UPDATE MOLECULAR DIAGNOSTICS IN SEXUAL HEALTH. Dr Arlo Upton Clinical Microbiologist Labtests Auckland
|
|
- Leslie Clarke
- 6 years ago
- Views:
Transcription
1 UPDATE MOLECULAR DIAGNOSTICS IN SEXUAL HEALTH Dr Arlo Upton Clinical Microbiologist Labtests Auckland
2 Talk outline Chlamydia trachomatis NAAT What does a positive test mean Interpreting low level positives Confirmatory testing Neisseria gonorrhoeae NAAT Confirmatory testing NAAT role in extra-genital sites NAAT role in forensics
3 Commercially available NAATs Name Company CT NG Method Cobas 4800 Roche Yes Yes PCR Cobas Taqman Roche Yes No PCR ProbeTec ET (Viper) BD Yes Yes SDA Aptima combo 2 (Tigris) Gen-probe Yes Yes TMA (RNA) Abbott real time (m2000) Abbott Yes Yes PCR NAAT advantages Very sensitive Does not require viable organism Can be used on non-invasive specimens Fully automated systems NAAT disadvantages Specificity issues Detects nucleic acid, not disease state Not licensed/validated for all specimen sites False-negative results caused by sequence variation or inhibition Does not provide antimicrobial resistance data
4 How good is a laboratory test? Reproducibility Consistency.could be repeatedly wrong Validity Test measures what it is intended to measure Analytical validity Clinical validity
5 What does a positive CT NAAT mean? 1. Infection 2. DNA only, no viable organisms 3. False positive
6 What tools do we have? CDC guidelines on confirmatory testing 1. Same specimen, same assay 2. Same specimen, different assay (different target) 3. Different specimen, different assay Clinical history, examination. Other laboratory information e.g. degree of positivity
7 Laboratory false positives -contamination
8 Evaluated all three CDC approaches to confirmatory testing Urine & genital specimens Abbott LCx probe, BD ProbeTec, Aptima combo 2, Amplicor PCR 1. >90% of original positives confirmed with additional testing 2. Failure to confirm mostly low-level positives 3. More confirmed by using combination of different NAATs 4. Can t confirm with less sensitive assay (SDA) 5. False positives may occur but confirmatory testing not the way to identify them
9 Low-level positive assays In our lab, approx 9% are low-level positives (>37 cycles) Repeat testing doesn t clarify as some will be positive, some negativedue to small amount of target present & sample variability dilution 1 in 100 Average Ct Detection rate % 1 in 500 Average Ct Detection rate % 1 in 1000 Average Ct Detection rate %
10 Positive test of cure At least five weeks after therapy Standard of care TOC not required unless Absorption Compliance Pregnant Children (?) Non-standard therapy
11 Young women aged 14 17y, primary care clinics 3 monthly interviews, examinations & sample collection Alternating quarters, wkly vaginal swabs & daily diaries Consenting partners investigated & treated Amplicor PCR + Aptima combo ompa genotyping Almost all treated with DOT azithromycin N = % with history of STI at study entry Point prevalence CT during study = %
12 Antibiotic effectiveness 92.1% Repeat episodes 13.7% probable or possible treatment failures
13 CT antibiotic resistance No standardised methods to detect phenotypic resistance In vitro azithromycin/doxycylineheterotypic resistance seen and occurs where there is high bacterial load Clinical implications of this uncertain It is possible that some organisms survive following treatment with azithromycin True resistance with mutation in rrna genes rare Possible fitness cost Re-treatment of possible treatment failures?????? In vitro resistance seen after passaging CT in sub-inhibitory concentrations of quinolones and rifampicin
14 Persistence CT lifecycle
15 Evidence for CT persistence in vitro Induction Observations Antibiotic exposure Enlarged, pleomorphic, aberrant RB Unable to differentiate to EB Depletion essential nutrients IFN-γ exposure Monocyte infection Aberrant RB Altered RB Unable to differentiate to EB Inhibition of inclusion formation Enlarged and aberrant RB Continuous infection Subpopulation of atypical inclusions with aberrant, enlarged RB Atypical inclusions reduction in susceptibly to azithromycin
16 Evidence for CT persistence in vivo EM visualisation in diseased tissue of aberrant RB Synovial macrophages of CT-associated reactive arthritis Macrophages in degenerative aortic stenosis (CP) CT DNA amplified from culture-negative tubal biopsies RNA detected in synovial biopsies Suggests viable organisms but culture negative
17 Evidence for reactivation Active trachoma in people years after leaving endemic trachoma region Intercurrent NG infection reactives CT infection that was previously latent & below level detection (culture)
18 N. gonorrhoeae NAAT Traditionally poor specificity due to cross-reactions with commensal Neisseria species Frequent genetic exchange between the Neisseria species can result in the acquisition of target N. gonorrhoeae sequences by commensal Neisseria species Assay Target Cross-reacts with strains of - Roche amplicor CMT N. cinerea, N. flavescens, N. lactamica, N. sicca, N. subflava BD ProbeTec Abbott CT/NG Pilin-inverting gene Opacity gene No data N. cinerea, N. flavescens, N. lactamica, N. subflava APTIMA combo 2 16SrRNA No cross reactivity found Roche Cobas 4800 DR-9 No cross reactivity found
19 Do positive NG NAAT require confirmatory testing? Prevalence 1% 1% No tested Sensitivity 99% 99% Specificity 99% 99.9% Total positives True positives PPV 50% 91%
20 Do positive NG NAAT require confirmatory testing? CDC confirmatory testing if PPV < 90% 1. >90% of original positives confirmed with additional testing 2. Failure to confirm mostly low-level positives 3. More (>97%) confirmed by using combination of different NAATs on different specimen 4. Can t confirm with less sensitive assay (SDA) 5. False positives may occur but confirmatory testing not the way to identify them
21 Extra-genital sites Ota et al Sex Transm Infect 2009;85:182-6 MSM, 18 years +, men s clinic Toronto Pharyngeal, rectal swabs, urine +/- urethral swab NAAT x 2, culture N = 248 NG culture NG NAAT CT culture CT NAAT Sens Spec 100 > >98
22 N=812 adults, oral sex + Pharyngeal specimens in addition to genital/rectal Amplicor, Aptima, ProbeTec, culture (direct plating) Sensitivity (%) Specificity (%) Culture ProbeTec Aptima Amplicor Prevalence Women 5.3 vs. 9.1% Men 3.5 vs. 7.0%
23 Role of NAAT in forensics CDC guidelines 2006 currently being updated Data are insufficient to adequately assess the utility of nucleic acid amplification tests in the evaluation of children who might havebeen sexually abused, but these tests might be an alternative if confirmation is available and culture systems for C. trachomatisare unavailable. Confirmation tests should consist of a second FDA-cleared nucleic acid amplification test that targets a different sequence from the initial test.
