Female Chlamydia Research Articles

Per- and Polyfluoroalkyl Substances May Be Correlated With Chlamydia trachomatis: Data From the National Health and Nutrition Examination Survey 2003-2016.

Per- and polyfluoroalkyl substances (PFAS) alter immune function increasing infectious diseases risk. We examined the relationship between PFAS and chlamydia. A total of 3965 nonpregnant adults ages 18-39 years from the National Nutrition Examination Survey 2003-2016 cycles were included. Poisson regression with robust error variance estimated the prevalence ratio and 95% confidence intervals for the association between PFAS and chlamydia. A g computation model was used to examine PFAS mixtures and chlamydia. In adjusted age and sex-stratified models, an increase in PFAS mixtures by one quintile was associated with chlamydia in older males and younger females. Associations were not observed before stratification. PFAS exposure associated with higher chlamydia prevalence, but only in stratified models suggesting biological differences by gender and age. However, small sample sizes could have affected the precision of our models.

Quantifying the Effects of Medical Examination and Possible Risk Factors against the Incidence of Cervical Cancer in a Low Human Papillomavirus Vaccination Coverage: An Ecological Study in Japan.

Simple SummaryCervical cancer (CC) is one of the most common gynecological malignancies in females, mainly caused by human papillomavirus (HPV). In countries with lower HPV vaccine coverage, such as Japan, medical examination may play a key role in decreasing CC incidence. The aim of this study is to measure the effect of medical examination (i.e., screening and detailed examination) on CC incidence in Japan by considering the effects of risk factors for the development of CC. We clarified associations between CC and possible risk factors by Pearson’s correlation coefficients and generalized linear models. Taking the time-dependent effects of Chlamydia, Gonorrhea, Condyloma, population economic status, and smoking rate into account, the effect of screening testing on CC incidence was estimated. The increase in screening rate was considered to decrease CC incidence effectively but not drastically, suggesting the need for the combined use of other efficient preventive measures such as HPV vaccination.Cervical cancer (CC) is one of the most common gynecological malignancies in females, mainly caused by human papillomavirus (HPV). In countries with lower HPV vaccine coverage, such as Japan, medical examination may play a key role in decreasing CC incidence. This study aimed to quantify the effect of medical examination on cervical cancer (CC) incidence in Japan, considering the effects of possible risk factors. By collecting Japan’s Prefectural data on CC incidence (2013–2017), incidence of sexually transmitted diseases (STDs; Chlamydia, Herpes, Condyloma, and Gonorrhea; 1993–2012), screening and detailed examination rate against CC (2013–2016), smoking rate (2001–2013), economic status (disposable income and economic surplus; 2014–2015), and education status (2015), we analyzed associations among them using Pearson’s correlation coefficients. Additionally, assuming that the incidence of STDs reflects the frequency of risky sexual behavior at the co-infection point with HPV, we constructed generalized linear models to predict CC incidence, taking a 5–20-year time-lag between incidences of STDs and the CC incidence. Against CC incidence, Chlamydia in females and Gonorrhea in males with a 15-year time-lag showed positive associations, while Condyloma in both genders with a 15-year time-lag, screening rate, economic status, and smoking rate showed negative associations. An increase in screening test rate by 10% was estimated to decrease CC incidence by 9.6%. This means that screening tests decrease CC incidence effectively, but not drastically, suggesting the need for additional countermeasures for CC prevention.

Can a Clean Catch Urine Sample Be Used to Diagnose Chlamydia and Gonorrhea in Adolescent Females?

PurposeClean catch urine samples may be an alternative specimen to test for chlamydia and gonorrhea infections. The aim of this study was to determine the sensitivity and specificity of clean urine for chlamydia and gonorrhea in women. MethodsThis was a noninferiority prospective cohort study of women aged 14–22 years requiring chlamydia and gonorrhea testing. Patients provided a vaginal swab (gold standard), clean urine (test sample), and dirty urine (usual care). All samples were analyzed using Hologic's Aptima Combo2 Assay, a second-generation nucleic acid amplification test. The sensitivity and specificity of the clean and dirty urine were calculated and compared. ResultsThree hundred and twenty-three females were included, mean age 17.0 ± 1.6 years. For chlamydia, 59 participants were positive by vaginal swab. The sensitivity of clean urine to diagnose chlamydia was 86.2% (95% CI: 74.8%–93.1%) and specificity was 98.8% (95% CI: 96.5%–99.8%). The sensitivity of dirty urine to diagnose chlamydia was 89.8% (95% CI: 79.2%–95.6%), and the specificity was 99.6% (95% CI 97.6%–100%). For gonorrhea, 18 participants were positive by vaginal swab. The sensitivity of clean urine to diagnose gonorrhea was 94.4% (95% CI: 72.4%–100%) and specificity was 99.7% (95% CI: 98.0%–100.0%). The sensitivity of dirty urine to diagnose gonorrhea was 100% (95% CI: 79.3%–100%) and specificity was 99.7% (95% CI: 98.0%–100%). Specificity of clean urine was noninferior compared with dirty urine for diagnosing chlamydia (p = .0004) and gonorrhea (p < .0001). ConclusionsClean urine samples may be an alternative option to diagnose chlamydia and gonorrhea in women.

