Rationale and Comments

Nucleic acid amplification testing (NAAT) for Chlamydia trachomatis and Neisseria gonorrhoeae is the standard of care for testing adults and has largely replaced culture. Vaginal swabs are the preferred single specimen for screening and diagnosis of C. trachomatis and N. gonorrhoeae by NAAT, providing 5% to greater than 10% increased sensitivity compared to urine for women; testing multiple specimens (i.e., vaginal, endocervical, urine) can further increase sensitivity. First-void urine can be considered as a noninvasive alternative when vaginal collections are not possible because of the setting, test, collection device shortages, or very strong patient preference.

Sponsoring Organizations

• American Society for Microbiology
• American Society for Clinical Laboratory Science
• American Society for Clinical Pathology

Sources

• Diagnostic accuracy studies

Disciplines

• Infectious disease

References

• Centers for Disease Control and Prevention. Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae—2014. MMWR Recomm Rep. 2014;63(RR-02):1-19.
• Shafer MA, Moncada J, Boyer CB, et al. Comparing first-void urine specimens, self-collected vaginal swabs, and endocervical specimens to detect Chlamydia trachomatis and Neisseria gonorrhoeae by a nucleic acid amplification test. J Clin Microbiol. 2003;41(9):4395-4399.
• Van Der Pol B, Taylor SN, Liesenfeld O, et al. Vaginal swabs are the optimal specimen for detection of genital Chlamydia trachomatis or Neisseria gonorrhoeae using the Cobas 4800 CT/NG test. Sex Transm Dis. 2013;40(3):247-250.