Microbiology

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The Aptima Multicollect System is used as a screening method for Chlamydia / Neisseria gonorrhoeae.  

Routine culture for Neisseria gonorrhoeae is no longer available to GPs.  Culture is available to specialised STI clinics only.

Endocervical Swabs for Neisseria gonorrhoeae culture are only to be taken on symptomatic patients for susceptibility testing.  A range of sexually transmissible organisms cause infections responsible for a large number of clinical syndromes.  When a specific STI is diagnosed, it is recommended to screen for other infections.  Screening has a role in helping to control gonorrhoea, syphilis, chlamydial infection, and human immunodeficiency virus (HIV) infection.

Local gonococcal infections in women primarily affect the cervix and are often asymptomatic, but can cause an increased vaginal discharge, genital itching or dysuria.  Endocervical/cervical and/or urethral swabs are the preferred specimens.

Appropriate specimens are often difficult to obtain, particularly from women, and incorrect or sub-optimal specimens are often received.  It is important to avoid contamination with vulva faecal flora during collection of specimens.Use a speculum without lubricant. Wipe the cervix clean of vaginal secretions and mucus. Gently insert a swab into the endocervical canal and rotate inside the endocervix to obtain any exudate. Place the swab in MW176 Liquid swab Transwab. Cervical, endocervical, and female urethral specimens have a gram stains performed.

As Neisseria gonorrhoea is highly susceptible to drying and changes in temperature the time it takes to culture and/or incubate the specimen in the appropriate conditions can affect recovery rate and thus the test results. Ideally, inoculation of specimens for N. gonorrhoeae is made directly to culture media (GC VCAT agar) at the bedside and incubated without delay. Ensure the medium is within the marked expiry date. The plates should be stored at 4º C and returned to room temperature before inoculating. Recovery of organisms may be affected by inappropriate storage of New York City medium.

Where possible specimen collection should occur before antimicrobial therapy is initiated. If pelvic infection, including gonorrhoea, is suspected, the cervix is also swabbed. Swabs with clinical details of ?PID will be processed for other bacterial causes of infection

Separate samples are collected into appropriate transport media for detection of viruses or C. trachomatis.

Investigation for Trichomonas vaginalis is no longer performed on Cervical Swabs. Please contact the laboratory if clinically indicated.

Send sample to the laboratory without delay.  Sample should be refrigerated if not transported immediately

Related links

HPA SOP B28: Investigation of genital tract and associated specimens.

Reference range

Last updated

Thu, 06 Jun 2024 16:31:29 IST