- Routine, universal testing for oropharyngeal Neisseria gonorrhoeae appears to increase detection vs selective testing among men who have sex with men (MSM).
- >50% of missed infections using selective testing would be oropharyngeal-only and not coincidentally treated with concurrent urogenital or anorectal N gonorrhoeae infections.
Why this matters
- Consider routine, universal testing vs selective testing to optimize identification/timely treatment of oropharyngeal N gonorrhoeae infections.
- A large percentage of oropharyngeal N gonorrhoeae infections remain positive between testing and treatment, highlighting risk for transmission between sex partners.
- 26,508 selectively tested and 238,619 universally tested MSM (median age, 36 years; interquartile range, 27-47 years).
- Routine universal oropharyngeal testing was conducted in 90% of consultations.
- Oropharyngeal N gonorrhoeae prevalence was higher with universal routine vs selective testing (5.5% vs 4.7%, respectively; P<.001>
- 54.8% (7436/13,568) oropharyngeal infections occurred without concurrent urogenital or anorectal N gonorrhoeae.
- Retrospective surveillance data analysis comparing selective oropharyngeal N gonorrhoeae testing vs routine universal testing among Dutch MSM 2008-2017.
- Funding: Public Health Service South Limburg, the Netherlands.
- False positives.
- Missed risk factors.
- No standardised universal testing cutoff.
- Calendar years, not months defined testing policy.