P122 Are pharyngeal swabs for CT/GC of value in heterosexual men? A retrospective review of a clinic cohort

Abstract

Background/introduction Pharyngeal testing for CT/GC is generally not recommended for heterosexual men whose only sexual exposure is cunilingus. However, some clinicians in this service also started sending self-taken swabs from heterosexual men when self-taken swabs became routine practice for MSM in 2014. Aim(s)/objectives To measure the utility of pharyngeal CT/GC swabs in heterosexual men Methods A retrospective case-note review of all heterosexual men who had been coded as having had a pharyngeal swab for CT/GC NAAT between July 2014 and August 2015. Results 1374 eligible patients were identified. 25/1374 (1.8%) of these were GC NAAT +ve of which 4/25 (16%) were +ve in the pharynx, the others being +ve in the urine. 3/4 pharyngeal +ve specimens were GC NAAT +ve in the pharynx only, 1 was positive in the urine also. 110/1374 (8%) patients were CT NAAT +ve of which 1/110 (0.9%) was in the pharynx only, the rest being from urine specimens Discussion/conclusion Out of 1374 pharyngeal swabs sent, only 5 (0.4%) were CT or GC +ve, of which 1 was also +ve in the urine. The 3 lone +ve pharyngeal GC NAAT specimens could be false-positive e.g. due to a cross-reaction with non-pathogenic Neisseria sp. Similarly the single CT+ve may be a false +ve assay. Alternatively, some of those patients with a +ve test may be MSM who had not revealed their status. Whatever the explanation, the very low pick-up rate does not justify taking pharyngeal CT/GC swabs in men who identify as being exclusively heterosexual.