Culture confirmation of gonococcal infection by recall of subjects found to be positive by nucleic acid amplification tests in general practice

OBJECTIVES: To evaluate a routine notification of general practitioners to recall nucleic acid amplification test (NAAT)-positive subjects for culture of Neisseria gonorrhoeae to confirm gonococcal infection in the community. METHODS: A retrospective observational study of the routine testing for N gonorrhoeae by analysis of test results compiled from the laboratory information system in two departments of clinical microbiology. RESULTS: Altogether, 158 male and female subjects with NAAT-positive results for N gonorrhoeae were included in the study. Samples for culture of N gonorrhoeae were collected from 102/158 (64.6%) subjects recalled after a NAAT assay was found positive. Growth of N gonorrhoeae was seen in the samples from 54/102 (52.9%) of the re-examined NAAT-positive subjects. Among subjects with samples collected within the first week after the positive NAAT test, 34/44 (77.3%) were confirmed positive by culture. CONCLUSION: This study shows that it is possible for the general practitioner to recall a substantial number of NAAT-positive subjects to collect swabs for culture of N gonorrhoeae to confirm gonococcal infection in the community. Most recall samples are culture positive if collected within a week of the NAAT-positive test, and may provide a sufficient monitoring of the drug susceptibility of N gonorrhoeae strains in the community. To evaluate a routine notification of general practitioners to recall nucleic acid amplification test (NAAT)-positive subjects for culture of Neisseria gonorrhoeae to confirm gonococcal infection in the community.