24 Children with suspected abuse, n = 536 Only 51 males Urine, vaginal, anal (urethral) swabs Culture + NAAT (except anal) Aptima + Probetec Probetec positives had additional in-house PCR confirmatory testing Males all negative
25 4.9% had positive result by any test (3.1% CT, 3.3% NG) Excellent specificity & PPV Sensitivity (CT) significantly better with NAAT (85 100%) compared with culture (39%) Sensitivity (NG) no significant difference
26 Study conclusions Prevalence of STIs low (<5%) in children investigated for sexual abuse NAATs on urine + vaginal swabs, with confirmatory testing, adequate Recommend confirmatory testing with different target Recommend caution for using NAAT for NG Alternative target confirmation Culture for susceptibility testing
27 Lymphogranuloma Venereum Labplus (Auckland Hospital) have assay for LGV Real-time PCR assay, which targets the pmpgene which has a unique gap in LGV serovars of CT compared to other serovars, so it is highly specific Usual specimen is rectal swab Few cases of treatment failure reported after 21 days of doxycyline
28 What are NZ labs doing? BD Probetec x 3 Roche Taqman x 3 Roche Amplicor x 1 Abbott m200 x 1 Roche Cobas 4800 x 3 Many accept forensic specimens, not all have chain of evidence NG NAAT only a few labs Confirmation not standardised but themes appear
29 Concluding comments Keep in mind difference between reproducibility and validity NAAT detects nucleic acid Confirmatory testing doesn t exclude all possible false reactive tests Improved technology More specific assays Limit laboratory error Persistence & resistance -research required Increasing acceptance for extra-genital sites & forensic specimens Unexpected result Talk to lab Consider additional testing
30 Acknowledgements Dr Gerardo Herrera NZ labs who provided details of their testing approaches
New CT/GC Tests. CDC National Infertility Prevention Project Laboratory Update Region II May 13-14, 2009
CDC National Infertility Prevention Project Laboratory Update Region II May 13-14, 2009 Richard Steece, Ph.D., D(ABMM) DrRSteece@aol.com New CT/GC Tests New Nucleic Acid Amplification Tests (NAATs) for
More informationControls for Chlamydia trachomatis and Neisseria gonorrhoea
Controls for Chlamydia trachomatis and Neisseria gonorrhoea Mark Manak, Ph.D., SeraCare Life Sciences Gaithersburg, MD USA SoGAT Clinical Diagnostic Meeting NIBSC, South Mimms, UK June 25, 2008 C. trachomatis
More informationPerformance of Chlamydia trachomatis and Neisseria gonorrhoeae nucleic acid amplification assays using low level controls
Performance of Chlamydia trachomatis and Neisseria gonorrhoeae nucleic acid amplification assays using low level controls 7 th International Symposium on Molecular Diagnostics, Graz, Austria May 2008 Phillip
More informationControls for Chlamydia trachomatis and Neisseria gonorrhoea
Controls for Chlamydia trachomatis and Neisseria gonorrhoea Mark Manak, Ph.D., Phil Moen, Ph.D., Bharathi Anekella, Ph.D SeraCare Life Sciences Gaithersburg, MD USA SoGAT Clinical Diagnostic Meeting NIBSC,
More informationDETECTION OF NEISSERIA GONORRHOEAE USING MOLECULAR METHODS
NATIONAL STANDARD METHOD DETECTION OF NEISSERIA GONORRHOEAE USING MOLECULAR METHODS QSOP 62 Issued by Standards Unit, Department for Evaluations,Standards and Training Centre for Infections Issue no: 1
More informationNucleic acid amplification testing for Neisseria gonorrhoeae where are we going?
