What are the urine laboratory tests for Neisseria gonorrhoeae (gonorrhea) and Chlamydia trachomatis (chlamydia)?

From the Guidelines

Urine laboratory testing using nucleic acid amplification tests (NAATs) is the recommended method for detecting gonorrhea and chlamydia infections, with high sensitivity and specificity exceeding 90% for both infections. To get tested, provide a first-void urine sample (the first part of your urine stream) after not urinating for at least one hour. The laboratory will use NAATs to detect genetic material from these bacteria, as supported by the U.S. Preventive Services Task Force recommendation statement 1. This non-invasive testing method is highly accurate, with sensitivity of NAAT specimens collected from genitourinary sites for detecting chlamydia ranging from 86% to 100% and for gonorrhea ranging from 90% to 100% in studies without major limitations 1. Some key points to consider when using urine laboratory testing for gonorrhea and chlamydia include:

• No special preparation is needed beyond following the collection instructions provided by your healthcare provider.
• Results typically take 1-3 days.
• If positive, treatment usually involves antibiotics: for chlamydia, a single 1-gram dose of azithromycin or doxycycline 100mg twice daily for 7 days; for gonorrhea, a single 500mg dose of ceftriaxone intramuscularly.
• Both infections should be treated simultaneously due to their frequent co-occurrence.
• Sexual partners should also be tested and treated, and you should abstain from sexual activity until treatment is complete and symptoms resolve. Early detection and treatment of these infections can significantly reduce the incidence of pelvic inflammatory disease (PID) in nonpregnant women at increased risk for infection, as demonstrated by randomized, controlled trials 1.

From the Research

Urine Laboratory Tests for Gonorrhea and Chlamydia

• Urine tests can be used to diagnose gonorrhea and chlamydia infections, as stated in the study 2.
• Nucleic acid amplification tests (NAATs) are highly sensitive and specific, and can be used on self-collected urine specimens to diagnose these infections 2, 3.
• The use of NAATs on urine specimens can increase the number of patients that can be screened for gonorrhea and chlamydia, especially in non-clinic settings 2, 3.

Advantages of Urine Tests

• Urine tests are non-invasive and can be self-collected, making them a convenient option for patients 2, 3.
• NAATs can detect gonorrhea and chlamydia infections even in asymptomatic patients, which can help prevent the spread of these infections 3, 4.
• Urine tests can be used to screen patients who are not presenting for pelvic or urogenital examinations, making them a useful tool for clinicians 2.

Comparison with Other Specimen Types

• The performance of NAATs on urine specimens is similar to that of cervical and vaginal specimens for detecting chlamydia and gonorrhea infections 5.
• Urine tests can be used as an alternative to traditionally used specimens, such as cervical and vaginal specimens, due to their higher acceptability and lower cost 5.

Recommendations for Laboratory-Based Detection

• The Centers for Disease Control and Prevention (CDC) recommends the use of NAATs for detecting chlamydia and gonorrhea infections, except in certain cases such as child sexual assault and suspected treatment failure 6.
• Laboratories should use NAATs that have been cleared by the Food and Drug Administration (FDA) for the detection of chlamydia and gonorrhea infections 6.