{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T07:48:07Z","timestamp":1791964087825,"version":"4.3.4"},"reference-count":26,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"unspecified","delay-in-days":286,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Sensitive and high-throughput testing for\n                    <jats:italic>Neisseria gonorrhoeae<\/jats:italic>\n                    (NG) is widely underpinned by automated commercial solutions using nucleic acid amplification tests. We outline our experience of using Roche Cobas 8800 CT\/NG (Cobas NG) for primary testing of NG at scale. Over 360000 specimens were tested over a three-year period. A disproportionate number of \u2018indeterminate\u2019 oropharyngeal swabs (25%) tested positive by Cobas NG but failed to confirm by Xpert CT\/NG, significantly higher than genital samples (4%) (chi-square\n                    <jats:italic>p<\/jats:italic>\n                    -value &lt;0.05). Such samples are highly problematic, as they fail to provide a definitive result for the patient. To investigate this non-specificity, publicly available sequences for Cobas NG DR-9 targets were aligned with\n                    <jats:italic>Neisseria<\/jats:italic>\n                    genome databases. We found a strain of\n                    <jats:italic>Neisseria lactamica<\/jats:italic>\n                    (PubMLST 49718), isolated from a throat swab, which was predicted to cross-react with Cobas NG. We subsequently confirmed a Cobas NG false-positive result with this isolate. BLAST analysis showed the target gene NG DR-9 was rare among available non-NG\n                    <jats:italic>Neisseria<\/jats:italic>\n                    whole genome sequences. This may suggest the existence of an as-yet unknown and difficult to cultivate oral commensal that contains NG DR-9. Our findings further highlight the need for NG confirmatory testing of oropharyngeal samples screened with Cobas NG.\n                  <\/jats:p>","DOI":"10.1017\/s0950268826102039","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T07:23:42Z","timestamp":1791962622000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["A large audit of Cobas CT\/NG screening and Xpert CT\/NG supplemental testing reveals low confirmatory rates in oropharyngeal samples with evidence of commensal cross-reactivity with an isolate of\n                    <i>Neisseria lactamica<\/i>"],"prefix":"10.1017","volume":"154","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6966-605X","authenticated-orcid":false,"given":"Ashley","family":"McEwan","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00he80998","id-type":"ROR","asserted-by":"publisher"}],"name":"Manchester University NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Lucidarme","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/018h10037","id-type":"ROR","asserted-by":"publisher"}],"name":"Meningococcal Reference Unit"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Whitfield","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/018h10037","id-type":"ROR","asserted-by":"publisher"}],"name":"UKHSA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Buttery","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00he80998","id-type":"ROR","asserted-by":"publisher"}],"name":"Manchester University NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Tilston","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00he80998","id-type":"ROR","asserted-by":"publisher"}],"name":"Manchester University NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Machin","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/018h10037","id-type":"ROR","asserted-by":"publisher"}],"name":"UKHSA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm","family":"Guiver","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/018h10037","id-type":"ROR","asserted-by":"publisher"}],"name":"UKHSA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,10,14]]},"reference":[{"key":"S0950268826102039_r18","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.01039-23"},{"key":"S0950268826102039_r19","doi-asserted-by":"publisher","DOI":"10.1093\/jalm\/jfaf120"},{"key":"S0950268826102039_r6","doi-asserted-by":"publisher","DOI":"10.33321\/cdi.2005.29.39"},{"key":"S0950268826102039_r25","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2025.30.36.2500673"},{"key":"S0950268826102039_r26","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00806-13"},{"key":"S0950268826102039_r13","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2958.2000.01932.x"},{"key":"S0950268826102039_r2","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-3762"},{"key":"S0950268826102039_r20","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-020-04004-5"},{"key":"S0950268826102039_r8","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02068-18"},{"key":"S0950268826102039_r14","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2021.784610"},{"key":"S0950268826102039_r1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01996-18"},{"key":"S0950268826102039_r7","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00485-13"},{"key":"S0950268826102039_r10","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.2.835-837.2003"},{"key":"S0950268826102039_r17","first-page":"95","article-title":"BioEdit: A user-friendly biological sequence alignment editor and analysis program for windows 95\/98\/NT","volume":"41","author":"Hall","year":"1999","journal-title":"Nucleic Acids Symposium Series"},{"key":"S0950268826102039_r21","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-022-04519-z"},{"key":"S0950268826102039_r9","doi-asserted-by":"publisher","DOI":"10.2353\/jmoldx.2006.050045"},{"key":"S0950268826102039_r12","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01217-11"},{"key":"S0950268826102039_r23","doi-asserted-by":"publisher","DOI":"10.12688\/wellcomeopenres.15362.1"},{"key":"S0950268826102039_r24","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2022-055576"},{"key":"S0950268826102039_r4","doi-asserted-by":"publisher","DOI":"10.1177\/0956462419886775"},{"key":"S0950268826102039_r5","doi-asserted-by":"publisher","DOI":"10.1071\/SH07050"},{"key":"S0950268826102039_r16","unstructured":"[16] Google Patents Database (2013) Patent EP 1 697 541 B1, https:\/\/patents.google.com\/patent\/EP1697541B1\/en (accessed 15 September 2025)."},{"key":"S0950268826102039_r22","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.01022-25"},{"key":"S0950268826102039_r15","unstructured":"[15] Google Patents Database (2009) Patent EP 2 050 826 A2, https:\/\/patents.google.com\/patent\/EP2050826A2\/en (accessed 15 September 2025)."},{"key":"S0950268826102039_r3","unstructured":"[3] Public Health England. (2021) Guidance for the detection of gonorrhoea in England. https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/972388\/Guidance_for_the_detection_of_gonorrhoea_in_England_2021.pdf (accessed 15 September 2025)."},{"key":"S0950268826102039_r11","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.39.9.3092-3098.2001"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268826102039","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T07:23:48Z","timestamp":1791962628000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268826102039\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":26,"alternative-id":["S0950268826102039"],"URL":"https:\/\/doi.org\/10.1017\/s0950268826102039","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"assertion":[{"value":"\u00a9 Crown Copyright - UKHSA, 2026. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e123"}}