Conventional versus molecular detection of Chlamydia trachomatis and Neisseria gonorrhoeae among males in a sexually transmitted infections clinic

Siti Fazilah Situ, Chuan Hun Ding, Salbiah Nawi, Asmah Johar, Ramliza Ramli

Research output: Contribution to journalArticle

Abstract

Background: Chlamydia trachomatis and Neisseria gonorrhoeae are important bacterial pathogens of sexually transmitted infections (STIs) worldwide. This study sought to compare the analytical sensitivity and specificity of conventional methods against a rapid molecular method in detecting STIs caused by these bacteria. Methods: Ninety five first-time male attendees of the Genito-urinary Medicine Clinic in Hospital Kuala Lumpur were included in this cross-sectional study. The detection of C. trachomatis was achieved through direct fluorescence antibody (DFA) staining of urethral swabs and real-time polymerase chain reaction testing (Xpert® CT/NG assay) on urine specimens. N. gonorrhoeae was detected through Gram staining and culture of urethral swabs and Xpert® CT/ NG assay on urine specimens. Results: From the Xpert® CT/NG results, 11 (11.6%) attendees had chlamydia, 23 (24.2%) had gonorrhoea and 8 (8.4%) had both STIs. The sensitivity and specificity of DFA in detecting chlamydia compared to Xpert® CT/NG were 5.3% (95% CI: 0-28) and 94.7% (95% CI: 86-98), respectively. For gonorrhoea, the sensitivity and specificity of Gram staining were 90.3% (95% CI: 73-98) and 95.3% (86-99), respectively, whereas the sensitivity and specificity of culture compared to Xpert® CT/NG were 32.2% (95% CI: 17-51) and 100% (95% CI: 93-100), respectively. Conclusion: Although Gram-stained urethral swab smears are sensitive enough to be retained as a screening tool for gonorrhoea, culture as well as DFA lack sensitivity and are poorly suited to screen for gonorrhoea and chlamydia, respectively. However, owing to their high specificity, conventional detection methods are still suitable as confirmatory tests for gonorrhoea and chlamydia.

Original languageEnglish
Pages (from-to)25-31
Number of pages7
JournalMalaysian Journal of Pathology
Volume39
Issue number1
Publication statusPublished - 2017

Fingerprint

Neisseria gonorrhoeae
Gonorrhea
Chlamydia trachomatis
Sexually Transmitted Diseases
Chlamydia
Sensitivity and Specificity
Fluorescence
Staining and Labeling
Antibodies
Urine
Real-Time Polymerase Chain Reaction
Cross-Sectional Studies
Medicine
Bacteria

Keywords

  • Chlamydia trachomatis
  • Neisseria gonorrhoeae
  • Sexually transmitted infection
  • Xpert CT/NG

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology
  • Medicine(all)
  • Cell Biology

Cite this

Conventional versus molecular detection of Chlamydia trachomatis and Neisseria gonorrhoeae among males in a sexually transmitted infections clinic. / Situ, Siti Fazilah; Ding, Chuan Hun; Nawi, Salbiah; Johar, Asmah; Ramli, Ramliza.

In: Malaysian Journal of Pathology, Vol. 39, No. 1, 2017, p. 25-31.

Research output: Contribution to journalArticle

@article{3932794455db409baf43cfec9bb63bf0,
title = "Conventional versus molecular detection of Chlamydia trachomatis and Neisseria gonorrhoeae among males in a sexually transmitted infections clinic",
abstract = "Background: Chlamydia trachomatis and Neisseria gonorrhoeae are important bacterial pathogens of sexually transmitted infections (STIs) worldwide. This study sought to compare the analytical sensitivity and specificity of conventional methods against a rapid molecular method in detecting STIs caused by these bacteria. Methods: Ninety five first-time male attendees of the Genito-urinary Medicine Clinic in Hospital Kuala Lumpur were included in this cross-sectional study. The detection of C. trachomatis was achieved through direct fluorescence antibody (DFA) staining of urethral swabs and real-time polymerase chain reaction testing (Xpert{\circledR} CT/NG assay) on urine specimens. N. gonorrhoeae was detected through Gram staining and culture of urethral swabs and Xpert{\circledR} CT/ NG assay on urine specimens. Results: From the Xpert{\circledR} CT/NG results, 11 (11.6{\%}) attendees had chlamydia, 23 (24.2{\%}) had gonorrhoea and 8 (8.4{\%}) had both STIs. The sensitivity and specificity of DFA in detecting chlamydia compared to Xpert{\circledR} CT/NG were 5.3{\%} (95{\%} CI: 0-28) and 94.7{\%} (95{\%} CI: 86-98), respectively. For gonorrhoea, the sensitivity and specificity of Gram staining were 90.3{\%} (95{\%} CI: 73-98) and 95.3{\%} (86-99), respectively, whereas the sensitivity and specificity of culture compared to Xpert{\circledR} CT/NG were 32.2{\%} (95{\%} CI: 17-51) and 100{\%} (95{\%} CI: 93-100), respectively. Conclusion: Although Gram-stained urethral swab smears are sensitive enough to be retained as a screening tool for gonorrhoea, culture as well as DFA lack sensitivity and are poorly suited to screen for gonorrhoea and chlamydia, respectively. However, owing to their high specificity, conventional detection methods are still suitable as confirmatory tests for gonorrhoea and chlamydia.",
keywords = "Chlamydia trachomatis, Neisseria gonorrhoeae, Sexually transmitted infection, Xpert CT/NG",
author = "Situ, {Siti Fazilah} and Ding, {Chuan Hun} and Salbiah Nawi and Asmah Johar and Ramliza Ramli",
year = "2017",
language = "English",
volume = "39",
pages = "25--31",
journal = "Malaysian Journal of Pathology",
issn = "0126-8635",
publisher = "Malaysian Society of Pathologists",
number = "1",

