Our hospital-based GUM clinic Neisseria gonorrhoeae (NG) cultures were directly plated, stored in a CO2-enriched incubator and portered twice daily to onsite microbiology. Service relocation in November 2015 to a citycentre hub and 4 community sites forced change due to distance from microbiology. Community samples are taken on charcoal swabs, taxied to the hub at close of clinic for plating. Hub samples are directly plated. All plates are incubated 48–72hrs and transported daily in CO2-enriched environment (not temperature controlled).Aims/objectives
Evaluate sensitivity for NG culture against positive NAAT before and after service relocation.Methods
Cases of NAAT positive NG with a culture taken January–June 2015 were compared with cases January–June 2016. Hub and community results were merged in 2016 due to small numbers from community.Results
Overall sensitivity per infected patient (any positive NAAT and culture from any site) 2016 176/253 (70%) versus 2015 218/279 (78%), OR 0.64 (95% CI 0.43–0.94), p=0.02. Total sites with positive NAAT and associated culture processed: 2015 n=375, 2016 n=333.Results
Culture sensitivity by site of positive NAAT 2016 versus 2015: Urogenital 78% versus 85% (OR 0.63(0.37–1.08);p=0.09), Rectal 39% versus 55% (OR 0.52(0.29–0.94);p=0.03), Pharynx 33% versus 51% (OR 0.49(0.25–0.96);p=0.04).Discussion
Despite extensive review of evidence to identify systems that would maintain NG culture sensitivity, the overall sensitivity of NG culture has dropped significantly since the community move. There has been a non-significant decline in urogenital culture sensitivity but significant reductions in rectal and pharyngeal sensitivities. A new method for NG transportation is now under consideration.