Molecular diagnosis of Neisseria gonorrhoeae infection in the United States

Expert Opinion on Medical Diagnostics

Volumn 3, Issue 3, 2009, Pages 327-343

  Munson, Erik ^a   Firmani, Marcia A ^a  

^a Wheaton Franciscan Laboratory   (United States)

Author keywords

Confirmatory testing; Gonococcal urethritis; Gonorrhea; Molecular diagnostics; Neisseria gonorrhoeae; Nucleic acid hybridization; Polymerase chain reaction; Sexually transmitted infection; Signal amplification; Strand displacement amplification; Test of cure; Transcription mediated amplification

Indexed keywords

AZITHROMYCIN; DOXYCYCLINE; QUINOLINE DERIVED ANTIINFECTIVE AGENT;

ANTIBIOTIC SENSITIVITY; BACTERIUM CULTURE; CHLAMYDIA TRACHOMATIS; CHLAMYDIASIS; CLINICAL FEATURE; CROSS REACTION; DEMOGRAPHY; DISEASE TRANSMISSION; FOOD AND DRUG ADMINISTRATION; GONORRHEA; HUMAN; IN VITRO STUDY; LABORATORY DIAGNOSIS; MALE HOMOSEXUAL; MEDICOLEGAL ASPECT; MOLECULAR BIOLOGY; NEISSERIA GONORRHOEAE; NUCLEIC ACID HYBRIDIZATION; PATHOGENICITY; PERFORMANCE; POLYMERASE CHAIN REACTION; PREVALENCE; RELIABILITY; REVIEW; SCREENING; UNITED STATES; URETHRITIS; URINALYSIS;

EID: 77953463883     PISSN: 17530059     EISSN: 17530067     Source Type: Journal    
DOI: 10.1517/17530050902860229     Document Type: Review

References (117)

1. Centers for Disease Control and Prevention. Sexually transmitted disease surveillance, 2006. Atlanta, GA: United States Department of Health and Human Services, 2007
2. Mandell GL, Bennett JE, Dolin R. Sixth edition. Principles and practice of infectious diseases, Philadelphia, PA: Elsevier Churchill Livingstone, 2005
3. Handsfield HH, Lipman TO, Harnisch JP, et al. Asymptomatic gonorrhea in men. N Engl J Med 1974;290:117-123
4. Hooper RR, Reynolds GH, Jones OG, et al. Cohort study of venereal disease. I: the risk of gonorrhea transmission from infected women to men. Am J Epidemiol 1978;108:136-144
5. Lin JL, Donegan SP, Heeren TC, et al. Transmission of Chlamydia trachomatis and Neisseria gonorrhoeae among men with urethritis and their female sex partners. J Infect Dis 1998;178:1707-1712 (Pubitemid 28558143)
6. Brunham RC. The concept of core and its relevance to the epidemiology and control of sexually transmitted diseases. Sex Transm Dis 1991;18:67-68
7. Handsfield HH, Rice RJ, Roberts MC, Holmes KK. Localized outbreak of penicillinase-producing Neisseria gonorrhoeae: paradigm for introduction and spread of gonorrhea in a community. JAMA 1989;261:2357-2361 (Pubitemid 19101415)
8. Potterat JJ, Rothenberg RB, Woodhouse DE, et al. Gonorrhea as a social disease. Sex Transm Dis 1985;12:25-32 (Pubitemid 15143206)
9. Evans BG, Catchpole MA, Heptonstall J, et al. Sexually transmitted diseases and HIV-1 infection among homosexual men in England and Wales. Brit Med J 1993;306:426-428 (Pubitemid 23045551)
10. Stoner BP, Whittington WL, Hughes JP, et al. Comparative epidemiology of heterosexual gonococcal and chlamydial networks. Sex Transm Dis 2000;27:215-223
11. Doll LS, Judson FN, Ostrow DG, et al. Sexual behavior before AIDS: the hepatitis B studies of homosexual and bisexual men. AIDS 1990;4:1067-1073
12. Steiner S, Lemke AL, Roffman RA. Risk behavior for HIV transmission among gay men surveyed in Seattle bars. Public Health Rep 1994;109:563-566 (Pubitemid 24252259)
13. Handsfield HH, Schwebke J. Trends in sexually transmitted diseases in homosexually active men in King County, Washington, 1980-1990. Sex Transm Dis 1990;17:211-215
14. Soendjojo A. Gonococcal urethritis due to fellatio. Sex Transm Dis 1981;10:41-42 (Pubitemid 13136142)
15. Schwarcz SK, Kellogg TA, Kohn RP, et al. Temporal trends in human immunodeficiency virus seroprevalence and sexual behavior at the San Francisco municipal sexually transmitted disease clinic, 1989-1992. Am J Epidemiol 1995;142:314-322