Nucleic acid amplification testing for Neisseria gonorrhoeae where are we going? David Whiley QPID Laboratory, Queensland Children s Medical Research Institute, Children s Health Service District, and
More informationScottish Bacterial Sexually Transmitted Infections Reference Laboratory (SBSTIRL) User Manual Jan 2018
Scottish Bacterial Sexually Transmitted Infections Reference Laboratory (SBSTIRL) User Manual Jan 2018 Page 1 Contents 1 Introduction Page 3 2 Contact details Page 4 3 Opening hours Page 4 4 Services provided
More informationGuidelines for the Laboratory Detection of Chlamydia trachomatis, Neisseria gonorrhoeae and Treponema pallidum Testing
Guidelines for the Laboratory Detection of Chlamydia trachomatis, Neisseria gonorrhoeae and Treponema pallidum Testing Recommendations from the an expert consultation meeting held at CDC January 13-15,
More informationEvaluation of CDC-Recommended Approaches for Confirmatory Testing of Positive Neisseria gonorrhoeae Nucleic Acid Amplification Test Results
JOURNAL OF CLINICAL MICROBIOLOGY, May 2008, p. 1614 1619 Vol. 46, No. 5 0095-1137/08/$08.00 0 doi:10.1128/jcm.02301-07 Copyright 2008, American Society for Microbiology. All Rights Reserved. Evaluation
More information6/11/15. BACTERIAL STDs IN A POST- HIV WORLD. Learning Objectives. How big a problem are STIs in the U.S.?
BACTERIAL STDs IN A POST- HIV WORLD Tracey Graney, PhD, MT(ASCP) Monroe Community College Learning Objectives Describe the epidemiology and incidence of bacterial STDs in the U.S. Describe current detection
More informationDr Selena Singh. Guy s and St Thomas NHS Foundation Trust, London THIRD JOINT CONFERENCE OF BHIVA AND BASHH 2014
THIRD JOINT CONFERENCE OF BHIVA AND BASHH 2014 Dr Selena Singh Guy s and St Thomas NHS Foundation Trust, London 1-4 April 2014, Arena and Convention Centre Liverpool Performance of ceftriaxone 500mgcontaining
More information2014 CDC GUIDELINES CHLAMYDIA & GONORRHEA DIAGNOSTICS. Barbara Van Der Pol, PhD, MPH University of Alabama at Birmingham
2014 CDC GUIDELINES CHLAMYDIA & GONORRHEA DIAGNOSTICS Barbara Van Der Pol, PhD, MPH University of Alabama at Birmingham DISCLOSURES Honorarium, Speaking Fees or Research Support Atlas Genetics BD Diagnostics
More informationClinical Guidelines Update (aka Know Your NAATs)
Clinical Guidelines Update (aka Know Your NAATs) WARNING: contains adult themes, sexual references and pictures that may be disturbing! Dr Heather Young Christchurch Sexual Health Centre heather.young@cdhb.health.nz
More information4. RED AND BLUE TOP COLLECTION SWABS WILL NO LONGER BE SUPPLIED FOR BACTERIAL CULTURE
Laboratory Testing Update Specimen Transport Changes dated 12-24-14 SEH Laboratory is making significant changes to specimen transports! The Laboratory is introducing new testing platforms along with working
More informationChlamydia trachomatis
Chlamydia trachomatis 2012 EQA Programme A Final Report QAB004101 (CTDNA12A) Dr Anton M van Loon Scientific Experts on behalf of QCMD Report authorised by the QCMD Executive in May 2012 A UKAS accredited
More informationChlamydia trachomatis
Chlamydia trachomatis 2012 EQA Programme A Final Report QAB004101 (CTDNA12A) Version 2 Dr Anton M van Loon Scientific Experts on behalf of QCMD Report authorised by the QCMD Executive in May 2012 A UKAS
More informationGenital Chlamydia and Gonorrhea Epidemiology, Diagnosis, and Management. William M. Geisler M.D., M.P.H. University of Alabama at Birmingham
Genital Chlamydia and Gonorrhea Epidemiology, Diagnosis, and Management William M. Geisler M.D., M.P.H. University of Alabama at Birmingham Chlamydia and Gonorrhea Current Epidemiology Chlamydia Epidemiology
More informationGuidance on the use of molecular testing for Neisseria gonorrhoeae in Diagnostic Laboratories 2011
Guidance on the use of molecular testing for Neisseria gonorrhoeae in Diagnostic Laboratories 2011 Molecular testing for gonorrhoea working group (see Appendix) Prepared by Kirstine Eastick March 2012-1
More informationBEIPH Final Report. QCMD 2009 Neisseria gonorrhoeae (NGDNA09) EQA Programme
QUALITY CONTROL for MOLECULAR DIAGNOSTICS Block 4, Kelvin Campus, West of Scotland Science Park, Glasgow, G20 0SP Scotland Tel: +44 (0) 141 945 6474 Fax: +44 (0) 141 945 5795 www.qcmd.org info@qcmd.org
More informationFEDERAL PUBLIC SERVICE, HEALTH, FOOD CHAIN SECURITY AND ENVIRONMENT CLINICAL BIOLOGY COMMISSION CLINICAL BIOLOGY SECTION
IPH J. Wytsmanstreet 14 B-1050 Brussels FEDERAL PUBLIC SERVICE, HEALTH, FOOD CHAIN SECURITY AND ENVIRONMENT CLINICAL BIOLOGY COMMISSION CLINICAL BIOLOGY SECTION External Quality Assessment for Molecular
More informationProcessing of female genital specimens at Labtests and Northland Pathology Laboratory
Consultation document Processing of female genital specimens at Labtests and Northland Pathology Laboratory Author: Dr Arlo Upton Page 1 of 9 Date: 07/03/16 Table of contents 1. INTRODUCTION...3 2. CURRENT
More informationOne week of doxycycline is an effective treatment for asymptomatic rectal Chlamydia trachomatis infection
One week of doxycycline is an effective treatment for asymptomatic rectal Chlamydia trachomatis infection A Elgalib, A Skingsley, O Dosekun, S Alexander, CYW Tong, JA White. Ali Elgalib Consultant in GUM/HIV
More informationCDC Laboratory Update
CDC Laboratory Update Chlamydia and Gonorrhea Laboratory Guidelines Overview of the APHL / CDC STD Steering Committee Laboratory Recommendations for the Detection of Chlamydia trachomatis, Neisseria gonorrhoeae
More informationAzithromycin for Rectal Chlamydia: Is it Time to Leave Azithromycin on the Shelf?...Not Yet. Jordan, Stephen J. MD, PhD; Geisler, William M.
