Effect of off-site transportation on detection of Neisseria gonorrhoeae in endocervical specimens.
OBJECTIVE
To evaluate both the effect of off-site transportation on detection of Neisseria gonorrhoeae in cultured endocervical specimens and the impact of transportation on viability of N. gonorrhoeae by comparison of culture with a nucleic acid probe assay.


METHODS
Three endocervical swabs were randomly collected; one was tested on-site using a nucleic acid-based assay (PACE 2NG System, Gen-Probe, Inc, San Diego, Calif), one was tested off-site following inoculation to modified Thayer-Martin agar (Remel, Lenexa, Kan), and a third swab was tested on-site by culture isolation. A nucleic acid amplification assay of the original swab for PACE 2NG testing was used to resolve discrepancies.


METHODS
The emergency department of a university medical center.


METHODS
Four hundred two patients were evaluated. The test population consisted of both asymptomatic and symptomatic patients.


METHODS
Positivity for N. gonorrhoeae by one or more of the test procedures, with discrepancy analysis when warranted.


RESULTS
Of 402 specimens evaluated, the sensitivities for on-site and off-site testing using culture isolation for N. gonorrhoeae were 88.9% and 77.8%, respectively, in a population prevalence of 6.7%. However, the sensitivity for on-site PACE 2NG testing for N. gonorrhoeae was 96.3%.


CONCLUSIONS
A decrease in sensitivity between on-site and off-site culture was found, which suggested transportation may have an adverse effect on the detection of N gonorrhoeae. However, with the limited population and prevalence, the difference was not found to be statistically significant. Further studies indicated that the nucleic acid probe assay was significantly more sensitive (P = .05) when compared with off-site testing using a culture isolation method, demonstrating that viability is an important consideration. These results suggested that a molecular probe assay should be considered in testing specimens for N. gonorrhoeae, especially when the specimen is to be transported off-site.
Iwen
P C
PC
Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha 68198-6495, USA.
Walker
R A
RA
Warren
K L
KL
Kelly
D M
DM
Linder
J
J
Hinrichs
S H
SH
D001431:Bacteriological Techniques / Q000706:statistics & numerical data; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis*; D006801:Humans; D015336:Molecular Probe Techniques / Q000706:statistics & numerical data; D009344:Neisseria gonorrhoeae / Q000235:genetics / Q000302:isolation & purification*; D017063:Outcome Assessment, Health Care; D012680:Sensitivity and Specificity; D013048:Specimen Handling / Q000379:methods*; D014186:Transportation; D014626:Vaginal Smears / Q000379:methods*