16. Lafferty WE, Hughes JP, Handsfield HH. Sexually transmitted diseases in men who have sex with men. Acquisition of gonorrhea and nongonococcal urethritis by fellatio and implications for STD/HIV prevention. Sex Transm Dis 1997;24:272-278
17. Katz MH, Schwarcz SK, Kellogg TA, et al. Impact of highly active antiretroviral treatment on HIV seroincidence among men who have sex with men: San Francisco. Am J Public Health 2002;92:388-394 (Pubitemid 34184826)
18. Chen SY, Gibson S, Katz MH, et al. Continuing increases in sexual risk behavior and sexually transmitted diseases among men who have sex with men: San Francisco, Calif. 1999-2001, USA. Am J Public Health 2002;92:1387-1388
19. Centers for Disease Control and Prevention. Update to CDC's sexually transmitted diseases treatment guidelines, 2006: fluoroquinolones no longer recommended for treatment of gonococcal infections. Morb Mortal Wkly Rep 2007;56:332-336
20. Murray PR, Baron EJ, Jorgensen JH, et al. Ninth edition. Manual of clinical microbiology, Washington, DC: ASM Press, 2007
21. Petri M. Infection in systemic lupus erythematosus. Rheum Dis Clin N Am 1998;24:423-456 (Pubitemid 28256646)
22. Barr J, Danielsson D. Septic gonococcal dermatitis. Brit Med J 1971;1:482-485
23. Shetty A, Ribeiro D, Evans A, Linnane S. Gonococcal endocarditis: a rare complication of a common disease. J Clin Pathol 2004;57:780-781 (Pubitemid 38901501)
24. Goodhart ME, Ogden J, Zaidi AA, Kraus SJ. Factors affecting the performance of smear and culture tests for the detection of Neisseria gonorrhoeae. Sex Transm Dis 1982;9:63-69 (Pubitemid 12057586)
25. Knud-Hansen CR, Dallabetta GA, Reichart C, et al. Surrogate methods to diagnose gonococcal and chlamydial cervicitis: comparison of leukocyte esterase dipstick, endocervical gram stain, and culture. Sex Transm Dis 1991;18:211-216
26. Rothenberg RB, Simon R, Chipperfield E, Catterall RD. Efficacy of selected diagnostic tests for sexually transmitted diseases. JAMA 1976;235:49-51
27. Human RP, Jones GA. Evaluation of swab transport systems against a published standard. J Clin Pathol 2004;57:762-763 (Pubitemid 38901494)
28. Martin JE Jr, Jackson RL. A biological environment chamber for the culture of Neisseria gonorrhoeae. J Am Vener Dis Assoc 1975;2:28-30
29. Beverly A, Bailey-Griffin JR, Schwebke JR. InTray GC medium versus modified Thayer-Martin agar plates for diagnosis for gonorrhea from endocervical specimens. J Clin Microbiol 2000;38:3825-3826 (Pubitemid 30768462)
30. Arbique JC, Forward KR, Leblanc J. Evaluation of four commercial transport media for the survival of Neisseria gonorrhoeae. Diagn Microbiol Infect Dis 2000;36:163-168 (Pubitemid 30145654)
31. Drake C, Barenfanger J, Lawhorn J, Verhulst S. Comparison of easy-flow Copan liquid Stuart's and Starplex swab transport systems for recovery of fastidious aerobic bacteria. J Clin Microbiol 2005;43:1301-1303 (Pubitemid 40364954)
32. Tapsall J. Antimicrobial resistance in Neisseria gonorrhoeae. Geneva, Switzerland: World Health Organization, WHO/CDS/DRS/2001;3:16
33. Ilina EN, Vereshchagin VA, Borovskaya AD, et al. Relation between genetic markers of drug resistance and susceptibility profile of clinical Neisseria gonorrhoeae strains. Antimicrob Agents Chemother 2008;52:2175-2182 (Pubitemid 351758556)
34. Hale YM, Melton ME, Lewis JS, Willis DE. Evaluation of the PACE 2 Neisseria gonorrhoeae assay by three public health laboratories. J Clin Microbiol 1993;31:451-453 (Pubitemid 23028662)