Azithromycin for Rectal Chlamydia: Is it Time to Leave Azithromycin on the Shelf?...Not Yet Jordan, Stephen J. MD, PhD; Geisler, William M. MD, MPH From the Department of Medicine, University of Alabama
More informationLymphogranuloma Venereum (LGV) Surveillance Project
Lymphogranuloma Venereum (LGV) Surveillance Project Lymphogranuloma venereum (LGV) is a systemic, sexually transmitted disease (STD) caused by a type of Chlamydia trachomatis (serovars L1, L2, L3) that
More informationProfessor Jonathan Ross
SECOND JOINT CONFERENCE OF BHIVA AND BASHH 2010 Professor Jonathan Ross Whittall Street Clinic, Birmingham COMPETING INTEREST OF FINANCIAL VALUE > 1,000: Speaker Name Statement Professor Ross has received
More informationBEIPH Final Report. EQA Programme 2011 Chlamydia trachomatis (CTDNA11A) William G Mackay on behalf of QCMD and its Scientific Council April 2011
BEIPH Final Report EQA Programme 2011 Chlamydia trachomatis (CTDNA11A) William G Mackay on behalf of QCMD and its Scientific Council April 2011 Not to be reproduced or quoted without permission of QCMD.
More informationThe objectives of this presentation are; to increase awareness of the issue of antimicrobial resistant gonorrhea, and to inform primary care and
1 Antimicrobial resistant gonorrhea is an emerging public health threat that needs to be addressed. Neisseria gonorrhoeae is able to develop resistance to antimicrobials quickly. Effective antibiotic stewardship
More informationMYCOPLASMA GENITALIUM FEASABILITY AND PITFALLS OF ADJUNCT TESTING FOR MACROLIDE RESISTANCE (a.k.a. no test is 100%)
MYCOPLASMA GENITALIUM FEASABILITY AND PITFALLS OF ADJUNCT TESTING FOR MACROLIDE RESISTANCE (a.k.a. no test is 100%) Collette Bromhead, Peter Lowe, Litty Tan, Arlo Upton The New Zealand Sexual Health Society
More informationAsymptomatic lymphogranuloma venereum in known HIV positive MSM: is it more common than we think?
Asymptomatic lymphogranuloma venereum in known HIV positive MSM: is it more common than we think? Mr Daniel Ward 1 Dr Meg Boothby 2 Dr Penny Goold 2 Dr Emma Hathorn 2 1 University of Birmingham, UK 2 Whittall
More informationTechnical Bulletin No. 98b
CPAL Central Pennsylvania Alliance Laboratory Technical Bulletin No. 98b Chlamydia trachomatis and Neisseria gonorrhoeae Dual Target PCR Assay UPDATED Specimen Requirements October 13, 2016 Contact: Susan
More informationScottish Bacterial Sexually Transmitted Infections Reference Laboratory (SBSTIRL) User Report for the period January - December 2011
Scottish Bacterial Sexually Transmitted Infections Reference Laboratory (SBSTIRL) User Report for the period January - ember 211 Kirstine Eastick PhD FRCPath (Director) SBSTIRL, Microbiology Edinburgh
More informationReceived 16 December 2005/Returned for modification 6 February 2006/Accepted 6 May 2006
JOURNAL OF CLINICAL MICROBIOLOGY, July 2006, p. 2512 2517 Vol. 44, No. 7 0095-1137/06/$08.00 0 doi:10.1128/jcm.02620-05 Copyright 2006, American Society for Microbiology. All Rights Reserved. Detection
More informationServices for GLBTQ Youth
Sexual Health Care Services for GLBTQ Youth Gale R Burstein, MD, MPH, FAAP, FSAHM Erie County Commissioner of Health Buffalo, NY Agenda Introduction Epidemiology Sexual health care services for YMSM Sexual
More informationBEIPH Final Report. EQA Programme 2011 Chlamydia trachomatis B (CTDNA11B) Prepared on behalf of QCMD and its Scientific Council October 2011
BEIPH Final Report EQA Programme 2011 Chlamydia trachomatis B (CTDNA11B) Prepared on behalf of QCMD and its Scientific Council October 2011 Not to be reproduced or quoted without permission of QCMD. Any
More informationCOMMUNICABLE DISEASE REPORT
COMMUNICABLE DISEASE REPORT Quarterly Report Volume 29, Number 3 September 2012 Sexually Transmitted and Bloodborne Infections Reporting All laboratory confirmed sexually transmitted and bloodborne infections
More informationNew diagnostic tests for sexually transmitted infections. Jens Van Praet 30/11/2018
New diagnostic tests for sexually transmitted infections Jens Van Praet 30/11/2018 Introduction Data from our national microbiological labs suggest STIs are an important clinical issue Correlation with
More informationNIH Public Access Author Manuscript Sex Transm Infect. Author manuscript; available in PMC 2013 June 04.
