What are the CDC recommendations for gonorrhea screening at extragenital sites?

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

Extragenital gonorrheal infections (pharyngeal and rectal infections) are often asymptomatic and are not uncommon in certain populations, such as men who have sex with men (MSM). Annual screening of extragenital sites in the MSM population is recommended by the CDC. While NAAT assay is the test of choice for extragenital gonorrheal infection screening, NAAT assays have not been approved by the FDA for pharyngeal and rectal specimens. Laboratories are recommended to process extragenital NAAT assay screens in compliance with Clinical Laboratory Improvement Amendments (CLIA) guidelines. [56] It is also important to be aware that certain NAAT assays may detect commensal Neisseria species and thereby yield false-positive results. In this situation, alternative testing methods may be needed for increased accuracy. If a patient has received a CDC-recommended antibiotic course with a repeat positive NAAT assay result 7 or more days after treatment and is not believed to have been re-exposed to gonorrhea after the treatment course, a rectal and/or oropharyngeal swab specimen for N gonorrhoeae culture should be obtained and evaluated for antibiotic susceptibility.


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