35. Limberger RJ, Biega R, Evancoe A, et al. Evaluation of culture and the Gen-Probe PACE 2 assay for detection of Neisseria gonorrhoeae and Chlamydia trachomatis in endocervical specimens transported to a state health laboratory. J Clin Microbiol 1992;30:1162-1166
36. Panke ES, Yang LI, Leist PA, et al. Comparison of Gen-Probe DNA probe test and culture for the detection of Neisseria gonorrhoeae in endocervical specimens. J Clin Microbiol 1991;29:883-888
37. Schachter J, Hook EW III, Mccormack WM, et al. Ability of the Digene Hybrid Capture II test to identify Chlamydia trachomatis and Neisseria gonorrhoeae in cervical specimens. J Clin Microbiol 1999;37:3668-3671 (Pubitemid 29491111)
38. Darwin LH, Cullen AP, Arthur PM, et al. Comparison of Digene Hybrid Capture 2 and conventional culture for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in cervical specimens. J Clin Microbiol 2002;40:641-644 (Pubitemid 34130895)
39. Modarress KJ, Cullen AP, Jaffurs WJ, et al. Detection of Chlamydia trachomatis and Neisseria gonorrhoeae in swab specimens by the Hybrid Capture II and PACE 2 nucleic acid probe tests. Sex Transm Dis 1999;26:303-308 (Pubitemid 29221066)
40. Saiki RK, Gelfand DH, Stoffel S, et al. Primer-directed enzymatic amplification of DNA with a thermostable DNA polymerase. Science 1988;239:487-491 • This publication describes the mechanism of PCR. (Pubitemid 18084310)
41. Livengood CH III, Wrenn JW. Evaluation of COBAS AMPLICOR (Roche): accuracy in detection of Chlamydia trachomatis and Neisseria gonorrhoeae by coamplification of endocervical specimens. J Clin Microbiol 2001;39:2928-2932 •• This publication provides early insight into the value of molecular diagnostics versus culture in the context of N. gonorrhoeae and C. trachomatis. (Pubitemid 32744013)
42. Martin DH, Cammarata C, Van Der pol B, et al. Multicenter evaluation of AMPLICOR and automated COBAS AMPLICOR CT/NG tests for Neisseria gonorrhoeae. J Clin Microbiol 2000;38:3544-3549 (Pubitemid 30768413)
43. Van Doornum GJJ, Schouls LM, Pijl A, et al. Comparison between the LCx probe system and the COBAS AMPLICOR system for detection of Chlamydia trachomatis and Neisseria gonorrhoeae infections in patients attending a clinic for treatment of sexually transmitted diseases in Amsterdam, The Netherlands. J Clin Microbiol 2001;39:829-835 (Pubitemid 32209688)
44. Gibbs CP, Meyer TF. Genome plasticity in Neisseria gonorrhoeae. FEMS Microbiol Lett 1996;145:173-179 (Pubitemid 26395412)
45. Palmer HM, Mallinson H, Wood RL, Herring AJ. Evaluation of the specificities of five DNA amplification methods for the detection of Neisseria gonorrhoeae. J Clin Microbiol 2003;41:835-837 • This publication describes deficiencies related to assay specificity. (Pubitemid 36184209)
46. Farrell D. Evaluation of AMPLICOR Neisseria gonorrhoeae PCR using cppB nested PCR and 16S rRNA PCR. J Clin Microbiol 1999;37:386-390 (Pubitemid 29056410)
47. Little MC, Andrews J, Moore R, et al. Strand displacement amplification and homogeneous real-time detection incorporated in a second-generation DNA probe system, BDProbeTecET. Clin Chem 1999;45:777-784 • This publication describes the mechanism of SDA. (Pubitemid 29266606)
48. Van Der Pol B, Ferrero DV, Buck-Barrington L, et al. Multicenter evaluation of the BDProbeTec ET system for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in urine specimens, female endocervical swabs, and male urethral swabs. J Clin Microbiol 2001;39:1008-1016 • This publication describes the utility of the BD ProbeTec™ ET assay. (Pubitemid 32215284)
49. Guatelli JC, Whitfield KM, Kwoh DY, et al. Isothermal, in vitro amplification of nucleic acids by a multienzyme reaction modeled after retroviral replication. Proc Natl Acad Sci USA 1990;87:1874-1878 • This publication describes the mechanism of TMA. (Pubitemid 20098074)
