Performance of the AnyplexTM CT/NG Real-time Detection for extra-genital Chlamydia trachomatis and Neisseria gonorrhoeae detection

Authors

  • Siwimol Phoomniyom Office of Disease Prevention and Control, Region 11 Nakhon Si Thammarat
  • Pongsathorn Sangprasert Division of AIDS and STIs, Department Of Disease Control
  • Rungnapa Luenprasit Division of AIDS and STIs, Department Of Disease Control
  • Rossaphorn Kittiyaowamarn Division of AIDS and STIs, Department Of Disease Control

DOI:

https://doi.org/10.14456/dcj.2022.67

Keywords:

Chlamydia trachomatis, Neisseria gonorrhoeae, extra-genital, AnyplexTM CT/NG Real-time Detection

Abstract

trachomatis and N. gonorrhoeae are the two most common sexually transmitted infections. Although these pathogens can be treated with antibiotics, infection with C. trachomatis and N. gonorrhoeae is frequently asymptomatic. Therefore, it often goes undetected and is left untreated, representing an important health concern, especially when infection occurs in extra-genital sites. Culture method has remained the ‘gold standard’ for N. gonorrhoeae detection, while nucleic acid amplification tests have increasingly become a preferred method. Therefore, the objective of this study is to evaluate the performance of AnyplexTM CT/NG Real-time Detection in comparison with the routine methods for the detection of C. trachomatis and N. gonorrhoeae from extra-genital specimens. Thirty C. trachomatis positive and thirty C. trachomatis negative samples tested by in-house real time PCR and thirty N. gonorrhoeae positive and thirty N. gonorrhoeae negative samples tested by culture during January 2019 - January 2020 were selected. All 120 samples were amplified by AnyplexTM CT/NG Real-time Detection. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were analyzed. The sensitivity, specificity, PPV and NPV of AnyplexTM CT/NG Real-time Detection for C. trachomatis compared with in-house real time PCR was 100%, 93.33%, 93.75%, 100%, respectively. In the meantime, the performance of this kit for N. gonorrhoeae was 100% in all parameters, compared with culture and in-house real time PCR. Two discrepancy results for C. trachomatis detection were found, which were negative by in-house real time PCR, but positive by the commercial PCR kits. Furthermore, we also found six samples were reported as CT/NG co-infection by AnyplexTM CT/NG Real-time Detection. 3 of 6 samples were positive for N. gonorrhoeae from culture method. The AnyplexTM CT/NG Real-time Detection result was also positive for C. trachomatis, whereas the routine method result was negative. In addition, another 3 samples were positive for C. trachomatis by in-house real time PCR method. The AnyplexTM CT/NG Real-time Detection result was also positive for N. gonorrhoeae, whereas the routine method result was negative. C. trachomatis negative by in-house real time PCR, while another 3 samples were N. gonorrhoeae negative by culture. These results indicated that AnyplexTM CT/NG Real-time Detection has efficiency to detect pathogen’s DNA, although pathogen died, and has highly acceptable performance characteristics for the detection of C. trachomatis and N. gonorrhoeae in extra-genital specimens.

References

World Health Organisation: Global strategy for the prevention and control of Sexually transmitted infections: 2006-2015: breaking the chain of transmission [Internet]. [Cited 2020 Sep 10]. Available from http://apps.who.int/iris/bitstream/handle/10665/43853/ 9789241563475_eng/Pdf;jessionid=B5D9ED847DD81C1795D67FFECE7D98AF?sequence=1

HIV info hub. Division of AIDS and STIs [Internet]. [Cited 2020 Sep 10]. Available from: https://hivhub.ddc.moph.go.th/epidemic.php (in Thai)

Cates W, Wasserheit JN. Genital Chlamydia infections; epidemiology and 3 reproductive sequalae. Am J Obstet Gynecol. 1991;164:1771-81.

Kent CK, Chaw JK, Wong W, Liska S, Gibson S, Hubbard G, et al. Prevalence of rectal, urethral, and pharyngeal chlamydia and gonorrhea detected in 2 clinical settings among men who have sex with men: San Francisco, California, 2003. Clin Infect Dis. 2005;41(1):67-74.

Jones RB, Rabinovitch RA, Katz BP, Batteiger BE, Quinn TS, Terho P, et al. Chlamydia trachomatis in the pharynx and rectum of heterosexual patients at risk for genital infection. Ann Intern Med. 1985;102(6):757-62.

Centers for Disease Control and Prevention. Clinic-based testing for rectal and pharyngeal Neisseria gonorrhoeae and Chlamydia trachomatis infections by community-based organizations-five cities, United States, 2007. MMWR Morb Mortal Wkly Rep. 2009;58:716-9.

Alexander S. The challenges of detecting gonorrhoea and chlamydia in rectal and pharyngeal sites: could we, should we, be doing more? Sex Transm Infect. 2009;85:159-60.

