Point-by-Point Progress: Gonorrhea Point of Care Tests

Expert Rev Mol Diagn. 2020 Aug;20(8):803-813. doi: 10.1080/14737159.2020.1778467. Epub 2020 Jun 30.

Abstract

Introduction: Point-of-care (POC) tests for Neisseria gonorrhoeae (Ng) are urgently needed to control the gonorrhea epidemic, so patients can receive immediate diagnoses and treatment. While the advent of nucleic acid amplification tests (NAATs) has improved the accuracy of Ng identification, very few POC assays are able to provide results of such tests at the clinical visit. Additionally, antimicrobial resistance (AMR) presents a unique treatment challenge for Ng.

Areas covered: This review notes that older POC tests have lower sensitivity for Ng, compared to the currently-available NAATs, and are not adequate for the current demand for high sensitivity. Promising newer assays, which can be used at the POC are covered. This review also includes data about clinicians' and patients' acceptability and expectations of POC tests for Ng, testing of extragenital specimens, pooling studies, as well as their impact clinically, and use in low-resource settings.

Expert opinion: The ability to use POC tests to identify and immediately treat Ng infections at the patient encounter offers many benefits and opportunities. POC tests for Ng are currently available, but not widely used especially in low-resource settings. Further development of POC tests with AMR testing capacity is needed to help guide antimicrobial stewardship.

Keywords: Neisseria gonorrhoeae; antimicrobial resistance; diagnostics; point-of-care tests; sexually transmitted infections.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Drug Resistance, Bacterial
  • Gonorrhea / diagnosis*
  • Gonorrhea / drug therapy
  • Gonorrhea / microbiology*
  • Humans
  • Microbial Sensitivity Tests
  • Neisseria gonorrhoeae* / drug effects
  • Neisseria gonorrhoeae* / genetics
  • Nucleic Acid Amplification Techniques
  • Point-of-Care Testing*

Substances

  • Anti-Bacterial Agents