Gonorrhea Tests in Australia

In current years, there has been a important change in the approach to the diagnosis of Gonorrhoea in Australia. Conventional culture methods for isolation of Neisseria Gonorrhoeae have been more and more replaced by nucleic acid detection tests, particularly in remote areas of Australia. This has occurred for numerous reasons, particularly the increased sturdiness and the better sensitivity for testing of patents outside hospital clinics. As a general rule NADT have performed well, particularly as reliable and sensitive tests for the exclusion of Gonococcal infection.

Though, after increasing experience with these tests, some troubles have been acknowledged with NADT. The most extensively used commercial examine, the Cobas Amplicor, was found to create a large number of fake positive results and it was realized that the goal sequence in the cytosine DNA methyltransferase (CMT) gene of N. Gonorrhoeae was also there in some strains of other Neisseria species, together with N. cinerea and N. subflava. These are normal flora in the upper respiratory tract, and may also be there in the genital tract. It is still not apparent whether this is the sole method of false positive results with this examination.

Consequently, numerous supplemental tests have been developed and used in Australia. The first ones were heading for targets in the 16S RNA and the cppB genes. Neither of these targets was, in themselves, completely specific but the mixture of two teats substantially improved specificity. Though, some obviously problematic results remained, with some fake positives still occurring in genital tract and urine samples, and more frequently in results with throat swabs, irrespective of the test combination used.

Recent developments in in-house NADT for Gonorrhea in Australia
Since 2002, numerous Australian laboratories have assessed further a number of existing tests and devised other methods for improving the specificity of Gonococcal NADT.