of self-taken specimens for the detection of Chlamydia trachomatis {(CT)} and Neisseria gonorrhoeae {(GC)} from both pharyngeal and rectal sites in asymptomatic {MSM} was assessed. {METHODS:} {MSM} were examined according to clinic protocol: a rectal and pharyngeal swab for {GC} culture and a rectal swab for the {CT} strand displacement assay. An extra set of nurse-taken and self-taken pharyngeal and rectal specimens were also requested and were tested using the Aptima Combo 2 assay and the result compared with the routine clinic result, which was considered the gold standard. {RESULTS:} A total of 272 {MSM} was recruited and the sensitivity and specificity of nurse-taken and patient-taken swabs, respectively, was as follows: rectal {GC:} 94.9\% and 90.1\% (nurse); 92.3\% and 87.9\% (patient); pharyngeal {GC:} 88.2\% and 91.8\% (nurse); 100\% and 87.8\% (patient); rectal {CT:} 80.0\% and 99.6\% (nurse); 91.4\% and 98.2\% (patient). No significant difference in sensitivity or specificity was observed between the nurse-taken and the patient-taken rectal swabs for either {GC} or {CT.} For the detection of {GC} from the pharynx, comparable sensitivities were achieved between nurse-taken and patient-taken swabs (p = 0.5); however, a significant difference in specificity was observed (p = 0.006). This was due to a higher number of false {GC-positive} self-taken pharyngeal swabs from patients with high rates (90.9\%; 10/11) of confirmed concurrent {GC} infection in different anatomical sites. {CONCLUSIONS:} {MSM} are able to collect self-taken rectal and pharyngeal swabs that are comparable to those taken by clinicians.},
added-at = {2011-03-11T10:05:34.000+0100},
author = {Alexander, S and Ison, C and Parry, J and Llewellyn, C and Wayal, S and Richardson, D and Phillips, A and Smith, H and Fisher, M},
biburl = {https://www.bibsonomy.org/bibtex/2e1dedc7a003f96fdbbc869562b23bcb2/jelias},
doi = {10.1136/sti.2008.031443},
interhash = {6f9b75aca809eb6e4c696a46919172b8},
intrahash = {e1dedc7a003f96fdbbc869562b23bcb2},
issn = {1472-3263},
journal = {Sexually Transmitted Infections},
keywords = {Acid Amplification Care, Chlamydia Diseases, Gonorrhea, Handling Homosexuality, Humans, Infections, Male, Neisseria Nucleic Observer Pharyngeal Pharynx, Rectal Rectum, Self Sensitivity Specificity, Specimen Techniques, Variation, and gonorrhoeae, trachomatis,},
month = nov,
note = {{PMID:} 19028953},
number = 6,
pages = {488--492},
timestamp = {2011-03-11T10:05:56.000+0100},
title = {Self-taken pharyngeal and rectal swabs are appropriate for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in asymptomatic men who have sex with men},
url = {http://www.ncbi.nlm.nih.gov/pubmed/19028953},
volume = 84,
year = 2008
}