title: Self-collected swabs of the urinary meatus diagnose more Chlamydia trachomatis and Neisseria gonorrhoeae infections than first catch urine from men.
abstract: OBJECTIVE
  To compare first catch urine (FCU) and self-collected urinary meatal swabs for the detection of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) using the APTIMA Combo 2 assay.
  
  
  METHODS
  A total of 511 young men from a high risk street youth clinic were studied. Group A (n=293) collected a FCU and a meatal APTIMA swab followed by Group B (n=218) who collected a FCU and two meatal samples using an APTIMA swab and a flocked swab. Order of sample collection was alternated. Individuals in Group B rated collection as easy, difficult or neither, then expressed a preference for sampling and swab type. All subjects performed meatal self-collection in the presence of a study monitor.
  
  
  RESULTS
  The combined CT prevalence was 7.8% and 2.7% for NG where 80% of the men were without symptoms. Meatal swabbing identified 35 cases of CT and 14 cases of NG compared to 33 and 11 for FCU. Flocked and APTIMA swabs were equally effective in detecting more cases. The majority of men found self-collection of meatal swabs and urine to be easy. Although 63% preferred urine sampling, 60% of those who preferred swabbing selected the flocked swab.
  
  
  CONCLUSIONS
  Collection of meatal swabs could serve as an alternative to urethral swabbing and FCU for the detection of CT and NG.
authors.affiliation: 1St Joseph’s Healthcare/McMaster University, Hamilton, Ontario, Canada. chernesk@gmail.com
authors.forename: Max A
authors.initials: MA
authors.lastname: Chernesky
authors.forename: Dan
authors.initials: D
authors.lastname: Jang
authors.forename: Eder
authors.initials: E
authors.lastname: Portillo
authors.forename: Marek
authors.initials: M
authors.lastname: Smieja
authors.forename: Jodi
authors.initials: J
authors.lastname: Gilchrist
authors.forename: Ruth
authors.initials: R
authors.lastname: Ewert
authors.forename: Cindy
authors.initials: C
authors.lastname: Macritchie
mesh_terms: D000293:Adolescent; D002690:Chlamydia Infections / Q000175:diagnosis*; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D006069:Gonorrhea / Q000175:diagnosis*; D006801:Humans; D008297:Male; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification*; D012646:Self Administration / Q000379:methods*; D013048:Specimen Handling / Q000379:methods*; D014556:Urine / Q000382:microbiology*; D055815:Young Adult