Taylor SN, Liesenfeld O, Lillis RA, Body BA, Nye M, Williams J, et al. Evaluation of the Roche cobas(R) CT/NG test for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in male urine. Sex Transm Dis. 2012;39:543-9.

Graver MA, Wade JJ. Survival of Neisseria gonorrhoeae isolates of different auxotypes in six commercial transport systems. J Clin Microbiol. 2004;42:4803-4.

Page-Shafer K, Graves A, Kent C, Balls JE, Zapitz VM, Klausner JD. Increased sensitivity of DNA amplification testing for the detection of pharyngeal gonorrhea in men who have sex with men. Clin Infect Dis. 2002;34:173-6.

Palmer H, Mallinson H, Wood RL. Evaluation of the specificities of five DNA amplification methods for the detection of Neisseria gonorrhoeae. J Clin Microbiol. 2003;41:835-7.

Papp JR, Schachter J, Gaydos CA, Van Der Pol B. Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae-2014. MMWR Recomm Rep. 2014;63(RR-02):1-19.

Harper M, Johnson R. The predictive value of culture for the diagnosis of gonorrhea and Chlamydia infections. Clin Microbiol Newslet. 1990;12:54-6.

Bamrungsak B, Phoomniyom S, Luengprasit R. Development and validation of an in-house real-time PCR assay for the detection of Chlamydia trachomatis in sexually transmitted infections clinic. Thai AIDS Journal. 2020;32:28-41. (in Thai)

Phoomniyom S, Bamrungsak B, Boonprathueng K, Sangprasert P, Luengprasit R, Ngarmjiratam N, et al. Efficiency evaluation of an in-house real-time PCR assay for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in urine specimens. Thai AIDS Journal. 2020;33:9-20. (in Thai)

Sudjai N. Sample size calculation for diagnostic test studies. J Med Health Sci. 2020; 27(2): 167-82. (in Thai)

Patton ME, Kidd S, Llata E, Stenger M, Braxton J, Asbel L, et al. Extragenital gonorrhea and chlamydia testing and infection among men who have sex with men-STD Surveillance Network, United States, 2010- 2012. Clin Infect Dis. 2014;58(11):1564-70.

Chan PA, Robinette A, Montgomery M, Almonte A, Cu-Uvin S, Lonks JR, et al. Extragenital Infections Caused by Chlamydia trachomatis and Neisseria gonorrhoeae: A Review of the Literature. Infect Dis Obstet Gynecol. 2016:1-17.

Gaydos CA, Theodore M, Dalesio N, Wood BJ, Quinn TC. Comparison of three nucleic acid amplification tests for detection of Chlamydia trachomatis in urine specimens. J Clin Microbiol. 2004;42(7):3041-5.

Centers for Disease Control and Prevention. Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae-2014. MMWR Recomm Rep. 2014;63(RR-02):1-19.

Carnicer-Pont D, González V, López-Corbeto E, Turu E, the Prison Health working Group. Prevalence and predictive factors of Chlamydia trachomatis genital infection in inmates 25 to 65 years old in four Catalan prisons. Rev Esp Sanid Penit. 2019;21(3):126-37.

Riera-Monroig J, Corbeto EL, Bosch J, Fuertes I. Screening for asymptomatic Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium in medical students in Barcelona. J Skin Sex Transmitted Dis. 2020;2(2):134-6.

Jongen VW, Loeff MF, Botha MH, Sudenga SL, Abrahamsen ME, Giuliano AR. Incidence and risk factors of C. trachomatis and N. gonorrhoeae among young women from the Western Cape, South Africa: The EVRI study. PLoS One. 2021:1-14.

Munrós J, Vergara A, Bataller E, Restovic G, García-Lorenzo B, Álvarez-Martínez MJ, et al. Performance and impact of using a rapid molecular test to detect Chlamydia trachomatis and Neisseria gonorrhoeae in women suspected of having pelvic inflammatory disease. Enferm Infecc Microbiol Clin. 2020:1-27.

Bamberger DM, Graham G, Dennis L, Gerkovich MM. Extragenital Gonorrhea and Chlamydia among Men and Women According to Type of Sexual Exposure. Sex Transm Dis. 2019;46(5):329-34.

Downloads

Published

2022-12-30

How to Cite

1.
Phoomniyom S, Sangprasert P, Luenprasit R, Kittiyaowamarn R. Performance of the AnyplexTM CT/NG Real-time Detection for extra-genital Chlamydia trachomatis and Neisseria gonorrhoeae detection. Dis Control J [Internet]. 2022 Dec. 30 [cited 2024 May 12];48(4):797-809. Available from: https://he01.tci-thaijo.org/index.php/DCJ/article/view/252290

Issue

Section

Original Article