50. Compton J. Nucleic acid sequence-based amplification. Nature 1991;350:91-92
51. Gaydos CA, Quinn TC, Willis D, et al. Performance of the APTIMA Combo 2 assay for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in female urine and endocervical swab specimens. J Clin Microbiol 2003;41:304-309 • This publication describes clinical data pertinent to APTIMA Combo 2®. (Pubitemid 36098592)
52. Lowe P, O'Loughlin P, Evans K, et al. Comparison of the Gen-Probe APTIMA Combo 2 assay to the AMPLICOR CT/ NG assay for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in urine samples from Australian men and women. J Clin Microbiol 2006;44:2619-2621 (Pubitemid 44092444)
53. Golden MR, Hughes JP, Cles LE, et al. Positive predictive value of Gen-Probe APTIMA Combo 2 testing for Neisseria gonorrhoeae in a population of women with low prevalence of N. gonorrhoeae infection. Clin Infect Dis 2004;39:1387-1390 (Pubitemid 39458527)
54. Comanor L, Anderson F, Ghany M, et al. Transcription-mediated amplification is more sensitive than conventional PCR-based assays for detecting residual serum HCV RNA at end of treatment. Am J Gastroenterol 2001;96:2968-2972 (Pubitemid 32959541)
55. Sarrazin C, Teuber G, Kokka R, et al. Detection of residual hepatitis C virus RNA by transcription-mediated amplification in patients with complete virologic response according to polymerase chain reaction-based assays. Hepatology 2000;32:818-823 (Pubitemid 30744281)
56. Chernesky M, Jang D, Luinstra K, et al. High analytical sensitivity and low rates of inhibition may contribute to detection of Chlamydia trachomatis in significantly more women by the APTIMA Combo 2 assay. J Clin Microbiol 2006;44:400-405 •• This publication uses in vitro experimentation to suggest high analytical sensitivity of commercial TMA. (Pubitemid 43222230)
57. Wood BJ, Rizzo-Price P, Holden J, et al. The microbicide tenofovir does not inhibit nucleic acid amplification tests for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in urine samples. J Clin Microbiol 2008;46:763-765 (Pubitemid 351231333)
58. Mahony J, Chong S, Jang D, et al. Urine specimens from pregnant and nonpregnant women inhibitory to amplification of Chlamydia trachomatis nucleic acid by PCR, ligase chain reaction, and transcription-mediated amplification: identification of urinary substances associated with inhibition and removal of inhibitory activity. J Clin Microbiol 1998;36:3122-3126 (Pubitemid 28476150)
59. Gaydos CA, Theodore M, Dalesio N, et al. Comparison of three nucleic acid amplification tests for detection of Chlamydia trachomatis in urine specimens. J Clin Microbiol 2004;42:3041-3045 (Pubitemid 38938055)
60. Harris JM, Brink T, Welborn C. Performance of the BD ProbeTec™ urine preservative transport with second generation assays for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae on the BD ProbeTec™ ET system [abstract]. 105th Gen. Meet. Am. Soc. Microbiol. Washington, DC: American Society for Microbiology, 2005
61. Levett PN, Brandt K, Olenius K, et al. Evaluation of three automated nucleic acid amplification systems for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in first-void urine specimens. J Clin Microbiol 2008;46:2109-2111 (Pubitemid 351831856)
62. Hook EW III, Ching SF, Stephens J, et al. Diagnosis of Neisseria gonorrhoeae infections in women by using the ligase chain reaction on patient-obtained vaginal swabs. J Clin Microbiol 1997;35:2129-2132 (Pubitemid 27318719)
63. Gaydos CA, Crotchfelt KA, Shah N, et al. Evaluation of dry and wet transported intravaginal swabs in detection of Chlamydia trachomatis and Neisseria gonorrhoeae infections in female soldiers by PCR. J Clin Microbiol 2002;40:758-761 (Pubitemid 34208619)
