Impact of time of culture specimen collection on the recovery of Neisseria gonorrhoeae after a positive nucleic acid amplification test

• Published in: Sexually transmitted infections Vol. 99; no. 8; pp. 520 - 526
• Main Authors: Nadal-Barón, Patricia, Trejo-Zahinos, Jesús, García, Jorge Nestor, Salmerón, Paula, Sulleiro, Elena, Arando, Maider, Descalzo, Vicente, Álvarez-Lopez, Patricia, El Ouazzani, Rachid, López, Luis, Zarzuela, Francesc, Ruiz, Edurne, Llinas, Montserrat, Blanco-Grau, Albert, Curran, Adrian, Larrosa, María Nieves, Pumarola, Tomàs, Hoyos-Mallecot, Yannick
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.12.2023; BMJ Publishing Group LTD
• Subjects: Asymptomatic; Automation; Chlamydia Infections - diagnosis; Chlamydia trachomatis; Clinical Laboratory Techniques; Condoms; Diagnostic Screening Programs; Gonorrhea; Gonorrhea - diagnosis; Gonorrhea - epidemiology; Homosexuality, Male; Humans; Infections; Male; NEISSERIA GONORRHOEAE; Neisseria gonorrhoeae - genetics; Nucleic Acid Amplification Techniques; Original research; Parasitology; Retrospective Studies; SCREENING; Self report; Sexual and Gender Minorities; Sexual orientation; Sexually transmitted diseases; Specimen Handling; STD; Surveillance; Testing laboratories; Transgender persons; Vagina; Womens health; United States > US; California; Spain; SCREENING; Clinical Laboratory Techniques; NEISSERIA GONORRHOEAE; Nucleic Acid Amplification Techniques; Diagnostic Screening Programs
• ISSN: 1368-4973; 1472-3263
• DOI: 10.1136/sextrans-2023-055899

ObjectivesCulture of Neisseria gonorrhoeae remains essential for antimicrobial resistance (AMR) surveillance. We evaluated the effect of time of specimen collection on culture yield following a positive nucleic acid amplification test (NAAT).MethodsWe retrospectively assessed N. gonorrhoeae culture yield among asymptomatic individuals (largely men who have sex with men) who attended for sexual health screening and had a positive NAAT. Participants underwent either same-day testing and notification (Drassanes Exprés) or standard screening with deferred testing.ResultsAmong 10 423 screened individuals, 809 (7.7%) tested positive for N. gonorrhoeae. A total of 995 different anatomical sites of infection culture was performed in 583 of 995 (58.6%) of anatomical sites (Drassanes Exprés 278 of 347, 80.1%; standard screening 305 of 648, 47.1%; p<0.001). Recovery was highest when culture specimens were collected within 3–7 days of screening with only a slight drop in recovery when the interval extended to 7 days . Recovery from pharynx was 38 of 149 (25.5%) within 3 days, 19 of 81 (23.4%) after 4–7 days (p=0.7245), 11 of 102 (10.7%) after 8–14 days (p<0.0036) and 1 of 22 (4.5%) with longer delays (p=0.00287). Recovery from rectum was 49 of 75 (65.3%) within 3 days, 28 of 45 (62.2%) after 4–7 days (p=0.7318), 41 of 69 (59.4%) after 8–14 days (p=0.4651) and 6 of 18 (33.3%) with longer delays (p=0.0131). Median culture specimen collection time was 1 day within Drassanes Exprés vs 8 days within standard screening. Consequently, the overall culture yield was slightly higher within Drassanes Exprés (102/278, 36.6% vs 99/305, 32.5%; p=0.2934).ConclusionReducing the interval between screening and collection of culture specimens increased N. gonorrhoeae recovery in extragenital samples. Implementing a same-day testing and notification programme increased collection of culture samples and culture yield in our setting, which may help AMR surveillance.