To the Editor: Australian gonorrhoea infection rates are rising.1 Infection spreads through various sexual practices, and extragenital infections are commonly asymptomatic.2 Nucleic acid amplification tests (NAATs) provide rapid, sensitive testing, regardless of the site involved or presence or absence of symptoms.3,4 There have therefore been calls for a change to NAAT-based screening for high-risk groups, including men who have sex with men (MSM).5 Limitations include false-positive and false-negative results due to molecular variation and lack of susceptibility data.
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- 1. The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia. Annual Surveillance Report 2011. Sydney: The Kirby Institute, 2011. http://www.med.unsw. edu.au/nchecrweb.nsf/page/Annual+ Surveillance+Reports (accessed Aug 2012).
- 2. Hook EW, Handsfield HH. Gonococcal infections in the adult. In: Holms K, Sparling P, Stamm W, et al, editors. Sexually transmitted diseases. 4th ed. New York: McGraw Hill, 2008: 627-646.
- 3. Koumans EH, Johnson RE, Knapp JS, St Louis ME. Laboratory testing for Neisseria gonorrhoeae by recently introduced nonculture tests: a performance review with clinical and public health considerations. Clin Infect Dis 1998; 27: 1171-1180.
- 4. Cook RL, Hutchison SL, Østergaard L, et al. Systematic review: noninvasive testing for Chlamydia trachomatis and Neisseria gonorrhoeae. Ann Int Med 2005; 142: 914-925.
- 5. Fairley CK, Chen MY, Bradshaw CS, Tabrizi SN. Is it time to move to nucleic acid amplification tests screening for pharyngeal and rectal gonorrhoea in men who have sex with men to improve gonorrhoea control? Sex Health 2011; 8: 9-11.
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