COMPARISONS OF COST AND ACCURACY OF DNA-PROBE TEST AND CULTURE FOR THE DETECTION OF NEISSERIA-GONORRHOEAE IN PATIENTS ATTENDING PUBLIC SEXUALLY-TRANSMITTED DISEASE CLINICS IN LOS-ANGELES-COUNTY

Background: Strict handling and transport requirements for the success ful use of culture in the detection of Neisseria gonorrhoeae warrant i nvestigation of accurate and cost-effective test alternatives such as the Gen-Probe PACE 2 DNA probe assay (Gen-Probe, Inc., San Diego, CA). Study Design: The Gen-Probe PACE 2 DNA probe assay for N. gonorrhoeae was compared with conventional culture methods in the principal Los A ngeles County (LAG) Department of Health Services (DHS) Public Health Laboratory and three of its branch laboratories, Urethral and endocerv ical samples were collected from 1,566 patients (921 males; 645 female s) attending six LAC DHS sexually transmitted disease clinics, Cost an alysis was performed comparing material and labor costs of the two tes t methods. Results: The overall prevalence based on culture was 11.8% (15.7% for males; 6.4% for females), Nine samples were culture positiv e, Gen-Probe negative and four samples were culture negative, Gen-Prob e positive and remained discordant after discrepant analysis, The sens itivity and specificity were 94.6% and 99.7%, respectively, for the PA CE 2 assay compared with culture, The positive and negative predictive values were 97.8% and 99.3%, respectively. No statistically significa nt difference was found between the two tests, A cost analysis found a n average cost of $3,11/test for culture and $3.85/test for PACE 2, gi ven the approximate 12% disease prevalence in this population. Conclus ions: Gen-Probe's PACE 2 assay may provide an acceptable, cost-effecti ve alternative to culture, especially among high-risk males.