title: Appropriate time for test-of-cure when diagnosing gonorrhoea with a nucleic acid amplification test.
abstract: Culture is commonly regarded as the gold standard for diagnosis of Neisseria gonorrhoeae. However, nucleic acid amplification tests (NAATs) have rapidly replaced culture for diagnostics in many settings. The aim of the present study was to investigate the appropriate time for test-of-cure (TOC) when NAATs are used for diagnosis of gonorrhoea. In total, 30 patients (28 men and 2 women) provided urethral, cervical, rectal or pharyngeal specimens for TOC. All included patients, except one who did not return for second TOC before day 19, tested negative within 2 weeks after treatment with cefixime 400 mg × 1. Antimicrobial susceptibility testing showed that 68% of the culture-positive strains were resistant to ciprofloxacin. Thus, the recommended empirical treatment with ciprofloxacin in Norway should be changed immediately. TOC can be performed 2 weeks after treatment when NAATs are used for diagnosis of gonorrhoea.
authors.affiliation: Department of Microbiology and Infection Control, University Hospital of North Norway, NO-9038 Tromsø, Norway. stig.ove.hjelmevoll@unn.no
authors.forename: Stig Ove
authors.initials: SO
authors.lastname: Hjelmevoll
authors.forename: Merethe Elise
authors.initials: ME
authors.lastname: Olsen
authors.forename: Johanna U
authors.initials: JU
authors.lastname: Sollid
authors.forename: Håkon
authors.initials: H
authors.lastname: Haaheim
authors.forename: Kjetil K
authors.initials: KK
authors.lastname: Melby
authors.forename: Harald
authors.initials: H
authors.lastname: Moi
authors.forename: Magnus
authors.initials: M
authors.lastname: Unemo
authors.forename: Vegard
authors.initials: V
authors.lastname: Skogen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D020682:Cefixime / Q000627:therapeutic use*; D002584:Cervix Uteri / Q000382:microbiology; D002939:Ciprofloxacin / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009344:Neisseria gonorrhoeae / Q000187:drug effects / Q000302:isolation & purification*; D021141:Nucleic Acid Amplification Techniques; D010614:Pharynx / Q000382:microbiology; D012007:Rectum / Q000382:microbiology; D013997:Time Factors; D014521:Urethra / Q000382:microbiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D020682:Cefixime