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. 2022 Apr 20;60(4):e0253021.
doi: 10.1128/jcm.02530-21. Epub 2022 Mar 23.

Evaluation of the Hologic Aptima Combo 2 Assay for Detection of Neisseria gonorrhoeae from Joint Fluid Specimens

David C Alexander  1   2 , Robert M Taylor  2 , Irene Martin  3 , Heather Adam  2   4 , Philippe Lagacé-Wiens  2   4 , Peter Pieroni  4 , James A Karlowsky  2   4 , Paul Van Caeseele  1   2
Affiliations

Evaluation of the Hologic Aptima Combo 2 Assay for Detection of Neisseria gonorrhoeae from Joint Fluid Specimens

David C Alexander et al. J Clin Microbiol. .

Abstract

Gonorrhea is a sexually transmitted bacterial infection caused by Neisseria gonorrhoeae. Nucleic acid amplification testing is the preferred method for routine diagnosis of gonorrhea from urogenital specimens, but culture is commonly used for diagnosis of disseminated infections, including gonococcal arthritis. The Hologic Aptima Combo 2 (AC2), a transcription-mediated amplification assay, is FDA and Health Canada licensed for detection of N. gonorrhoeae and Chlamydia trachomatis from urogenital, rectal, and pharyngeal specimens, but not joint fluid. In the current study, we compared the performance of microscopy, culture, and the AC2 for detection of N. gonorrhoeae from 170 joint fluid specimens. A total of five specimens were culture-positive, whereas 14 were AC2-positive. Gram-negative diplococci, characteristic of Neisseria, were observed in only two joint fluid specimens. Complementary testing confirmed the presence of N. gonorrhoeae in seven discordant (i.e., culture-negative/AC2-positive) specimens. These results indicate that the AC2 is more sensitive than culture for the diagnosis of gonococcal arthritis.

Keywords: Neisseria gonorrhoeae; disseminated gonococcal infection; nucleic acid amplification testing.

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Conflict of interest statement

The authors declare a conflict of interest. David C. Alexander has received nonfinancial support to explore the development of assays on the Hologic Fusion system.

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