An audit of the results of the Roche Amplicor gonorrhoea test on female genital samples - a cheaper and more sensitive method than culture in an urban English population

We report an audit of the use of the Roche Amplicor gonorrhoea test in an urban English genitourinary (GU) medicine clinic. A number of studies have shown polymerase chain reaction (PCR) to be more sensitive than culture in detecting Neisseria gonorrhoea (NG) in genital samples. PCR also offers benefits over culture in terms of samples transport and storage requirements but cannot produce antibiotic sensitivities. In this audit, the use of both methods within an algorithm has reduced the overall cost of NG detection by approximately 30%. In all, 4.2% (99 out of 2336) of the endocervical samples were positive, but only 69% (68 out of 99) of these were also positive by culture. Urine samples showed twice as many inhibitory results as positive results: 19 (3%) inhibitory and 10 (1.5%) positive out of 662 samples. The use of the GC PCR in this protocol has been cost-saving and has increased the sensitivity of GC detection, but some results have been difficult to interpret. We hope to remedy this by the introduction of confirmatory testing for discrepant PCR results.