What are the CDC guidelines for gonorrhea screening?

Updated: Sep 07, 2018
  • Author: Brian Wong, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Culture is the criterion standard test in the workup of gonorrheal infections. Bacterial culture has high sensitivity and high specificity, is relatively low cost, is suitable for different types of specimen sources, and can be used for epidemiologic and resistance testing purposes. However, culturing for Neisseria is problematic because it is difficult to maintain the bacteria’s viability during transport and storage in various settings. Another drawback is that 24-72 hours is needed before a preliminary culture result may return.

Based on CDC guidelines and the USPS Task Force recommendations, nucleic acid amplification test (NAAT) assay is the test of choice to evaluate for urogenital infections in both males and females, whether symptomatic or asymptomatic. [36, 37]

One benefit of NAAT assay is that it does not require live organisms yet can yield a positive result with minimal genetic material available, using specimens such as first catch urine and vaginal swabs. Sensitivity for detection exceeds 90%, and specificity is 99% or higher. NAAT assays approved for use with vaginal swabs may also be approved for use with patient-collected vaginal specimens. Among patients engaging in oral or anal receptive sexual intercourse, NAAT assays may be useful to detect gonorrheal infection. However, NAAT assays using specimens collected from extragenital sites have not been approved by the US Food and Drug Administration (FDA). [38]

For specific CDC screening recommendations based on sex and health state, see the 2015 Sexually Transmitted Diseases Treatment Guidelines.

For the clinical guideline summary from the US Preventive Services Task Force, see the Screening for Gonorrhea: Recommendation Statement.


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