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No widespread disse...
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Cole, Michelle JayneNational Infection Service, Public Health England, London, UK
(author)
No widespread dissemination of Chlamydia trachomatis diagnostic : escape variants and the impact of Neisseria gonorrhoeae positivity on the Aptima Combo 2 assay
- Article/chapterEnglish2022
Publisher, publication year, extent ...
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2021-09-11
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BMJ Publishing Group Ltd,2022
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printrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:oru-94361
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https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-94361URI
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https://doi.org/10.1136/sextrans-2021-054988DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Funding agency:NIHR Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol
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OBJECTIVES: (NG) with the Hologic Aptima CT (ACT) assay was recommended to identify any CT variants.METHODS: From June to October 2019, specimens with discrepant AC2/ACT CT results were submitted to Public Health England and screened for detectable CT DNA using an inhouse real-time (RT)-PCR. When enough DNA was present, partial CT 23S rRNA gene sequencing was performed. Analysis of available relative light units and interpretative data was performed.RESULTS: A total of 317 discordant AC2/ACT specimens were collected from 315 patients. Three hundred were tested on the RT-PCR; 53.3% (n=160) were negative and 46.7% (n=140) were positive. Due to low DNA load in most specimens, sequencing was successful for only 36 specimens. The CT 23S rRNA wild-type sequence was present in 32 specimens, and two variants with C1514T or G1523A mutation were detected in four specimens from three patients. Of the discordant specimens with NG interpretation, 36.6% of NG-negative/CT-negative AC2 specimens had detectable CT DNA on the inhouse RT-PCR vs 53.3% of NG-positive/CT-negative specimens.CONCLUSIONS: No widespread dissemination of AC2 diagnostic-escape CT variants has occurred in England. We however identified the impact of NG positivity on the discordant AC2/ACT specimens; a proportion appeared due to NG positivity and the associated NG signal, rather than any diagnostic-escape variants or low DNA load. Several patients with gonorrhoea may therefore receive false-negative AC2 CT results. Single diagnostic targets and multiplex diagnostic assays have their limitations such as providing selection pressure for escape mutants and potentially reduced sensitivity, respectively. These limitations must be considered when establishing diagnostic pathways.
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Davis, Grahame S.National Infection Service, Public Health England, London, UK
(author)
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Fifer, HelenNational Infection Service, Public Health England, London, UK
(author)
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Saunders, John MichaelNational Infection Service, Public Health England, London, UK; Research Department of Infection and Population Health, University College London, London, UK
(author)
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Unemo, Magnus,1970-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,WHO Collaborating Centre for Gonorrhoea and Other STIs, National Reference Laboratory for Pathogenic Neisseria, Department of Laboratory Medicine, Microbiology(Swepub:oru)muo
(author)
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Hadad, Ronza,1984-Örebro universitet,Institutionen för medicinska vetenskaper(Swepub:oru)rahd
(author)
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Roberts, David J.National Infection Service, Public Health England, London, UK
(author)
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Fazal, MohammedNational Infection Service, Public Health England, London, UK
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Day, Michaela JoanneNational Infection Service, Public Health England, London, UK
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Minshull, JackNational Infection Service, Public Health England, London, UK
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Muir, PeterBristol Public Health Laboratory, Public Health England, Bristol, UK
(author)
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Horner, Paddy J.School of Social and Community Medicine, University of Bristol, Bristol, UK; Bristol Sexual Health Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
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Gill, Noel O.National Infection Service, Public Health England, London, UK
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Folkard, KateNational Infection Service, Public Health England, London, UK
(author)
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National Infection Service, Public Health England, London, UKNational Infection Service, Public Health England, London, UK; Research Department of Infection and Population Health, University College London, London, UK
(creator_code:org_t)
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In:Sexually Transmitted Infections: BMJ Publishing Group Ltd98:5, s. 366-3701368-49731472-3263
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