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Date of last update: 10/12/2017.

Forum Name: Sexually Transmitted Diseases

Question: chlamydia and gonorrhea

 momof9 - Fri Jul 09, 2010 9:55 am

How is it possible to be tested for chlamydia and gonorrhea and the duel test came back postive but the seprate test came back negative which one am I suppose to believe.

I had recently had intercorse with my husbend and we were doing differnt sexual postions as well as anal. A day later I started to get an irritation, I know I am allergic to certin perfume lotion and creams but I used a water base cream for in hasments purpose. Is it possible that I caught a bactrial infection and not an STD. Is it also possible that the bactrial infection caused a false postive.

Marriage in crisies please answer soon
 Dr.M.Aroon kamath - Wed Jul 21, 2010 6:41 am

User avatar Hi,
It would have been more helpful if you had give a little more information about which particular methods were used, which type of specimen was used and which site was sampled in your instance for testing. Another crucial information that is not forthcoming is whether your husband has been tested and what the results were.

However,i would urge you to first visit the following link
before continuing to read the compiled information that follows, addressing the various tests available in this regard, their advantages and disadvantages.

A variety of laboratory tests are now available for the diagnosis of Chlamydial infections including isolation in cell culture, direct florescent antibody (DFA) assays, enzyme immunoassays (EIA), nucleic acid probe (NAP), and nucleic acid amplification tests (NAAT) such as polymerase chain reaction (PCR) etc.

NAATs can be used with either urine or swab specimens for men and women.
- The real advantage is that this test can detect C. trachomatis or N. gonorrhoeae in a single specimen.
- A disadvantage of some NAATs (specifically the PCR platforms), is that specimens can contain "amplification inhibitors" that can cause false negative results.
- NAATs need a high level of technical laboratory expertise to perform the test.
- The sensitivity of NAATs can vary by specimen type with particularly low sensitivities for PCR using urine samples from women.(to the extent, that some experts recommend that non culture test results should be confirmed due to chances of potential false positive results, particularly among asymptomatic individuals).

Nucleic acid hybridization (nucleic acid probe) tests are also available. Both of the U.S. Food and Drug Administration (FDA) approved tests, PACEĀ® 2 and the Hybrid Capture IIĀ®, can detect C. trachomatis or N. gonorrhoeae in a single specimen.
- These tests also require a high level of technical laboratory expertise to perform the test, and
- also [color=#FF0000]exhibit lower sensitivities compared to NAATs.

It is obvious from the foregoing account that even the best available tests have a false positive or false negative rates. Clinicians are perhaps as concerned as yourself about the interpretation of these results and treating their clients.

Currently, CDC recommends empiric treatment against chlamydia in persons diagnosed with gonorrhea, but not vice versa.

Ultimately, for a clinician, the decision to empirically treat even in the setting of a negative lab result depends upon (among other considerations),
- the population involved(high risk/low risk),
- The probability of a given individual having the infection,
- the probability of a person not returning for re-testing (if deemed necessary), or
- partner testing positive.

It is very unlikely that one may test positive due to another bacterial infection.
Even if one of the tests is truly negative, if your doctor feels that you should better be empirically treated, i would urge you to follow his/her advice.
Best wishes!

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