Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.
J Clin Microbiol. 2022 Apr 20;60(4):e0021121. doi: 10.1128/JCM.00211-21. Epub 2021 Nov 3.
Chlamydia trachomatis and Neisseria gonorrhoeae are two of the most often reported bacterial infections in the United States. The rectum and oropharynx are important anatomic sites of infection and can contribute to ongoing transmission. Nucleic acid amplification tests (NAATs) are the mainstays for the detection of C. trachomatis and N. gonorrhoeae infections owing to their high sensitivity and specificity. Several NAATs have been evaluated for testing in rectal and pharyngeal infections. A few assays recently received clearance by the Food and Drug Administration, including one point-of-care test. Those assays can be used for testing in symptomatic individuals, as well as for asymptomatic screening in certain patient populations. Routine screening for C. trachomatis in pharyngeal specimens is not recommended by the Centers for Disease Control and Prevention, though it is often performed due to the use of multiplex assays. While expanding the types of settings for screening and using self-collected rectal and pharyngeal specimens can help to increase access and uptake of testing, additional research is needed to determine the potential benefits and costs associated with increased screening for rectal and pharyngeal C. trachomatis and N. gonorrhoeae infections on a population level.
沙眼衣原体和淋病奈瑟菌是美国报告最多的两种细菌感染。直肠和口咽是感染的重要解剖部位,可导致持续传播。由于核酸扩增检测(NAAT)具有高灵敏度和特异性,因此是检测沙眼衣原体和淋病奈瑟菌感染的主要方法。已经有几种 NAAT 用于直肠和咽部感染的检测。一些检测方法最近获得了美国食品和药物管理局的批准,包括一种即时检测方法。这些检测方法可用于有症状个体的检测,也可用于某些患者群体的无症状筛查。尽管由于使用多重检测方法,咽拭子中沙眼衣原体的常规筛查不被疾病预防控制中心推荐,但它经常被进行。虽然扩大筛查的场所类型并使用自我采集的直肠和咽拭子标本有助于增加检测的机会,但仍需要进一步研究,以确定在人群水平上增加对直肠和咽拭子沙眼衣原体和淋病奈瑟菌感染的筛查的潜在益处和成本。