Comparison of self-collected meatal swabs with urine specimens for the diagnosis of Chlamydia trachomatis and Neisseria gonorrhoeae in men

Purpose. Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) are common bacterial causes of sexually transmitted infections. Self-taken meatal swabs are a possible alternative to urine samples in testing for infection; however, the data surrounding their use are limited. Methodology. We carried out a prospective service review in a large sexual health clinic comparing urine samples and self-taken meatal swabs in men presenting for sexual transmissible infection screening for CT and GC with the BD Viper XTR system. Results. We found an overall prevalence of 10.5% for CT infections and 4.2% for GC infections in our patient population. Meatal swab testing had a sensitivity and specificity of 91 and 99% with an negative predictive value (NPV) of 99% and a positive predictive value (PPV) of 96% for CT testing compared to a sensitivity and specificity of 100 and 99% with an NPV of 100% and a PPV of 98% for urine samples. The sensitivity and specificity of meatal swabs was 100 and 99 %, respectively, for GC detection with an NPV of 100% and PPV of 89% compared to urine which had 93% sensitivity and 99% specificity with an NPV and PPV of 99 and 93 %, respectively. Conclusions. Meatal samples were not inferior to urine samples for the detection of CT and GC. Male urethral meatal self-sampling offers an alternative sample type when compared to male urine specimens.