What is the role of nucleic acid amplification tests (NAATs) in the workup of urethritis?

Updated: Dec 12, 2018
  • Author: Martha K Terris, MD, FACS; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Polymerase chain reaction assays are available for gonococcal urethritis and Chlamydia infection. NAATs are also available for Mycoplasma species, Ureaplasma species, and T vaginalis, but these are not recommended, as they are expensive and do not alter the choice of treatment.

NAATs are the preferred test for Chlamydia and are more sensitive than traditional culture methods. Chlamydia DNA probe results are 60%-70% sensitive and nearly 100% specific. Obtain samples on swabs at least 2 hours after micturition, using a calcium-alginate swab on a nonwooden stick inserted at least 1 cm in depth to help prevent false-negative findings. Chlamydia ligase chain reaction is 90%-95% sensitive and nearly 100% specific. Obtain samples on swabs at least 2 hours after micturition, using a calcium-alginate swab on a nonwooden stick inserted at least 1 cm in depth to help prevent false-negative results.

DNA-based tests, unlike culture, do not allow for antibiotic susceptibility testing, but this is unnecessary in most patients.


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