NIH Public Access Author Manuscript Published in final edited form as: Sex Transm Infect. 2013 June ; 89(4): 305 307. doi:10.1136/sextrans-2012-050686. Comparison of self-obtained penile-meatal swabs to
More informationNucleic Acid Amplification Testing for the Diagnosis of TB
Roche Nucleic Acid Amplification Testing for the Diagnosis of TB David Warshauer, PhD Deputy Director, Communicable Diseases Wisconsin State Laboratory of Hygiene 19 th /20 th Century Traditional Algorithm
More informationComparison of Three Nucleic Acid Amplification Tests for Detection of Chlamydia trachomatis in Urine Specimens
JOURNAL OF CLINICAL MICROBIOLOGY, July 2004, p. 3041 3045 Vol. 42, No. 7 0095-1137/04/$08.00 0 DOI: 10.1128/JCM.42.7.3041 3045.2004 Copyright 2004, American Society for Microbiology. All Rights Reserved.
More informationSexually transmitted infections (in women)
Sexually transmitted infections (in women) Timothy Kremer, MD Assistant Professor, Department of Obstetrics and Gynecology University of North Texas Health Science Center Last official CDC guidelines:
More informationMolecular Diagnosis of Sexually-transmitted Chlamydia trachomatis in the United States
Marquette University e-publications@marquette Clinical Lab Sciences Faculty Research and Publications Clinical Lab Sciences, Department of 1-1-2011 Molecular Diagnosis of Sexually-transmitted Chlamydia
More informationOAML Guideline on the Investigation of Genital Tract Infections November, 2015
OAML Guideline on the Investigation of Genital Tract Infections November, 2015 1. Purpose The purpose of this guideline is to provide ordering clinicians with a clear and concise reference for the investigation
More informationCOMMUNICABLE DISEASE REPORT
June 2011 Department of Health and Community Services Government of Newfoundland and Labrador COMMUNICABLE DISEASE REPORT Reporting Sexually Transmitted and Bloodborne Infections All laboratory-confirmed
More informationXpert CT/NG. Detect it in here. Stop it out there. Three targets, 90 minutes. No repeat testing. Xpert CT/NG. Xpert. A better way.
/ Detect it in here. Stop it out there. / Three targets, 90 minutes. No repeat testing. In Vitro Diagnostic Medical Device A better way. For the first time, we are able to offer highly accurate results
More informationCHLAMYDIA/GC AMPLIFIED RNA ASSAY
Lab Dept: Test Name: Microbiology/Virology CHLAMYDIA/GC AMPLIFIED RNA ASSAY General Information Lab Order Codes: CGRNA Synonyms: CPT Codes: Test Includes: Chlamydia trachomatis/neisseria gonorrhoeae by
More informationChlamydia Curriculum. Chlamydia. Chlamydia trachomatis
Chlamydia Chlamydia trachomatis 1 Learning Objectives Upon completion of this content, the learner will be able to: 1. Describe the epidemiology of chlamydial infection in the U.S. 2. Describe the pathogenesis
More informationChlamydia Trachomatis and Neisseria Gonorrhoeae. Khalil G. Ghanem, MD Johns Hopkins University
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike License. Your use of this material constitutes acceptance of that license and the conditions of use of materials on this
More informationAnswers to those burning questions -
Answers to those burning questions - Ann Avery MD Infectious Diseases Physician-MetroHealth Medical Center Assistant Professor- Case Western Reserve University SOM Medical Director -Cleveland Department
More informationSTIs in Primary Care. Dr Eleanor Draeger 19 th January 2016
STIs in Primary Care Dr Eleanor Draeger 19 th January 2016 Poli=cs! 2012! Health and Social Care act! Sexual Health commissioning moved to local authority! 2015! 200 million cuts to public health! 40%
More informationReceived 26 November 2003/Returned for modification 6 January 2004/Accepted 6 April 2004
JOURNAL OF CLINICAL MICROBIOLOGY, July 2004, p. 3089 3093 Vol. 42, No. 7 0095-1137/04/$08.00 0 DOI: 10.1128/JCM.42.7.3089 3093.2004 Copyright 2004, American Society for Microbiology. All Rights Reserved.
