What are the US Preventive Task Force (USPTF) recommendations for gonorrhea screening in females?

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

According to the USPTF recommendation, sexually active women younger than 25 years and older women at increased risk for gonococcal infection (defined by the CDC as those who have a new sex partner, more than one sex partner, a sex partner with concurrent partners, or a sex partner who has an STI) should be screened annually. Other medical governing bodies have also suggested other risk factors for gonorrhea, including prior gonococcal infection, other concurrent sexually transmitted infections, inconsistent condom use, commercial sex work, and illicit drug use.

The preferred method to screen for genitourinary gonorrhea is collection of vaginal swab specimens sent for NAAT assay testing. Studies have shown that the sensitivity of vaginal swab specimens is equal to that of cervical swab specimens. [53] In addition, patient-collected vaginal specimens also have the same sensitivity and specificity as clinician-collected specimens. [54, 55]

If the patient needs a concurrent pelvic examination, an endocervical swab is reasonable. However, in contrast with workup in males, first catch urine specimens to detect gonorrhea may detect about 10% fewer infections when compared with vaginal and endocervical swab specimens.

In patients in whom CDC-recommended initial therapy has failed based on repeat positive NAAT assay results 7 or more days after treatment and are not believed to have been re-exposed to gonorrhea after the treatment course, an endocervical swab for N gonorrhoeae should be obtained and sent for antibiotic susceptibility to evaluate for antimicrobial resistance.


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