}

TY - JOUR

T1 - Conventional versus molecular detection of Chlamydia trachomatis and Neisseria gonorrhoeae among males in a sexually transmitted infections clinic

AU - Situ, Siti Fazilah

AU - Ding, Chuan Hun

AU - Nawi, Salbiah

AU - Johar, Asmah

AU - Ramli, Ramliza

PY - 2017

Y1 - 2017

N2 - Background: Chlamydia trachomatis and Neisseria gonorrhoeae are important bacterial pathogens of sexually transmitted infections (STIs) worldwide. This study sought to compare the analytical sensitivity and specificity of conventional methods against a rapid molecular method in detecting STIs caused by these bacteria. Methods: Ninety five first-time male attendees of the Genito-urinary Medicine Clinic in Hospital Kuala Lumpur were included in this cross-sectional study. The detection of C. trachomatis was achieved through direct fluorescence antibody (DFA) staining of urethral swabs and real-time polymerase chain reaction testing (Xpert® CT/NG assay) on urine specimens. N. gonorrhoeae was detected through Gram staining and culture of urethral swabs and Xpert® CT/ NG assay on urine specimens. Results: From the Xpert® CT/NG results, 11 (11.6%) attendees had chlamydia, 23 (24.2%) had gonorrhoea and 8 (8.4%) had both STIs. The sensitivity and specificity of DFA in detecting chlamydia compared to Xpert® CT/NG were 5.3% (95% CI: 0-28) and 94.7% (95% CI: 86-98), respectively. For gonorrhoea, the sensitivity and specificity of Gram staining were 90.3% (95% CI: 73-98) and 95.3% (86-99), respectively, whereas the sensitivity and specificity of culture compared to Xpert® CT/NG were 32.2% (95% CI: 17-51) and 100% (95% CI: 93-100), respectively. Conclusion: Although Gram-stained urethral swab smears are sensitive enough to be retained as a screening tool for gonorrhoea, culture as well as DFA lack sensitivity and are poorly suited to screen for gonorrhoea and chlamydia, respectively. However, owing to their high specificity, conventional detection methods are still suitable as confirmatory tests for gonorrhoea and chlamydia.

AB - Background: Chlamydia trachomatis and Neisseria gonorrhoeae are important bacterial pathogens of sexually transmitted infections (STIs) worldwide. This study sought to compare the analytical sensitivity and specificity of conventional methods against a rapid molecular method in detecting STIs caused by these bacteria. Methods: Ninety five first-time male attendees of the Genito-urinary Medicine Clinic in Hospital Kuala Lumpur were included in this cross-sectional study. The detection of C. trachomatis was achieved through direct fluorescence antibody (DFA) staining of urethral swabs and real-time polymerase chain reaction testing (Xpert® CT/NG assay) on urine specimens. N. gonorrhoeae was detected through Gram staining and culture of urethral swabs and Xpert® CT/ NG assay on urine specimens. Results: From the Xpert® CT/NG results, 11 (11.6%) attendees had chlamydia, 23 (24.2%) had gonorrhoea and 8 (8.4%) had both STIs. The sensitivity and specificity of DFA in detecting chlamydia compared to Xpert® CT/NG were 5.3% (95% CI: 0-28) and 94.7% (95% CI: 86-98), respectively. For gonorrhoea, the sensitivity and specificity of Gram staining were 90.3% (95% CI: 73-98) and 95.3% (86-99), respectively, whereas the sensitivity and specificity of culture compared to Xpert® CT/NG were 32.2% (95% CI: 17-51) and 100% (95% CI: 93-100), respectively. Conclusion: Although Gram-stained urethral swab smears are sensitive enough to be retained as a screening tool for gonorrhoea, culture as well as DFA lack sensitivity and are poorly suited to screen for gonorrhoea and chlamydia, respectively. However, owing to their high specificity, conventional detection methods are still suitable as confirmatory tests for gonorrhoea and chlamydia.

KW - Chlamydia trachomatis

KW - Neisseria gonorrhoeae

KW - Sexually transmitted infection

KW - Xpert CT/NG

UR - http://www.scopus.com/inward/record.url?scp=85019687920&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85019687920&partnerID=8YFLogxK

M3 - Article

VL - 39

SP - 25

EP - 31

JO - Malaysian Journal of Pathology

JF - Malaysian Journal of Pathology

SN - 0126-8635

IS - 1

ER -