Chlamydia trachomatis & Neisseria gonorrhoeae – detection (including LGV genotyping)

Detection of Chlamydia trachomatis (chlamydia) and Neisseria gonorrhoeae (gonorrhea)
Microbiology
Virology
○ Urine (first catch) ○ Cervical, conjunctival, genital ulcer, penile, pharyngeal, rectal, vaginal, urethral swabs ○ Seminal fluid
Other Information
○ Culture is the preferred testing method to identify genitourinary pathogens in children (PCR testing not recommended)

○ Vaginal specimens are not optimal to diagnose gonorrhea in women. Vaginal swabs should only be used to screen for sexually transmitted diseases due to presumed sexual abuse or assault in preteen-aged girls.
○ LGV must be indicated on the requisition for testing to be performed, except all male rectal specimen that will be sent automatically.
○ For N. gonorrheae culture, see Bacterial culture – genitals
○ For C. trachomatis culture, see Chlamydia trachomatis – Culture
○ Urine: cobas urine PCR tube (2 mL)
○ Swabs: cobas PCR swab container

Urine
○ Urine is the preferred specimen type for testing males and women who have undergone a hysterectomy
○ Collect a first-voided urine specimen in sterile container. Transfer 2 mL of urine into cobas urine PCR tube.

Swabs
○ Swabs are the preferred specimen type for women (except those who have undergone a hysterectomy)
○ Collect specimen from areas indicated based on clinical presentation and previous history (e.g. MSM), rotate swab several times to collect any discharge if present. Place swabs in cobas PCR swab container if testing for chlamydia and gonorrhoea ensuring to break swab at dark line once placed in transport media. If N. gonorrhoeae culture is requested, place each swab in separate Amies transport medium.

Seminal fluid
○ Wash the periurethral area and hands prior to collection. Urine should be passed immediately before seminal fluid collection. Using as much of an aseptic technique as possible, collect seminal fluid by masturbation directly into a clean, sterile container.

Refer to section Sample Processing / Delivery
In- house LGV Genotyping NML
○ PCR:
○ Up to 10 days for LGV detection after receipt by NML
○ Up to 21 days for LGV genotyping after receipt by NML
416-586-4800 extension 4467
NO
○ Label specimen container. Place specimens in biohazard bag and seal.

○ Transport specimens to the UHN/SH Microbiology Laboratory at room temperature (20-25˚C) ASAP after collection.

○ UHN/SH Microbiology Laboratory will perform GC/CT PCR in house. The laboratory can refer the original specimen to the National Microbiology Laboratory for testing if positive for C. trachomatis and LGV is suspected. All male rectal positive Chlamydia specimens will be send to NML for LGV genotyping.