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Self-sampling with oral rinse to detect oropharyngeal Neisseria gonorrhoeae among men who have sex with men: results from an exploratory study in Belgium (the SSONG Study).
- Source :
-
Sexually transmitted infections [Sex Transm Infect] 2024 May 31; Vol. 100 (4), pp. 222-225. Date of Electronic Publication: 2024 May 31. - Publication Year :
- 2024
-
Abstract
- Objectives: We aimed to assess whether a self-collected oral rinse was non-inferior to clinician-collected oropharyngeal swabs to detect Neisseria gonorrhoeae (Ng) using culture and nucleic acid amplification tests (NAAT) among men who have sex with men (MSM), and whether Ng may still be detected in oral rinses for a minimum of 5 days after collection.<br />Methods: MSM with a positive Ng result in an oropharyngeal or pooled sample (oropharynx, urethra and anorectum) were approached. Clinician-collected oropharyngeal swabs and oral rinses (15 mL sterile water) were taken. Ng culture and NAAT (Abbott 2000m RealTime System CT/NG assay and in-house PCR) were performed. Diagnostic accuracy was assessed using sensitivity and specificity, and agreement between both techniques using Cohen's kappa statistic. Aliquots of positive oral rinses were left at room temperature for a minimum of 5 days and reanalysed using NAAT. Lastly, participants filled in a questionnaire to explore perceptions of both methods.<br />Results: We included 100 participants between June 2022 and October 2023. 45 individuals (45 of 100) had a positive Ng result in either the oral rinses (42 of 45, 93%) or the swabs (36 of 45, 80%). Sensitivity was higher for oral rinses than swabs (sensitivity=0.93/0.80, specificity=1.0/1.0, respectively) and agreement between both techniques was good (kappa=0.75, p<0.001). Of the 42 positive oral rinses, 37 remained positive after a minimum of 5 days (88.1%). Using culture, 18 individuals had a positive Ng result in either the oral rinses (8 of 18, 44%) or the swabs (16 of 18, 88%). Most participants found the oral rinse easy or very easy to use and would be willing to use the oral rinse for home-based sampling.<br />Conclusion: We detected more oropharyngeal Ng infections via NAAT using oral rinses than swab samples. However, swabs were better than oral rinses for culturing Ng. Oral rinses might allow for home-based self-sampling to detect oropharyngeal Ng.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Humans
Male
Adult
Belgium
Middle Aged
Urethra microbiology
Young Adult
Neisseria gonorrhoeae isolation & purification
Neisseria gonorrhoeae genetics
Gonorrhea diagnosis
Homosexuality, Male
Oropharynx microbiology
Specimen Handling methods
Nucleic Acid Amplification Techniques methods
Sensitivity and Specificity
Subjects
Details
- Language :
- English
- ISSN :
- 1472-3263
- Volume :
- 100
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Sexually transmitted infections
- Publication Type :
- Academic Journal
- Accession number :
- 38553038
- Full Text :
- https://doi.org/10.1136/sextrans-2023-056059