More informationCase Studies, or Verification Vignettes
Case Studies, or Verification Vignettes 1 Vignette #1 Change from One Automated AST to Another Your lab is changing from one FDA-cleared automated AST to another Is a verification study required? 2 Yes
More informationEvaluation of the Abbott RealTime CT/NG Assay in Comparison to the Roche Cobas Amplicor CT/NG Assay
JOURNAL OF CLINICAL MICROBIOLOGY, Apr. 2011, p. 1294 1300 Vol. 49, No. 4 0095-1137/11/$12.00 doi:10.1128/jcm.02595-10 Copyright 2011, American Society for Microbiology. All Rights Reserved. Evaluation
More informationDepartments of Medicine and Epidemiology, Division of Infectious Diseases, University of Alabama at Birmingham
SUPPLEMENT ARTICLE Diagnosis and Management of Uncomplicated Chlamydia trachomatis Infections in Adolescents and Adults: of Evidence Reviewed for the 2015 Centers for Disease Control and Prevention Sexually
More informationWhat's the problem? - click where appropriate.
STI Tool v 1.9 @ 16/11/2017 What's the problem? - click where appropriate. Male problems: screening urethral symptoms proctitis in gay men lumps or swellings ulcers or sores skin rash and/or itch Female
More informationSTI control. Dr. Jane Morgan Hamilton Sexual Health Clinic
STI control Dr. Jane Morgan Hamilton Sexual Health Clinic Overview STI control in theory NZ s reality Where to from here? STI control framework R0=ßcD R0 = reproductive rate; the rate at which infection
More informationEvaluation of the new BD MAX GC real time PCR assay, analytically and clinically as a
JCM Accepted Manuscript Posted Online 14 October 2015 J. Clin. Microbiol. doi:10.1128/jcm.01962-15 Copyright 2015, American Society for Microbiology. All Rights Reserved. 1 2 3 4 Evaluation of the new
More informationSexually transmitted infections (in women)
Sexually transmitted infections (in women) Timothy Kremer, MD Assistant Professor, Department of Obstetrics and Gynecology University of North Texas Health Science Center Last official CDC guidelines:
More informationDr Edward Coughlan. Clinical Director Christchurch Sexual Health Christchurch
Dr Edward Coughlan Clinical Director Christchurch Sexual Health Christchurch 16:30-17:25 WS #48: Mycoplasma Genitalium - The New Black 17:35-18:30 WS #58: Mycoplasma Genitalium - The New Black (Repeated)
More informationSexually Transmitted Infection surveillance in Northern Ireland An analysis of data for the calendar year 2011
Sexually Transmitted Infection surveillance in Northern Ireland 2012 An analysis of data for the calendar year 2011 Contents Page Summary points. 3 Surveillance arrangements and sources of data.. 4 1:
More informationResearch Article External Quality Assessment for the Detection of Chlamydia trachomatis in Urine Using Molecular Techniques in Belgium
Sexually Transmitted Diseases Volume 2015, Article ID 835261, 8 pages http://dx.doi.org/10.1155/2015/835261 Research Article External Quality Assessment for the Detection of Chlamydia trachomatis in Urine
More information5/1/2017. Sexually Transmitted Diseases Burning Questions
Sexually Transmitted Diseases Burning Questions Jeffrey D. Klausner, MD, MPH Professor of Medicine and Public Health University of California Los Angeles Los Angeles, California FORMATTED: 04-03-17 Financial
More informationSexually Transmitted Infections In Manitoba
Sexually Transmitted Infections In Manitoba 2014 A focus on bacterial sexually transmitted infections Data reported to December 31, 2014 Epidemiology & Surveillance Public Health Branch Public Health and
More informationValidation of a Laboratory Developed Real-Time PCR Protocol for Detection of Chlamydia trachomatis and Neisseria gonorrhoeae in Urine
Validation of a Laboratory Developed Real-Time PCR Protocol for Detection of Chlamydia trachomatis and Neisseria gonorrhoeae in Urine Mark J Hopkins, Lynne J Ashton, Fath Alloba, Anura Alawattegama, Ian
More informationDisclosures. STD Screening for Women. Chlamydia & Gonorrhea. I have no disclosures or conflicts of interest to report.
