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Bacteriology

Changing from Clinician-Collected to Self-Collected Throat Swabs for Oropharyngeal Gonorrhea and Chlamydia Screening among Men Who Have Sex with Men

Eric P. F. Chow, Catriona S. Bradshaw, Deborah A. Williamson, Shauna Hall, Marcus Y. Chen, Tiffany R. Phillips, Ria Fortune, Kate Maddaford, Christopher K. Fairley
Erik Munson, Editor
Eric P. F. Chow
aMelbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
bCentral Clinical School, Monash University, Melbourne, Victoria, Australia
cCentre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
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Catriona S. Bradshaw
aMelbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
bCentral Clinical School, Monash University, Melbourne, Victoria, Australia
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Deborah A. Williamson
dMicrobiological Diagnostic Unit, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
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Shauna Hall
aMelbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
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Marcus Y. Chen
aMelbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
bCentral Clinical School, Monash University, Melbourne, Victoria, Australia
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Tiffany R. Phillips
aMelbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
bCentral Clinical School, Monash University, Melbourne, Victoria, Australia
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Ria Fortune
aMelbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
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Kate Maddaford
aMelbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
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Christopher K. Fairley
aMelbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
bCentral Clinical School, Monash University, Melbourne, Victoria, Australia
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Erik Munson
Marquette University
Roles: Editor
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DOI: 10.1128/JCM.01215-20
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ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has led many clinics to move from clinician-collected to self-collected oropharyngeal swabs for the detection of sexually transmitted infections (STIs). Before this change, however, self-collection was used primarily for genital and anorectal infections, with only limited studies on the performance of self-collection of oropharyngeal swabs for oropharyngeal STI detection. The Melbourne Sexual Health Centre (MSHC) changed from clinician-collected to self-collected oropharyngeal swabs for oropharyngeal gonorrhea and chlamydia screening on 16 March 2020 in order to reduce health care worker risk during the COVID-19 pandemic. We compared the proportions of valid and positive samples for gonorrhea and chlamydia among men who have sex with men (MSM) in two time periods; the clinician collection period, between 20 January and 15 March 2020, and the self-collection period, between 16 March and 8 May 2020. A total of 4,097 oropharyngeal swabs were included. The proportion of oropharyngeal swabs with equivocal or invalid results for Neisseria gonorrhoeae was higher in the self-collection period (1.6% [24/1,497]) than in the clinician collection period (0.9% [23/2,600]) (P = 0.038), but the proportions did not differ for the detection of Chlamydia trachomatis. The positivity rates of oropharyngeal N. gonorrhoeae (adjusted prevalence ratio [PR], 1.07 [95% confidence interval {CI}, 0.85 to 1.34]) (P = 0.583) and oropharyngeal C. trachomatis (adjusted PR, 0.84 [95% CI, 0.51 to 1.39]) (P = 0.504) specimens did not differ between the two periods. Self-collected oropharyngeal swabs for the detection of N. gonorrhoeae and C. trachomatis have acceptable performance characteristics and, importantly, reduce health care worker exposure to respiratory infections.

FOOTNOTES

    • Received 21 May 2020.
    • Returned for modification 14 June 2020.
    • Accepted 23 June 2020.
    • Accepted manuscript posted online 1 July 2020.
  • Supplemental material is available online only.

  • Copyright © 2020 American Society for Microbiology.

All Rights Reserved.

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Changing from Clinician-Collected to Self-Collected Throat Swabs for Oropharyngeal Gonorrhea and Chlamydia Screening among Men Who Have Sex with Men
Eric P. F. Chow, Catriona S. Bradshaw, Deborah A. Williamson, Shauna Hall, Marcus Y. Chen, Tiffany R. Phillips, Ria Fortune, Kate Maddaford, Christopher K. Fairley
Journal of Clinical Microbiology Aug 2020, 58 (9) e01215-20; DOI: 10.1128/JCM.01215-20

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Changing from Clinician-Collected to Self-Collected Throat Swabs for Oropharyngeal Gonorrhea and Chlamydia Screening among Men Who Have Sex with Men
Eric P. F. Chow, Catriona S. Bradshaw, Deborah A. Williamson, Shauna Hall, Marcus Y. Chen, Tiffany R. Phillips, Ria Fortune, Kate Maddaford, Christopher K. Fairley
Journal of Clinical Microbiology Aug 2020, 58 (9) e01215-20; DOI: 10.1128/JCM.01215-20
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KEYWORDS

Chlamydia trachomatis
Neisseria gonorrhoeae
sexually transmitted infection
detection
performance
pharyngeal
sexually transmitted disease
testing
sampling

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