Gonorrhoea Testing Singapore | Shim Clinic
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Gonorrhoea Test is usually by
- Gonorrhoea PCR (polymerase chain reaction) test
- Gonococcal (GC) culture
- Gram-negative intracellular diplococci by gram stain smear
LABORATORY TESTS
- Presumptive diagnosis of gonorrhoea is made on finding Gram-negative intracellular diplococci in a smear of the discharge. In men, microscopy of urethral smears is more sensitive in symptomatic (90–95%) than in asymptomatic (50–75%) patients. In women sensitivity of microscopy of Gram-stained endocervical smears is around 50%. Microscopy is not appropriate for pharyngeal and rectal specimens.
- Confirmatory diagnosis is made by identification of the organism on selective culture media.
- NAATs (PCR) are more sensitive than culture and can be used as diagnostic/ screening tests on non-invasively collected specimens (urine and self-taken vaginal swabs). The sensitivity of NAATs is >90% for genital sites, whilst the sensitivity of culture may be < than 75% for endocervical swabs.
- There are currently no NAATs licensed for use with rectal or pharyngeal samples, although studies suggest that the sensitivity of NAATs at non-genital sites exceeds 90% whereas the sensitivity of culture can be <60% for rectal swabs and <50% for pharyngeal swabs.
- The DSC clinic currently uses NAATs to detect rectal, urethral and cervical GC, and cultures for pharyngeal GC.
- Some degree of caution is required in interpretation of positive results as the specificity of NAATs is not 100%; especially if the risk profile of the patient is at odds with the result. Confirmation of a NAAT positive result by culture can be considered in cases where there is some doubt. However, generally NAATs are considered reliable for detection.
- As nonculture tests cannot provide antimicrobial susceptibility results, in cases of persistent gonococcal infection after treatment, clinicians should perform both culture and antimicrobial susceptibility testing.
- Gonococcal complement fixation test (GC-CFT) should not be used for diagnosing gonorrhoea.
Specimen collection:
Males:
Routinely from the urethra; rectal and/or oropharyngeal tests when indicated by sexual activity. FVU provides an alternative urethral specimen for testing with a NAAT.
Females:
Routinely from endocervix if speculum examination performed; and rectal and oropharyngeal tests when indicated by the sexual history. Urine or a self-taken vaginal swab are suitable alternative specimens as screening tests using a NAAT.
Sexual risk (of HIV/STD/pregnancy), and what you can do before and after exposure.
Timeline | HIV | STD | Pregnancy |
---|---|---|---|
Before exposure | |||
Contraception (females only) |
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HIV PrEP (pre-exposure prophylaxis) – Stop HIV infection before exposure |
STD vaccine: – Hepatitis vaccine – HPV vaccine |
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STD / HIV exposure | No condom / Condom broke / Condom slip |
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0-72 hours | HIV PEP (post-exposure prophylaxis) – Stop HIV infection after exposure |
STD testing * – Screening test – to look for asymptomatic infections – from previous exposures |
Emergency contraception with the morning-after pill (females only) |
2 weeks | HIV DNA Test | ||
1 month | HIV 4th Generation Test – SD Bioline HIV Ag/Ab Combo – Fingerprick blood sampling. – 20 minutes to results |
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3 months | HIV 3rd Generation Test – OraQuick® HIV-1/2 Antibody – Oral fluid or – Fingerprick blood sampling. – 20 minutes to results |
STD testing * – Full & comprehensive – diagnostic test – to look for current infections |
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Watch for | HIV Symptoms | STD Symptoms | |
If infected | HIV Treatment | STD Treatment | Abortion |
* Males: Do not urinate for at least 4 hours before arriving.
* Females: testing is more accurate when you are not menstruating.
References