Disclosures Management of STIs: Challenges in Practice I have no disclosures or conflicts of interest to report. Alison O. Marshall, MSN, FNP-C Associate Professor of Practice & Director of the Family
More information87491 Chlamydia trachomatis, amplified probe technique Neisseria gonorrhoeae, amplified probe technique. Virology (Performed on Mpls campus)
Lab Dept: Test Name: Microbiology/Virology CHLAMYDIA & GONORRHOEAE PCR General Information Lab Order Codes: CGPCR Synonyms: CPT Codes: Test Includes: Chlamydia trachomatis/neisseria gonorrhoeae by Nucleic
More informationIncidence and Treatment Outcomes of Pharyngeal. Infections in Men Who Have Sex with Men: A 13-Year Retrospective Cohort Study
MAJOR ARTICLE Incidence and Treatment Outcomes of Pharyngeal Neisseria gonorrhoeae and Chlamydia trachomatis Infections in Men Who Have Sex with Men: A 13-Year Retrospective Cohort Study Kaede V. Ota,
More informationAPTIMA Combo 2 Testing Detected Additional Cases of Neisseria. gonorrhoeae in Men and Women in Community Settings. * Corresponding Author at:
JCM Accepts, published online ahead of print on 16 March 2011 J. Clin. Microbiol. doi:10.1128/jcm.02062-10 Copyright 2011, American Society for Microbiology and/or the Listed Authors/Institutions. All
More informationOBJECTIVES. Emerging Laboratory Diagnostic Options for Sexually-transmitted Infections
Emerging Laboratory Diagnostic Options for Sexually-transmitted Infections OBJECTIVES I. Appreciate the changing epidemiology of trichomoniasis and clinician ordering patterns on the basis of improved
More informationKhalil G. Ghanem, MD, PhD Associate Professor of Medicine Johns Hopkins University School of Medicine. April 2, 2014
Khalil G. Ghanem, MD, PhD Associate Professor of Medicine Johns Hopkins University School of Medicine April 2, 2014 E-mail your questions for the presenter to: maphtc@jhsph.edu DISCLOSURES OFF- LABEL USES
More informationEmerging Laboratory Diagnostic Options for Sexually-transmitted Infections
Emerging Laboratory Diagnostic Options for Sexually-transmitted Infections Erik Munson Wheaton Franciscan Laboratory Marquette University Milwaukee, Wisconsin 1 OBJECTIVES I. Appreciate the changing epidemiology
More informationNovos desafios para controlar as infecções sexualmente transmissíveis [New Challenges in Managing Sexually Transmitted Infections]
Novos desafios para controlar as infecções sexualmente transmissíveis [New Challenges in Managing Sexually Transmitted Infections] Khalil Ghanem, MD, PhD Associate Professor of Medicine Directors, STD/HIV/TB
More informationReceived 20 September 2006/Returned for modification 30 October 2006/Accepted 20 December 2006
JOURNAL OF CLINICAL MICROBIOLOGY, Mar. 2007, p. 747 751 Vol. 45, No. 3 0095-1137/07/$08.00 0 doi:10.1128/jcm.01956-06 Copyright 2007, American Society for Microbiology. All Rights Reserved. Characteristics
More informationIndustry Sponsored Symposia. Québec City, CANADA JULY 10 TO 13,
19th biennial conference of the International Society for sexually transmitted diseases Research Québec City, CANADA JULY 10 TO 13, 2011 Industry Sponsored Symposia www.isstdrquebec2011.com SUNDAY JULY
More informationHawaii State Laboratories Required Submission Information for APHL RFP: Validation of the MALDI-TOF for the identification of Neisseria gonorrhoeae
Hawaii State Laboratories Required Submission Information for APHL RFP: Validation of the MALDI-TOF for the identification of Neisseria gonorrhoeae 1. Please describe the laboratory s current MALDI-TOF
More informationBACTERIOLOGY PROFICIENCY TESTING PROGRAM
BACTERIOLOGY PROFICIENCY TESTING PROGRAM Comprehensive Category September 6, 2016 If you have any questions or comments, please contact either: Dr. Wendy Archinal Nellie Dumas Dr. Kimberlee Musser Phone:
More informationLearning Objectives. STI Update. Case 1 6/1/2016
Learning Objectives STI Update June 16 th, 2016 Madhu Choudhary, MD. FIDSA Assoc. Prof of Medicine Albany Medical College Review screening recommendations for STI in different patient populations Describe
More informationReliable, cost-effective CT/GC testing For labs with low to medium throughput needs. The BD ProbeTec ET System
Reliable, cost-effective CT/GC testing For labs with low to medium throughput needs The BD ProbeTec ET System The demand is there. The system is here. Now your lab can run up to 15,000 samples a year reliably
More informationNucleic Acid Amplification Tests for Diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis Rectal Infections
JOURNAL OF CLINICAL MICROBIOLOGY, May 2010, p. 1827 1832 Vol. 48, No. 5 0095-1137/10/$12.00 doi:10.1128/jcm.02398-09 Copyright 2010, American Society for Microbiology. All Rights Reserved. Nucleic Acid
More informationPerformance of the Abbott RealTime CT/NG for Detection of
JOURNAL OF CLINICAL MICROBIOLOGY, Sept. 2010, p. 3236 3243 Vol. 48, No. 9 0095-1137/10/$12.00 doi:10.1128/jcm.01019-10 Copyright 2010, American Society for Microbiology. All Rights Reserved. Performance
More informationPrevalence of human papillomavirus and Chlamydia trachomatis infection in paired urine and cervical smear samples of Palestinian young women.