Adolescent Chlamydia Rates by Region, Race, and Sex: Trends From 2013 to 2017.

Chlamydia is the most common bacterial sexually transmitted infection in the United States. Adolescents (ages 15-19 years) have the highest infection rate, second only to young adults (ages 20-24 years). The purpose of this secondary data analysis is to examine trends from 2013 to 2017 in adolescent chlamydia rates by region, race, and sex. Adolescent chlamydia rate data were obtained from the Center for Disease Control's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention database. Descriptive statistics were used to analyze the trends. The overall trend in male and female adolescent chlamydia rates increased from 2013 to 2017. Specifically, the trend increased faster in males, White adolescents, and those in the Northeast and Midwest regions of the country. Health care providers are uniquely positioned to positively affect adolescent chlamydia rates through targeted sexual health discussions and increased screening for sexually transmitted infections.

International travel as risk factor for Chlamydia trachomatis infections among young heterosexuals attending a sexual health clinic in Melbourne, Australia, 2007 to 2017.

BackgroundInternational travel is considered a risk factor for acquiring Chlamydia trachomatis; however, there are little empirical data to support this.AimTo examine the prevalence and risk factors for Chlamydia trachomatis infections among heterosexual international travellers (n = 28,786) attending the Melbourne Sexual Health Centre (MSHC), Australia, compared to Australian residents (n = 20,614).MethodsWe conducted a repeated cross-sectional study and analysed sexual behaviours and chlamydia positivity among heterosexual males and females aged ≤ 30 attending MSHC for the first time between January 2007 and February 2017. ‘Travellers’ were defined as individuals born outside of Australia who had resided in the country < 2 years. Associations between patient characteristics and chlamydia positivity were examined.ResultsChlamydia positivity was higher among travellers (11.2%) compared with Australian residents (8.5%; p < 0.001). Male travellers had higher chlamydia positivity (12.1%) than Australian males (9.3%; p < 0.001), as did female travellers (10.4%) compared with Australian females (7.7%; p < 0.001). Travellers had a higher mean number of sexual partners than Australian residents among males (5.7 vs 4.7; p < 0.001) and females (3.6 vs 3.2; p < 0.001). Travellers from the United Kingdom, Europe, Ireland and New Zealand accounted for 29.6%, 21%, 8.5% and 5.8% of C. trachomatis infections, respectively. Chlamydia in males and females was associated with younger age (≤ 25), inconsistent condom use, a higher number of sexual partners (≥ 4 partners) and being a traveller (p < 0.001).ConclusionsWe found that international travel is an independent risk factor for chlamydia among young heterosexual travellers in Australia, who should therefore be a target group for chlamydia prevention.

Hematogenous dissemination of Chlamydia muridarum from the urethra in macrophages causes testicular infection and sperm DNA damage†

The incidence of Chlamydia infection, in both females and males, is increasing worldwide. Male infections have been associated clinically with urethritis, epididymitis, and orchitis, believed to be caused by ascending infection, although the impact of infection on male fertility remains controversial. Using a mouse model of male chlamydial infection, we show that all the major testicular cell populations, germ cells, Sertoli cells, Leydig cells, and testicular macrophages can be productively infected. Furthermore, sperm isolated from vas deferens of infected mice also had increased levels of DNA damage as early as 4 weeks post-infection. Bilateral vasectomy, prior to infection, did not affect the chlamydial load recovered from testes at 2, 4, and 8 weeks post-infection, and Chlamydia-infected macrophages were detectable in blood and the testes as soon as 3 days post-infection. Partial depletion of macrophages with clodronate liposomes significantly reduced the testicular chlamydial burden, consistent with a hematogenous route of infection, with Chlamydia transported to the testes in infected macrophages. These data suggest that macrophages serve as Trojan horses, transporting Chlamydia from the penile urethra to the testes within 3 days of infection, bypassing the entire male reproductive tract. In the testes, infected macrophages likely transfer infection to Leydig, Sertoli, and germ cells, causing sperm DNA damage and impaired spermatogenesis.

