{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T16:52:00Z","timestamp":1765039920410},"reference-count":24,"publisher":"American Society for Microbiology","issue":"11","license":[{"start":{"date-parts":[[2002,11,1]],"date-time":"2002-11-01T00:00:00Z","timestamp":1036108800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2002,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            The COBAS AMPLICOR CT\/NG test is widely used for the diagnosis of\n            <jats:italic>Neisseria gonorrhoeae<\/jats:italic>\n            infection using genital swabs or urine samples. Although highly specific, cross-reactivity occurs with some nonpathogenic strains of\n            <jats:italic>Neisseria<\/jats:italic>\n            and\n            <jats:italic>Lactobacillus<\/jats:italic>\n            species. In low-prevalence populations, even highly specific assays may require confirmatory testing of positive results. We assessed the positive predictive value (PPV) of this test in a low-prevalence (0.5%) setting. Genital and urine specimens testing positive using the COBAS AMPLICOR NG test were retested using an investigational 16S rRNA PCR assay. Additionally, 737 specimens were tested in parallel by both culture and the above PCR protocol. Of 9,772 specimens tested in-house, 168 were positive by the AMPLICOR test; in addition, 62 AMPLICOR-positive specimens were referred to our laboratory for confirmatory testing, yielding 230 positive specimens. Of these, 72 were confirmed positive by 16S rRNA PCR, yielding a specificity of 98.7% and a PPV of 31.3%. Specificity was similar for all specimen types, whereas PPV varied with prevalence: specimens from males, females, urine specimens, and genital swabs had PPVs of 70.8, 13.3, 51.9, and 20.1%, respectively. The PPV was higher when the initial AMPLICOR optical density (OD) was \u22653.5 versus initial and repeat OD readings in an equivocal zone of \u22650.2 to &lt;3.5 (65.1 versus 10.1%;\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001). On repeat testing of specimens with ODs in the equivocal zone, 54 gave ODs of \u22650.2 and &lt;2.0, 35 gave ODs of \u22652.0 and &lt;3.5, and 12 gave ODs of \u22653.5, with 3.7, 20, and 33.3% confirmed positive, respectively (\n            <jats:italic>P<\/jats:italic>\n            = 0.004). Comparing PCR to culture as the \u201cgold standard,\u201d specificity increased from 96.8 to 99.9% when 16S rRNA PCR was performed on specimens positive by the COBAS AMPLICOR NG test. Confirmatory testing with a more specific method such as 16S rRNA PCR should be considered in low-prevalence populations, especially for specimens with an OD in the equivocal zone.\n          <\/jats:p>","DOI":"10.1128\/jcm.40.11.4056-4059.2002","type":"journal-article","created":{"date-parts":[[2002,10,30]],"date-time":"2002-10-30T20:42:12Z","timestamp":1036010532000},"page":"4056-4059","update-policy":"http:\/\/dx.doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":40,"title":["Confirmation by 16S rRNA PCR of the COBAS AMPLICOR CT\/NG Test for Diagnosis of\n            <i>Neisseria gonorrhoeae<\/i>\n            Infection in a Low-Prevalence Population"],"prefix":"10.1128","volume":"40","author":[{"given":"David J.","family":"Diemert","sequence":"first","affiliation":[{"name":"Department of Microbiology, Montreal General Hospital, McGill University Health Centre, Montreal, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael D.","family":"Libman","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Montreal General Hospital, McGill University Health Centre, Montreal, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Lebel","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Montreal General Hospital, McGill University Health Centre, Montreal, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.35.10.2556-2560.1997"},{"key":"e_1_3_1_3_2","unstructured":"Centers for Disease Control and Prevention. 2000. Tracking the hidden epidemics. Trends in STDs in the United States p. 2. CDC Atlanta Ga."},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.33.12.3111-3114.1995"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.35.6.1536-1540.1997"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.37.2.386-390.1999"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.35.10.2628-2633.1997"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.36.2.375-381.1998"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(99)00101-8"},{"key":"e_1_3_1_10_2","unstructured":"Hook E. W. III and H. H. Handsfield. 1990. Gonococcal infections in the adult p. 149-165. In K. K. Holmes et al. (ed.) Sexually transmitted diseases. 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