Description
Chlamydia trachomatis and Neisseria gonorrhoeae are the most frequently reported sexually-transmitted diseases in the US. In 2002, the Centers for Disease Control and Prevention (CDC) published guidelines for laboratory testing that emphasized the use of nucleic acid amplification tests in screening for Chlamydia trachomatis and also for Neisseria gonorrhoeae when conditions of transport could compromise viability of the organism. Other guidelines have recommended Chlamydia screening for all women, ages 15 to 25, as well as testing pregnant women during their first trimester for both Chlamydia and Neisseria. In some settings, the fact that both Neisseria and Chlamydia testing can be performed on the same specimen, testing for both can be an effective strategy.
Because nucleic acid amplification (NAA) tests are more sensitive than conventional culture methods and nonculture tests, the CDC recommendations stressed the potential for false-positives and the impact of low incidence on the positive predictive value of a test. For this reason, they recommend that all nonculture methods should be considered as “presumptively” positive. In those cases where a positive result is thought to be incorrect, they suggested that treatment should be offered while awaiting the results of additional testing. Only another NAA test was recommended as follow-up testing after an initial suspect positive test and a test with an alternate target was the first choice of additional testing. Culture continued to be the method recommended for all medicolegal cases. Testing of children was actively discouraged because of the potentially low positive predictive value of the tests in low incidence populations.
Chlamydia trachomatis is recognized as a leading agent of bacterial sexually-transmitted disease worldwide. The asymptomatic nature of a large proportion of chlamydial infections leads to underdiagnosis and consequent health problems. Approximately 75% of infections in females and 50% of male infections are asymptomatic.3,4 Women are the most severely affected due to the correlation between untreated Chlamydia infection and ectopic pregnancy and infertility.5 Rapid detection and diagnosis of chlamydial infection is critical in controlling not only the spread of disease but also the devastating sequelae. Partner evaluation to prevent reinfection is also an important aspect of controlling spread of the disease.
Gonorrhea manifests as acute urethritis in males and as cervicitis in females.7 N gonorrhoeae can be detected from asymptomatic females. Detection and treatment of these individuals is critical because if left untreated, gonorrhea can result in serious complications, including pelvic inflammatory disease, sterility, and ectopic pregnancy. It is very important to control the spread of this disease between sexual partners; thus, the use of a quick reliable test system is essential.
Please consult your Physician when reviewing your test results.
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