The complexity of interactions between female sex hormones and Chlamydia trachomatis infections.

This review focuses specifically on the mechanisms by which female sex hormones, estrogen and progesterone, affect Chlamydia trachomatis infections in vivo and in vitro. Recent data support previous work indicating that estrogen enhances chlamydial development via multiple mechanisms. Progesterone negatively impacts Chlamydia infections also through multiple mechanisms, particularly by altering the immune response. Conflicting data exist regarding the effect of synthetic hormones, such as those found in hormonal contraceptives, on chlamydial infections. Numerous studies over the years have indicated that female sex hormones affect C. trachomatis infection. However, we still do not have a clear understanding of how these hormones alter Chlamydia disease transmission and progression. The studies reviewed here indicate that there are many variables that determine the outcome of Chlamydia/hormone interactions, including: 1) the specific hormone, 2) hormone concentration, 3) cell type or area of the genital tract, 4) hormone responsiveness of cell lines, and 5) animal models.

Genital Infiltrations of CD4+ and CD8+ T Lymphocytes, IgA+ and IgG+ Plasma Cells and Intra-Mucosal Lymphoid Follicles Associate With Protection Against Genital Chlamydia trachomatis Infection in Minipigs Intramuscularly Immunized With UV-Inactivated Bacteria Adjuvanted With CAF01.

The development of a vaccine against genital chlamydia in women is advancing, and the evaluation of in situ immune responses following vaccination and challenge infections is crucial for development of a safe and protective vaccine. This study employs the sexually mature minipig model to characterize the genital in situ immune response to Chlamydia trachomatis infection in pigs previously immunized intramuscularly with UV-inactivated C. trachomatis serovar D (UV-SvD) adjuvanted/formulated with CAF01 adjuvant compared to a CAF01-alone control group. Pigs immunized with UV-SvD were significantly protected against vaginal challenge with C. trachomatis on day 3 post inoculation and showed significantly higher cervical infiltrations of approximately equal numbers of CD4+ and CD8+ T-cells, and IgG+ and IgA+ plasma cells compared to adjuvant-alone immunized controls. These immunological signatures correspond to findings in mice and are similar to those described in female chlamydia patients. This proves important potential for the pig model in elucidating immunological in situ signatures in future translational research in chlamydia vaccinology.

Extragenital Gonorrhea and Chlamydia Testing Among Women Reporting Extragenital Exposure at an Urban STD Clinic: Is It Worth the Cost?

Background Current guidelines only recommend screening for gonorrhea (GC) and chlamydia (CT) at extragenital sites of exposure in men who have sex with men (MSM). With Medicaid reimbursement for GC/CT nucleic acid amplification testing (NAAT) at approximately $48/test, expanding testing to women requires a value assessment. We report the prevalence of extragenital GC/CT in women with extragenital exposure, determine the proportion of disease missed by urogenital NAAT, and estimate additional cost per infection identified by extragenital testing in women vs MSM.Methods We conducted a retrospective analysis of women undergoing extragenital NAAT for GC and CT at Denver Metro Health Clinic. Data were analyzed for all women with extragenital testing from 9/11/2015 to 7/8/2016, and for MSM from 9/3/2013 to 7/8/2016. Statistical Package for the Social Sciences and Excel programs were used for data analysis.ResultsIn a total 804 female visits, the mean age was 29 (13–67years); 46% were White non-Hispanic; 37% were Hispanic; and 15% were Black. In women, the prevalence of extragenital GC and CT was 2% (16/804) and 5% (38/804), respectively. The rate of GC infection in women was the same at genital and pharyngeal sites (2%, 16/804) but lower at the rectum (0.25%, 2/804). Female chlamydia rates were 11% genital (85/804), 4% pharyngeal (30/804), and 1.4% rectal (11/804). If only urogenital testing had been performed in women, 27% (6/22) of GC infections and 14% (14/99) of CT infections would have been missed. Overall, isolated extragenital infection accounted for 18% (20/111, 95% CI 12–26%) and 65% (943/1453, 95% CI 62–67%) of the combined GC and CT burden in women and MSM, respectively. On average, 40 women and five MSM were screened with extragenital tests to identify one isolated extragenital infection. Estimated additional Medicaid costs for isolated extragenital infection identified in women was $3,851 and in men was $480 for pharyngeal and rectal testing.Conclusion Urogenital screening misses a significant number of extragenital infections in women. However, given the high cost of extragenital screening in women, further work is needed to determine whether screening can be limited to the pharynx or if risk factors can be used to target screening for cost savings.Disclosures All authors: No reported disclosures.

