When is nucleic acid probe signal amplification (NAPSA) indicated in the workup of gonorrhea?

Updated: Jun 15, 2021
  • Author: Shahab Qureshi, MD, FACP; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Nucleic acid probe signal amplification (NAPSA) detects DNA sequences using RNA probes. Located sequences are then coated with detection antibodies, which allow detection. One commercial product uses a single test to detect gonorrhea and chlamydia. More study is needed to evaluate the sensitivity of this technique compared with that of NAAT.

Consider verifying positive urogenital nucleic acid detection test results (PCR, LCR, strand displacement amplification, ribosomal RNA or DNA sequence amplification tests) when false-positive results are likely. The CDC recommends testing a second specimen with a different test to confirm the positive results. [48] Australia and the United Kingdom have proposed guidelines to test the initial specimen with supplementary tests using different target sequences. The recommendations were that a result be reported as positive only if both test results were positive. [49]

Be aware that nonculture tests do not provide antimicrobial susceptibility results. Thus, in scenarios in which resistance or treatment failure is considered, culture and antimicrobial susceptibility testing may be warranted.

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