Prevalence of human papillomavirus and Chlamydia trachomatis infection in paired urine and cervical smear samples of Palestinian young women. Walid Salim Basha, PhD Faculty of Human Medicine An-Najah National
More informationPerformance of the Abbott RealTime CT/NG for the Detection of Chlamydia. trachomatis and Neisseria gonorrhoeae
JCM Accepts, published online ahead of print on 28 July 2010 J. Clin. Microbiol. doi:10.1128/jcm.01019-10 Copyright 2010, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights
More informationSTOCS-H Scottish TOC Study HPV test comparison
STOCS-H Scottish TOC Study HPV test comparison What is entailed? Trial of new HPV tests on residual sample after HC2 result obtained, reported and acted on Complements English Sentinel Sites HPV Multi-test
More informationMedical and Legal Implications of Testing for Sexually Transmitted Infections in Children
CLINICAL MICROBIOLOGY REVIEWS, July 2010, p. 493 506 Vol. 23, No. 3 0893-8512/10/$12.00 doi:10.1128/cmr.00024-09 Copyright 2010, American Society for Microbiology. All Rights Reserved. Medical and Legal
More informationMYCOPLASMA GENITALIUM A PRACTICAL GUIDE
MYCOPLASMA GENITALIUM A PRACTICAL GUIDE DR JENNY HAYWARD FRANZCOG FACHSHM NEW ZEALAND SEXUAL HEALTH CONFERENCE SATURDAY 9 TH SEPTEMBER 1 ACKNOWLEDGE FRUSTRATIONS AWARENESS EVOLVING AREA TESTING OFTEN MULTIPLE
More informationChlamydia trachomatis and Neisseria gonorrhoeae are the
ORIGINAL STUDY Screening of Oropharynx and Anorectum Increases Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae Infection in Female STD Clinic Visitors Remco P. H. Peters, MD, PhD,* Noëmi
More informationTreatment resistant STIs relevant to MSM
Treatment resistant STIs relevant to MSM David A. Lewis FRCP (UK) PhD Centre for HIV and STIs National Institute for Communicable Diseases (NHLS) Johannesburg, South Africa Regional Director, IUSTI Africa
More informationManagement of NGU (Non-gonococcal urethritis)
Management of NGU (Non-gonococcal urethritis) First line Doxycycline 100mg po bd for 7 days (contra-indicated in pregnancy) Alternative regimens Azithromycin 1G po stat Azithromycin 500mg po stat, then
More informationSTIs: Practical Aspects of Management
STIs: Practical Aspects of Management Dr Heather Young FAChSHM DipPH Christchurch Sexual Health heathery@xtra.co.nz 027 343 4963 Sexually Transmitted Infections BACTERIAL STIs: CHLAMYDIA GONORRHOEA SYPHILIS
More informationTB/HIV 2 sides of the same coin. Dr. Shamma Shetye, MD Microbiology Metropolis Healthcare, Mumbai
TB/HIV 2 sides of the same coin Dr. Shamma Shetye, MD Microbiology Metropolis Healthcare, Mumbai Global- Tb new cases Diagnosis-Microscopy ZN,Flourescent microscopy(fm) Rapid, inexpensive test Specificity>95%
More informationBACTERIOLOGY PROFICIENCY TESTING PROGRAM
BACTERIOLOGY PROFICIENCY TESTING PROGRAM Comprehensive Category January 19, 2016 If you have any questions or comments, please contact either: Dr. Wendy Archinal Nellie Dumas Dr. Kimberlee Musser Phone:
More informationHPSC SEXUALLY TRANSMITTED INFECTIONS IN IRELAND, 2010
HPSC SEXUALLY TRANSMITTED INFECTIONS IN IRELAND, 21 Health Protection Surveillance Centre, www.hpsc.ie Version 1. May 212 Table of Contents Acknowledgements... 5 Key Points... 5 Introduction... 7 Methods...
More information2012 California Clinical Laboratory Survey: STD/HIV/Hepatitis Testing
2012 California Clinical Laboratory Survey: STD/HIV/Hepatitis Testing Joan M. Chow, MPH, DrPH Surveillance, Epidemiology, Assessment & Evaluation Section Sexually Transmitted Disease Control Branch Division
More informationAdvances in STI diagnostics. Dr Paddy Horner Consultant Senior Lecturer University of Bristol
Advances in STI diagnostics Dr Paddy Horner Consultant Senior Lecturer University of Bristol Advances in STI diagnostics Rapid expansion in on-line STI testing Outstripping NHS expert advice Increasing
More informationSTI Indicators by STI
STI Indicators by STI Table of Contents pg. 2 Sexual History pg. 3-4 Syphilis pg. 5-6 Gonorrhea pg. 7-9 Chlamydia pg. 10 HIV/PrEP 1 Sexual History Comprehensive Sexual History Elements Percentage of patients
More informationUpdate on Sexually Transmitted Infections among Persons Living with HIV
Update on Sexually Transmitted Infections among Persons Living with HIV Stephen A. Berry, MD PhD Assistant Professor of Medicine Johns Hopkins University Division of Infectious Diseases Abbreviations and
More informationSexually transmitted infections
Sexually transmitted infections Dr Caroline CHARLIER-WOERTHER Université Paris Descartes Paris, France Learning objectives Counsel patients about the risk of STD Know how to diagnose and treat a sexuallytransmitted
More informationReceived 26 November 2008/Returned for modification 4 February 2009/Accepted 2 April 2009
JOURNAL OF CLINICAL MICROBIOLOGY, June 2009, p. 1657 1662 Vol. 47, No. 6 0095-1137/09/$08.00 0 doi:10.1128/jcm.02269-08 Copyright 2009, American Society for Microbiology. All Rights Reserved. Evaluation
More informationReceived 5 March 2007/Returned for modification 17 May 2007/Accepted 11 June 2007
JOURNAL OF CLINICAL MICROBIOLOGY, Sept. 2007, p. 2793 2797 Vol. 45, No. 9 0095-1137/07/$08.00 0 doi:10.1128/jcm.00491-07 Copyright 2007, American Society for Microbiology. All Rights Reserved. Evaluation
More informationACCEPTED. Instrument in Female Self-obtained Vaginal Swabs and Male Urine Samples. Andrew Hardick 1. Justin Hardick 1.
JCM Accepts, published online ahead of print on 30 August 2006 J. Clin. Microbiol. doi:10.1128/jcm.01447-06 Copyright 2006, American Society for Microbiology and/or the Listed Authors/Institutions. All
More information