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Pharyngeal gonococcal infection and the sensitivity of oral gargle samples in comparison to self-collected throat swabs for the detection of N. gonorrhoeae in persons in Tyrol, Austria

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Abstract

Purpose

Asymptomatic pharyngeal gonorrhoea could play an important role in transmission and should be screened for in persons at risk. We investigated the sensitivity of oral gargle samples to detect N. gonorrhoea and describe the frequency of infection by anatomical site.

Methods

From June 2021 to July 2022 persons diagnosed with gonorrhoea in the STI/HIV department were asked to provide self-collected specimens for single-site testing by NAAT from throat (by gargling and swabbing), anorectum, and first-void urine.

Results

104 episodes of gonorrhoea were analysed in 88 individuals. The median age was 33 years, 85 persons (96.5%) were male. The pharynx was the most common site of infection (71 cases, 68.2%); in 26 persons (25.0%) it was the only site of infection. Anorectal infection was detected in 65 cases (62.5%) and urogenital infection in 25 cases (24.0%). In 46 cases (44.2%) infection was detected in more than one anatomical site. Gargling was less sensitive than throat swabbing to detect pharyngeal infection (85.9% versus 97.2%, p = .038), but was preferred by patients. Only 4 of 71 pharyngeal infections (5.6%) were symptomatic; anorectal and urogenital infections were symptomatic in 12.3% and 76.0% of cases, respectively. Culture recovery of N.gonorrhoeae was only possible in 15.8% of throat swabs, but was successful in 61.9% of anorectal and 84.2% of urogenital samples.

Conclusions

Asymptomatic pharyngeal gonorrhoea is common. Gargle samples should be used only as alternative specimens with inferior sensitivity compared to throat swab samples.

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Funding

No funding was received for conducting this study.

Author information

Authors and Affiliations

  1. Klinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria

    Maria Kitchen, Martin Gisinger, Eva Meindl, Marina Wanner & Mario Sarcletti

  2. Institut für Virologie, Medizinische Universität Innsbruck, Austria, Innsbruck

    Wegene Tamire Borena

  3. Institut für Hygiene und Medizinische Mikrobiologie, Medizinische Universität Innsbruck, Innsbruck, Austria

    Miriam Alisa Govrins

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  1. Maria Kitchen
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  2. Wegene Tamire Borena
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  4. Eva Meindl
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  5. Marina Wanner
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  6. Miriam Alisa Govrins
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  7. Mario Sarcletti
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Contributions

Study concept: MK, MS. Clinical data acquisition: MK, MG, MW, EM. Molecular diagnostics: WTB. Cultures: MAG. Manuscript preparation: MK,MS. All authors have read and approved the definitive version of the manuscript.

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Correspondence to Maria Kitchen.

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Kitchen, M., Borena, W.T., Gisinger, M. et al. Pharyngeal gonococcal infection and the sensitivity of oral gargle samples in comparison to self-collected throat swabs for the detection of N. gonorrhoeae in persons in Tyrol, Austria. Infection (2024). https://doi.org/10.1007/s15010-024-02359-x

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