64. Cosentino LA, Landers DV, Hillier SL. Detection of Chlamydia trachomatis and Neisseria gonorrhoeae by strand displacement amplification and relevance of the amplification control for use with vaginal swab specimens. J Clin Microbiol 2003;41:3592-3596 (Pubitemid 36994687)
65. Page-Shafer K, Graves A, Kent C, et al. Increased sensitivity of DNA amplification testing for detection of pharyngeal gonorrhea in men who have sex with men. Clin Infect Dis 2002;34:173-176 (Pubitemid 34028348)
66. Whiley DM, Buda PP, Freeman K, et al. A real-time PCR assay for the detection of Neisseria gonorrhoeae in genital and extragenital specimens. Diagn Microbiol Infect Dis 2005;52:1-5 (Pubitemid 40692733)
67. Moncada J, Donegan E, Schachter J. Evaluation of CDC-recommended approaches for confirmatory testing of positive Neisseria gonorrhoeae nucleic acid amplification test results. J Clin Microbiol 2008;46:1614-1619 •• This publication calls into question the necessity of N. gonorrhoeae confirmatory testing. (Pubitemid 351657203)
68. Schachter J, Moncada J, Liska S, et al. Nucleic acid amplification tests in the diagnosis of chlamydial and gonococcal infections of the oropharynx and rectum in men who have sex with men. Sex Transm Dis 2008;35:637-642 •• This publication summarizes potential value of highly sensitive NAAT for analysis of extragenital specimens.
69. Munson E, Napierala M, Olson R, et al. Impact of Trichomonas vaginalis transcription-mediated amplification-based analyte-specific-reagent testing in a metropolitan setting of high sexually transmitted disease prevalence. J Clin Microbiol 2008;46:3368-3374
70. College of American Pathologists. C. trachomatis and N. gonorrhoeae by nucleic acid amplification participant summary, HC6A-HC6C. Northfield, IL: College of American Pathologists, 2003-2008
71. Dicker LW, Mosure DJ, Steece R, Stone KM. Testing for sexually transmitted diseases in U.S. public health laboratories in 2004. Sex Transm Dis 2007;34:41-46
72. Centers for disease control and prevention. Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections - 2002. Morb Mortal Wkly Rep 2002;51(No.):1-38
73. Culler EE, Caliendo AM, Nolte FS. Reproducibility of positive test results in the BDProbeTec ET system for detection of Chlamydia trachomatis and Neisseria gonorrhoeae. J Clin Microbiol 2003;41:3911-3914 (Pubitemid 36994739)
74. Castriciano S, Luinstra K, Jang D, et al. Accuracy of results obtained by performing a second ligase chain reaction assay and PCR analysis on urine samples with positive or near-cutoff results in the LCx test for Chlamydia trachomatis. J Clin Microbiol 2002;40:2632-2634 (Pubitemid 34747377)
75. Schachter J, Chow JM, Howard H, et al. Detection of Chlamydia trachomatis by nucleic acid amplification testing: our evaluation suggests that CDC-recommended approaches for confirmatory testing are ill-advised. J Clin Microbiol 2006;44:2512-2517 • This publication further calls into question the necessity of confirmatory testing. (Pubitemid 44092420)
76. Dunham LB, Sconce KJ, Schreck LR, Craft DW. Reproducibility of low range positive results for Chlamydia trachomatis and Neisseria gonorrhoeae using GEN-PROBE APTIMA COMBO 2 assay [abstract]. 105th Gen. Meet. Am. Soc. Microbiol. Washington, DC: American Society for Microbiology, 2005
77. Wang YF, Gustafson M, Triplet T, Allen RC. Evaluation of low positive results from Gen-Probe APTIMA Combo 2 assay for C. trachomatis and N. gonorrhoeae (CT/ GC) [abstract]. 105th Gen. Meet. Am. Soc. Microbiol. Washington, DC: American Society for Microbiology, 2005
