Abstract

BackgroundWe aimed to evaluate the clinical performance of the GeneXpert® (Xpert) CT/NG assay for the detection of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) using urine and cervical swabs collected from patients in China.MethodsThis study was conducted from September 2016 to September 2018 in three Chinese urban hospitals. The results from the Xpert CT/NG test were compared to those from the Roche cobas® 4800 CT/NG test. Discordant results were confirmed by DNA sequence analysis.ResultsIn this study, 619 first void urine (FVU) specimens and 1,042 cervical swab specimens were included in the final dataset. There were no statistical differences between the results of the two tests for the detection of CT/NG in urine samples (p > 0.05), while a statistical difference was found in cervical swabs (p < 0.05). For CT detection, the sensitivity and specificity of the Xpert test were 100.0% (95%CI = 96.8–99.9) and 98.3% (95%CI = 96.6–99.2) for urine samples and 99.4% (95%CI = 96.5–100.0) and 98.6% (95%CI 97.5–99.2) for cervical swabs, respectively. For NG detection, the sensitivity and specificity of the Xpert test were 99.2% (95%CI = 94.9–100.0) and 100.0% (95%CI = 99.0–100.0) for urine and 100% (95%CI = 92.8–100.0) and 99.7% (95%CI = 99.0–99.9) for cervical swabs, respectively.ConclusionThe Xpert CT/NG test exhibited high sensitivity and specificity in the detection of CT and NG in both urine and cervical samples when compared to the reference results. The 90-min turnaround time for CT and NG detection at the point of care using Xpert may enable patients to receive treatment promptly.

Highlights

  • Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are two of the most common sexually transmitted bacterial pathogens across the world and are the main contributors to sexually transmitted infections (STIs) in China

  • 619 first void urine (FVU) specimens and 1,042 cervical swab specimens were included in the final dataset (Figure 1)

  • 197 (31.8%) urine specimens were obtained from the Institute of Dermatology, Chinese Academy of Medical Sciences, and Peking Union Medical College

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Summary

Introduction

Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are two of the most common sexually transmitted bacterial pathogens across the world and are the main contributors to sexually transmitted infections (STIs) in China. Both infections can have serious sequelae, especially in women, including pelvic inflammatory disease, which can lead to ectopic pregnancy and infertility (Baud et al, 2008; Ginocchio et al, 2012) and facilitate the risk of HIV transmission (Cohen et al, 1999; Bernstein et al, 2010). We aimed to evaluate the clinical performance of the GeneXpert® (Xpert) CT/NG assay for the detection of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) using urine and cervical swabs collected from patients in China

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