EFFECT OF OFF-SITE TRANSPORTATION ON DETECTION OF NEISSERIA-GONORRHOEAE IN ENDOCERVICAL SPECIMENS

Objectives.-To evaluate both the effect of off-site transportation on detection of Neisseria gonorrhoeae in cultured, endocervical specimens and the impact of transportation on viability of N gonorrhoeae by com parison of culture with a nucleic acid probe assay. Design.-Three endo cervical swabs were randomly collected; one was tested on-site using a nucleic acid-based assay (PACE 2NG System, Cen-Probe, Inc, San Diego, Calif), one was tested off-site following inoculation to modified Tha yer-Martin agar (Remel, Lenexa, Kan), and a third swab was tested on-s ite by culture isolation. A nucleic acid amplification assay of the or iginal swab for PACE 2NG testing was used to resolve discrepancies. Se tting.-The emergency department of a university medical center. Patien ts.-Four hundred two patients were evaluated. The test population cons isted of both asymptomatic and symptomatic patients. Main Outcome Meas ure.-Positivity for N gonorrhoeae by one or more of the test procedure s, with discrepancy analysis when warranted. Results.-Of 402 specimens evaluated, the sensitivities for on-site and off-site testing using c ulture isolation for N gonorrhoeae were 88.9% and 77.8%, respectively, in a population prevalence of 6.7%. However, the sensitivity for on-s ite PACE 2NG testing for N gonorrhoeae was 96.3%. Conclusions.-A decre ase in sensitivity between on-site and off-site culture was found, whi ch suggested transportation may have an adverse effect on the detectio n of N gonorrhoeae. However, with the limited population and prevalenc e, the difference was not found to be statistically significant. Furth er studies indicated that the nucleic acid probe assay was significant ly more sensitive (P = .05) when compared with off-site testing using a culture isolation method, demonstrating that viability is an importa nt consideration. These results suggested that a molecular probe assay should be considered in testing specimens for N gonorrhoeae, especial ly when the specimen is to be transported off-site.