78. Munson E, Boyd V, Czarnecka J, et al. Evaluation of Gen-Probe APTIMA-based Neisseria gonorrhoeae and Chlamydia trachomatis confirmatory testing in a metropolitan setting of high disease prevalence. J Clin Microbiol 2007;45:2793-2797 • This publication calls into question the necessity of N. gonorrhoeae confirmatory testing in a community of high STI prevalence. (Pubitemid 47417316)
79. Schachter J, Hook EW, Martin DH, et al. Confirming positive results of nucleic acid amplification tests (NAATs) for Chlamydia trachomatis: all NAATs are not created equal. J Clin Microbiol 2005;43:1372-1373 (Pubitemid 40364964)
80. Peterson EM, Darrow V, Blanding J, et al. Reproducibility problems with the AMPLICOR PCR Chlamydia trachomatis test. J Clin Microbiol 1997;35:957-959 (Pubitemid 27146544)
81. Chernesky MA, Martin DH, Hook EW, et al. Ability of new APTIMA CT and APTIMA GC assays to detect Chlamydia trachomatis and Neisseria gonorrhoeae in male urine and urethral swabs. J Clin Microbiol 2005;43:127-131 (Pubitemid 40096289)
82. Boyadzhyan B, Yashina T, Yatabe JH, et al. Comparison of the APTIMA CT and GC assays with the APTIMA Combo 2 assay, the Abbott LCx assay, and direct fluorescent-antibody and culture assays for detection of Chlamydia trachomatis and Neisseria gonorrhoeae. J Clin Microbiol 2004;42:3089-3093 • This publication presents potential value for alternative target testing. (Pubitemid 38938063)
83. Ripa T, Nilsson PA. A Chlamydia trachomatis strain with a 377-bp deletion in the cryptic plasmid causing false-negative nucleic acid amplification tests. Sex Transm Dis 2007;34:255-256 (Pubitemid 46707474)
84. Herrmann B, Törner A, Low N, et al. Emergence and spread of Chlamydia trachomatis variant, Sweden. Emerg Infect Dis 2008;14:1462-1465
85. Herrmann B. A new genetic variant of Chlamydia trachomatis. Sex Transm Infect 2007;83:253-254 (Pubitemid 47242499)
86. Zanto SN, Beebe J, Hieb E, et al. Performance of Gen-Probe ASR CT and GC reagents as confirmatory tests for Chlamydia trachomatis and Neisseria gonorrhoeae APTIMA screening - a multistate study [abstract]. 105th Gen. Meet. Am. Soc. Microbiol. Washington, DC: American Society for Microbiology, 2005
87. Jenny C. Sexually transmitted diseases and child abuse. Pediatr Ann 1992;21:497-503
88. Rawston SA, Bromberg K, Hammerschlag MR. STD in children: syphilis and gonorrhea. Genitourin Med 1993;69:66-75
89. Kellogg N. American Academy of Pediatrics Committee on Child Abuse and Neglect. The evaluation of sexual abuse of children. Pediatrics 2005;116:506-512
90. Ingram DL, White ST, Durfee MF, et al. Sexual contact in children with gonorrhea. Am J Dis Child 1982;136:994-996 (Pubitemid 12035173)
91. Siegel RM, Schubert CJ, Myers PA, Shapiro RA. The prevalence of sexually transmitted diseases in children and adolescents evaluated for sexual abuse in Cincinnati: rationale for limited STD testing in prepubertal girls. Pediatrics 1995;96:1090-1094
92. Hammerschlag MR. Use of nucleic acid amplification tests in investigating child sexual abuse. Sex Transm Inf 2001;77:153-157 (Pubitemid 32595733)
93. Bassiri M, Mårdh PA, Domeika M. The European Chlamydia Epidemiology Group. Multiplex AMPLICOR PCR screening for Chlamydia trachomatis and Neisseria gonorrhoeae in women attending non-sexually transmitted disease clinics. J Clin Microbiol 1997;35:2556-2560 (Pubitemid 27402660)
94. Corneli HM. Nucleic acid amplification tests (polymerase chain reaction, ligase chain reaction) for the diagnosis of Chlamydia trachomatis and Neisseria gonorrhoeae in pediatric emergency medicine. Pediatr Emerg Care 2005;21:264-270 (Pubitemid 40559605)
95. Girardet RG, McClain N, Lahoti S, et al. Comparison of the urine-based ligase chain reaction test to culture for detection of Chlamydia trachomatis and Neisseria gonorrheae in pediatric sexual abuse victims. Pediatr Infect Dis J 2001;20:144-147 (Pubitemid 32151935)
96. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2006. Morb Mortal Wkly Rep 2006;55(RR-11):1-94
97. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2002. Morb Mortal Wkly Rep 2002;51(RR-6):1-80
98. Martin IMC, Foreman E, Hall V, et al. Non-cultural detection and molecular genotyping of Neisseria gonorrhoeae from a piece of clothing. J Med Microbiol 2007;56:487-490 (Pubitemid 46626565)
99. Moran JS, Levine WC. Drugs of choice for the treatment of uncomplicated gonococcal infections. Clin Infect Dis 1995;20(Suppl 1):S47-65
100. Tapsall JW. What management is there for gonorrhea in the postquinolone era? Sex Transm Dis 2006;33:8-10
101. Thomas JC, Weiner DH, Schoenbach VJ, Earp J. Frequent re-infection in a community with hyperendemic gonorrhoea and chlamydia: appropriate clinical actions. Int J STD AIDS 2000;11:461-467 (Pubitemid 30417200)
102. Hanks JW, Scott CT, Butler CE, Wells DW. Evaluation of a DNA probe assay (Gen-Probe PACE 2) as the test of cure for Neisseria gonorrhoeae genital infections. J Pediatr 1994;125:161-162 (Pubitemid 24225201)
103. Bachmann LH, Desmond RA, Stephens J, et al. Duration of persistence of gonococcal DNA detected by ligase chain reaction in men and women following recommended therapy for uncomplicated gonorrhea. J Clin Microbiol 2002;40:3596-3601
104. Lau CY, Qureshi AK. Azithromycin versus doxycycline for genital chlamydial infections: a meta-analysis of randomized clinical trials. Sex Transm Dis 2002;29:497-502 (Pubitemid 35001337)
105. Workowski KA, Lampe MF, Wong KG, et al. Long-term eradication of Chlamydia trachomatis genital infection after antimicrobial therapy. Evidence against persistent infection. JAMA 1993;270:2071-2075
106. Gaydos CA, Crotchfelt KA, Howell MR, et al. Molecular amplification assays to detect chlamydial infections in urine specimens from high school female students and to monitor the persistence of chlamydial DNA after therapy. J Infect Dis 1998;177:417-424 (Pubitemid 28063768)
107. Mooré SA, Sillekens PTG, Jacobs MV, et al. Monitoring Chlamydia trachomatis infections after antibiotic treatment using RNA detection by nucleic acid sequence based amplification. Mol Pathol 1998;51:149-154 (Pubitemid 28375018)
108. Bianchi A, Bogard M, Cessot G, et al. Kinetics of Chlamydia trachomatis clearance in patients with azithromycin, as assessed by first void urine testing by PCR and transcription-mediated amplification. Sex Transm Dis 1998;25:366-367 (Pubitemid 28368949)
109. McCutchan JA. Epidemiology of venereal urethritis: comparison of gonorrhea and nongonococcal urethritis. Rev Infect Dis 1984;6:669-688
110. Harrison WO, Hooper RR, Wiesner PJ, et al. A trial of minocycline given after exposure to prevent gonorrhea. N Engl J Med 1979;300:1074-1078 (Pubitemid 9198741)
111. Jacobs NF, Kraus SJ. Gonococcal and nongonococcal urethritis in men. Ann Intern Med 1975;82:7-12
112. Rothenberg R, Judson FN. The clinical diagnosis of urethral discharge. Sex Transm Dis 1983;10:24-28 (Pubitemid 13136137)
113. Volk J, Kraus SJ. Nongonococcal urethritis: a venereal disease as prevalent as epidemic gonorrhea. Arch Intern Med 1974;134:511-514
114. AMPLICOR® CT/NG Test for Neisseria gonorrhoeae product insert. Branchburg, NJ: Roche Molecular Systems, Incorporated, 2003
115. BD ProbeTec™ ET Chlamydia trachomatis and Neisseria gonorrhoeae Amplified DNA Assays product insert. Sparks, MD: Becton, Dickinson and Company, 2008
116. APTIMA combo 2® Assay product insert. San Diego, CA: Gen-Probe Incorporated, 2008
117. Triola MF. Fifth edition. Elementary statistics, Boston, MA: Addison Wesley, 1992