{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T01:47:28Z","timestamp":1793756848040,"version":"4.6.1"},"reference-count":14,"publisher":"American Society for Microbiology","issue":"7","license":[{"start":{"date-parts":[[2017,7,1]],"date-time":"2017-07-01T00:00:00Z","timestamp":1498867200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100000060","name":"HHS | NIH | National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["U19AI113212"],"award-info":[{"award-number":["U19AI113212"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Urethral swabs are the samples of choice for point-of-care Gram stain testing to diagnose\n            <jats:named-content content-type=\"genus-species\">Neisseria gonorrhoeae<\/jats:named-content>\n            infection and nongonococcal urethritis (NGU) in men. As an alternative to urethral swabs, meatal swabs have been recommended for the collection of urethral discharge to diagnose\n            <jats:named-content content-type=\"genus-species\">N. gonorrhoeae<\/jats:named-content>\n            and\n            <jats:named-content content-type=\"genus-species\">Chlamydia trachomatis<\/jats:named-content>\n            infection in certain populations by nucleic acid amplification testing (NAAT), as they involve a less invasive collection method. However, as meatal swabs could be sampling a reduced surface area and result in fewer collected epithelial cells compared to urethral swabs, the adequacy of meatal swab specimens to collect sufficient cellular material for Gram stain testing remains unknown. We enrolled 66 men who underwent either urethral or meatal swabbing and compared the cellular content and Gram stain failure rate. We measured the difference in swab cellular content using the Cepheid Xpert CT\/NG sample adequacy control crossing threshold (SAC\n            <jats:sub>CT<\/jats:sub>\n            ) and determined the failure rate of Gram stain smears (GSS) due to insufficient cellular material. In the absence of discharge, meatal smears were associated with a significant reduction in cellular content (\n            <jats:italic>P<\/jats:italic>\n            = 0.0118), which corresponded with a GSS failure rate significantly higher than that for urethral swabs (45% versus 3%, respectively;\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.0001). When discharge was present, there was no difference among results from urethral and meatal swabs. Therefore, if GSS testing is being considered for point-of-care diagnosis of\n            <jats:named-content content-type=\"genus-species\">N. gonorrhoeae<\/jats:named-content>\n            infection or NGU in men, meatal swabs should be avoided in the absence of a visible discharge.\n          <\/jats:p>","DOI":"10.1128\/jcm.00423-17","type":"journal-article","created":{"date-parts":[[2017,5,11]],"date-time":"2017-05-11T14:11:31Z","timestamp":1494511891000},"page":"2249-2254","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":9,"title":["Meatal Swabs Contain Less Cellular Material and Are Associated with a Decrease in Gram Stain Smear Quality Compared to Urethral Swabs in Men"],"prefix":"10.1128","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4063-2566","authenticated-orcid":false,"given":"Stephen J.","family":"Jordan","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane R.","family":"Schwebke","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristal J.","family":"Aaron","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3064-8564","authenticated-orcid":false,"given":"Barbara","family":"Van Der Pol","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Edward W.","family":"Hook","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","unstructured":"Centers for Disease Control and Prevention. 2015. Sexually transmitted disease surveillance 2014. Atlanta: U.S. Department of Health and Human Services."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-1043-4"},{"issue":"02","key":"e_1_3_2_4_2","first-page":"1","article-title":"Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae\u20142014","volume":"63","author":"Centers for Disease Control and prevention","year":"2014","unstructured":"Centers for Disease Control and prevention. 2014. Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae\u20142014. MMWR Recomm Rep63(RR-02):1\u201319.","journal-title":"MMWR Recomm Rep"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/sti.77.3.224"},{"issue":"03","key":"e_1_3_2_6_2","first-page":"1","article-title":"Sexually transmitted diseases treatment guidelines, 2015","volume":"64","author":"Workowski KA","year":"2015","unstructured":"Workowski KA Bolan GA ; Centers for Disease Control and Prevention. 2015. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep64(RR-03):1\u2013137.","journal-title":"MMWR Recomm Rep"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2016.07.018"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2012-050686"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000539"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.15406\/jmen.2014.01.00026"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2010.042861"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1363\/3522003"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.157.6.523"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-4-21"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3181e3d771"}],"container-title":["Journal of Clinical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/JCM.00423-17","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/JCM.00423-17","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,5]],"date-time":"2022-03-05T10:01:57Z","timestamp":1646474517000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/JCM.00423-17"}},"subtitle":[],"editor":[{"given":"Erik","family":"Munson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2017,7]]},"references-count":14,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2017,7]]}},"alternative-id":["10.1128\/JCM.00423-17"],"URL":"https:\/\/doi.org\/10.1128\/jcm.00423-17","relation":{},"ISSN":["0095-1137","1098-660X"],"issn-type":[{"value":"0095-1137","type":"print"},{"value":"1098-660X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7]]},"assertion":[{"value":"2017-03-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-05-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-06-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}