Prevalence of syphilis and chlamydia in married females of Quetta

Prevalence of syphilis and chlamydia in married females of Quetta

The Effect of Changes in Cervical Cancer Screening Guidelines on Chlamydia Testing.

Many chlamydia infections are identified through screening, which is frequently offered to females concomitantly with cervical cancer screening. Recent cervical cancer screening guidelines recommend screening less frequently and starting later. We sought to evaluate the impact of the May 2012 Ontario, Canada, cervical cancer screening guideline change on Papanicolaou (Pap) and chlamydia trachomatis (chlamydia) testing and incidence. We extracted population-based physician billing claims data to identify Pap and chlamydia tests and public health surveillance data to identify chlamydia cases. We used interrupted time series analysis of quarterly data spanning 2 years before and after the guideline change and fitted segmented linear regression or rational functions to the outcomes using autoregressive integrated moving average models. Outcomes were stratified by sex and age group. Two years after the guideline change, we observed reduced chlamydia testing in females, with the greatest relative reduction (25.5%) among those aged 15 to 19 years. We also observed decreases in reported chlamydia incidence for females aged 15 to 19 years and 20 to 24 years (relative reductions of 16.8% and 14.4%, respectively). Chlamydia incidence remained the same for males, despite increased chlamydia testing. Recent cervical cancer screening guideline changes in Ontario were associated with reduced chlamydia testing and reported new cases of chlamydia in females. Females aged 15 to 19 years, who are at high risk for chlamydia if sexually active, and who no longer warrant cervical cancer screening, were disproportionately affected. Females should be tested for chlamydia based on risk, regardless of need for Pap testing.

Perceived Patient Preference and Clinical Testing for Chlamydia and Gonorrhea in Females: How Closely Are These Aligned?

Perceived Patient Preference and Clinical Testing for Chlamydia and Gonorrhea in Females: How Closely Are These Aligned?

What explains anorectal chlamydia infection in women? Implications of a mathematical model for test and treatment strategies

ObjectivesFemale anorectal Chlamydia trachomatis (chlamydia) infections are common irrespective of recent anal sex. We explored the role of anorectal infections in chlamydia transmission and estimated the impact of interventions aimed...

006.4 Azithromycin versus doxycycline for urogenital chlamydia: a randomised clinical trial in females and males in youth correctional facilities

Background Urogenital Chlamydia trachomatis infection (“chlamydia”) remains highly prevalent and causes significant reproductive morbidity. Earlier randomised chlamydia treatment trials comparing azithromycin 1g versus a 7-day regimen of doxycycline 100mg twice daily reported high cure rates, but used less sensitive diagnostics and results may have been confounded by chlamydia re-exposure or doxycycline nonadherence. Recent studies have raised concern about azithromycin efficacy for chlamydia. Methods We conducted a randomised trial comparing azithromycin versus doxycycline for chlamydia in males and females in youth correctional facilities (YCFs) to evaluate for noninferiority of azithromycin compared to doxycycline. Treatment was directly observed and participants had no furloughs from the YCF throughout the study. The primary endpoint was treatment failure at 28 days after treatment initiation, determined by nucleic acid amplification test results, sexual history, and C. trachomatis OmpA genotyping. Results Of 567 participants enrolled, 284 were randomised to azithromycin and 283 to doxycycline. There were 155 participants in each treatment arm comprising the per protocol population: 65% male and 35% female. No treatment failures occurred in the doxycycline arm. In the azithromycin arm, five treatment failures occurred (3.2%; 95% CI: 0.4–7.4%): four were males (3.9%; 95% CI: 1.1–9.7%) and one female (1.9%; 95% CI: 0.0–10.1%). The observed failure rate difference in the treatments was 3.2%, with a 90% upper CI of 5.9%, exceeding the predetermined 5% cutoff for establishing azithromycin noninferiority. Conclusion Doxycycline had a 100% cure rate for chlamydia. Noninferiority of azithromycin to doxycycline was not established in this study, although azithromycin treatment failures occurred infrequently and the high azithromycin cure rate was consistent with earlier chlamydia treatment trials. Because of possible chlamydia treatment failures when azithromycin is used, further surveillance is needed and doxycycline might be considered for persons with suspected chlamydia treatment failure following azithromycin treatment. Disclosure of interest statement Nothing to Declare.

