Sexual health: benefits of point-of-care testing

In genitourinary medicine (GUM), point-of-care (POC) nucleic amplification technology is proving to be beneficial, as a recent study has demonstrated.1 Chlamydia trachomatis and Neisseria gonorrhoeae are responsible for a significant number of sexually transmitted infections (STIs), with genitourinary medicine (GUM) clinics diagnosing 100,647 cases of Chlamydia and 20,964 of gonorrhoea in England alone in 2011.2

Currently, patients with symptoms indicating possible Chlamydia or gonorrhoea infection usually undergo presumptive treatment for Chlamydia prior to a diagnosis being confirmed by laboratory testing.3,4 As symptoms are often non­specific, and may be due to other infections such as Mycoplasma genitalium, this ‘syndromic’ management strategy can lead to suboptimal, inappropriate or unnecessary treatment,5,6 resulting in unnecessary cost, delays in patients receiving appropriate treatment and poor antimicrobial stewardship.5–7  Asymptomatic infection is also a common problem, and patients remain untreated until the laboratory diagnosis is available, increasing the risk of complications or additional individuals becoming infected, increasing the overall cost of care.

Under current best practice guidelines, off-site laboratories should provide clinicians with results of diagnostic testing within seven?days; however, a 2011 audit identified that only 75% of GUM clinics received this level of service, leading to further delays in patients receiving appropriate treatment.8 This issue is compounded by difficulties in contacting many patients to arrange follow-up appointments, as well as non-attendance at these appointments,9 highlighting a place for rapid and robust POC diagnosis.