P04.04 Chlamydia infection in males and females reporting sex with partners with chlamydia

Background Justification for presumptive treatment for a sexually transmitted infection depends in part on the underlying prevalence of that infection among those reporting exposure. To examine these data for chlamydia we aimed to ascertain the proportion infected with chlamydia, and factors predictive of infection, amongst females, heterosexual males and men who have sex with men (MSM) presenting to a sexual health service reporting sexual contact with a chlamydia infected partner. Methods Patients included were those attending the Melbourne Sexual Health Centre from October 2010 to September 2013. Proportions testing positive amongst females, heterosexual males, and MSM reporting sexual contact with a chlamydia infected partner were ascertained. Demographic and behavioural data obtained using computer assisted self-interview were analysed to determine predictive factors. Results Of the 491 female, 808 heterosexual male, and 268 MSM chlamydia contacts, the proportion diagnosed with chlamydia were 39.9% (95% CI 35.7–44.3), 36.1% (95% CI 32.9–39.9), and 23.5% (95% CI 18.8–29.0) respectively. Female chlamydia contacts were more likely to have chlamydia if age ≤24 (AOR 1.86, 95% CI 1.12–3.10) or if they reported inconsistent condom use during vaginal sex with a regular male partner (AOR 2.5, 95% CI 1.12–6.14). Heterosexual male contacts were more likely to have chlamydia if age ≤26 (AOR 1.70, 95% CI 1.26–2.30) or if they had a regular female sexual partner (AOR 1.42, 95% CI 1.06–1.91). In MSM urethral chlamydia was diagnosed in 8.8%, rectal chlamydia in 20.2%, and in 3.9% at both sites. MSM were more likely to have chlamydia if they had a regular male sexual partner (OR 2.12 95% CI 1.18–3.81). Conclusion This study of female, heterosexual male and MSM presentations with self-reported chlamydia contact provides insight as to their likelihood of infection. The data may inform policy and individual clinical decision making regarding presumptive treatment of chlamydia contacts. Disclosures No potential conflicts of interest.

Tissue Culture versus PCR in Diagnosis of Female Genital Chlamydia Trachomatis Infection

Background: Chlamydia trachomatis (C. trachomatis )is the most prevalent sexually transmitted pathogen worldwide. It is common among sexually active young women. Objectives: Evaluate the sensitivity and specificity of tissue culture followed by antigen detection by immunoflurescencein comparison with nested PCR for diagnosis of genital C. trachomatis infection. Methodology: This study was carried out on 50 women, among those attending the Gynecology Outpatient Clinics of Benha University Hospital during the period from May 2014 to March 2015. The participants suffer from symptoms suggestive of genital C. trachomatis infection , their ages ranged from 20 to 39 years old (mean ± SD =29.80±4.647) .Two endocervical swabs were taken from each patient. One used for cytological examination, and the other used for tissue culture detected by, immunoflurescence as well as nested PCR. Results: The result of tissue culture detected by direct immunoflurecence revealed that out of 50 patient, 24 (48%) were positive for C.trachomatis and 26 (52%) were negative .Result of nested PCR revealed that out of 50 patient, 34 (68%) were positive and 24 (32%) were negative . The result of cytological examination revealed that out of 50 patient, 17 (34%) were positive and 33 (66%) were negative. The sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPP) of tissue culture for detection of C.trachomatis were 70.6%, 100%, 100% and 61.5% respectively. Roc curve of tissue culture revealed that it is considered to be a good test compared to PCR in diagnosis of genital C.trachomatis. Conclusion: The tissue culture as detected by immunoflurescence is a good test in relation to nested PCR in diagnosis of genital C.trachomatis

Chlamydia infection in individuals reporting contact with sexual partners with chlamydia: a cross-sectional study of sexual health clinic attendees

ObjectivesWe aimed to ascertain the proportion of positive, and predictive factors of chlamydia infection among females, heterosexual males and men who have sex with men (MSM) presenting to a sexual...

Chlamydial Testing Practice Effectiveness in a High Incidence Area of Northern Canada: An Aggregate Data Analysis and Chart Review

Background: Chlamydia trachomatis infections are increasing in Canada and its North, with female rates several times higher than males. Understanding testing practices may aid in the development of strategies to reduce chlamydial rates. Research questions: To what effect are testing frequencies contributing to the difference in chlamydial rates between females and males? Which testing approaches are most effective in identifying chlamydia infections? Methods: Aggregated data for 2009 to 2012 of Northern Saskatchewan chlamydial testing was analyzed utilizing age, gender, and positivity. Additionally, a chart review on testing practices was conducted on 400 chlamydial tests at a Northern medical clinic. Results: In an area of high incidence of chlamydia infections, the annual incidence of chlamydia for females was 2.49 times the rate in males. Women’s testing rates were 3.46 times the rate in males. However, men had a 1.52 fold greater rate of positivity. For one medical clinic, contact tracing returned the greatest percent positive cases, with 50% positivity. Females were identified to be high risk, and tested significantly more often, than males. Routine tests on patients 30 years old and over were 35.3% of the total tests, although male and female positive rates in these ages were 0.72% and 0.85% respectively. Discussion: If males were tested to a similar frequency as females, male rates may increase. Female and male chlamydia rates were over 4000/100,000 until age 30, suggesting that screening recommendations include both sexes in these ages, especially in high incidence populations. Contact tracing resulted in the most percent positive cases, highlighting its importance. While routine screening occurred frequently, many occurred in older age groups with low prevalence, producing very few positive results.

The Effect of Case Rate and Coinfection Rate on the Positive Predictive Value of a Registry Data-Matching Algorithm

Statistical modeling has suggested that the prevalence of false matches in data matching declines as the events become rarer or the number of matches increases. We examined the effect of case rate and coinfection rate in the population on the positive predictive value (PPV) of a matching algorithm for HIV/AIDS and sexually transmitted disease (STD) surveillance registry data. We used LinkPlus™, a probabilistic data-matching program, to match HIV/AIDS cases diagnosed in New York City (NYC) from 1981 to March 31, 2012, and reported to the NYC HIV/AIDS surveillance registry against syphilis and chlamydia cases diagnosed in NYC from January 1 to June 30, 2010, and reported to the NYC STD registry. Match results were manually reviewed to determine true matches. With an agreement/disagreement comparison score cutoff value of 10.0, LinkPlus identified 3,013 matches, of which 1,582 were determined to be true by manual review. PPV varied greatly in subpopulations with different case rates and coinfection rates. PPV was the highest (91.6%) in male syphilis cases, who had a relatively low case rate but a high HIV coinfection rate, and lowest (18.0%) in female chlamydia cases, who had a high case rate but a low HIV coinfection rate. When the cutoff value was increased to 15.0, PPVs in male syphilis and female chlamydia cases increased to 98.3% and 90.5%, respectively. Case rates and coinfection rates have a significant effect on the PPV of a registry data-matching algorithm: PPV decreases as the case rate increases and coinfection rate decreases. Before conducting registry data matching, program staff should assess the case rate and coinfection rate of the population included in the data matching and select an appropriate matching algorithm.

Performance of the Cepheid CT/NG Xpert Rapid PCR Test for Detection of Chlamydia trachomatis and Neisseria gonorrhoeae

Tests for Chlamydia trachomatis and Neisseria gonorrhoeae, which can provide results rapidly to guide therapeutic decision-making, offer patient care advantages over laboratory-based tests that require several days to provide results. We compared results from the Cepheid GeneXpert CT/NG (Xpert) assay to results from two currently approved nucleic acid amplification assays in 1,722 female and 1,387 male volunteers. Results for chlamydia in females demonstrated sensitivities for endocervical, vaginal, and urine samples of 97.4%, 98.7%, and 97.6%, respectively, and for urine samples from males, a sensitivity of 97.5%, with all specificity estimates being ≥ 99.4%. Results for gonorrhea in females demonstrated sensitivities for endocervical, vaginal, and urine samples of 100.0%, 100.0%, and 95.6%, respectively, and for urine samples from males, a sensitivity of 98.0%, with all estimates of specificity being ≥ 99.8%. These results indicate that this short-turnaround-time test can be used to accurately test patients and to possibly do so at the site of care, thus potentially improving chlamydia and gonorrhea control efforts.