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Epic Code LAB1230885 Chlamydia/Gonococcus PCR

Important Note

  • Corewell Health Reference Laboratory's Chlamydia and Gonococcus testing is not validated for performance on pediatric patients under the age of 14 years old.  Testing for these patients must be collected in either an APTIMA Multi-Test Swab collection kit or the APTIMA Urine collection kit and will be sent out to a reference laboratory.  Please order a Reference Miscellaneous Test (#LAB848) and indicate complete test name when pediatric testing is necessary.
  • Chlamydia and Gonococcus testing cannot be added onto a previous completed Pap Test Order. 

Test Name Alias

Chlamydia | Gonococcus | CT | GC | NG

 

Interface Order Alias

1230885

Clinical Information

Chlamydia trachomatis (CT) is the major cause of genital chlamydial infections in men and women.

 

CT can cause nongonococcal urethritis, epididymitis, proctitis, cervicitis, acute salpingitis, and Pelvic Inflammatory Disease (PID).  CT infections are often asymptomatic in both males and females.  Children born to infected mothers are at significantly higher risk for inclusion conjunctivitis and chlamydial pneumonia.

 

N. gonorrhoeae is the causative agent of gonococcal (GC) infections, the majority of which are uncomplicated lower genital tract infections and may be asymptomatic.  However, if left untreated in women, infections can ascend and cause PID which can manifest as endometriosis, salpingitis, pelvic peritonitis, and tubo-ovarian abscesses.  A smaller percentage of persons with gonococcal infections may develop disseminated Gonococcal Infection.

 

A negative test result does not preclude the presence of a CT or GC infection because results are dependent on adequate specimen collection, absence of inhibitors, and sufficient rRNA to be detected.  

 

If a specimen has small numbers of CT and GC cellular material, uneven distribution may occur which may affect the ability to detect small numbers of organisms in the collected material.  A cellular control is included in the assay to ensure an adequate sample has been obtained. If negative results from the specimen do not fit with the clinical impression, a new specimen may be necessary.

 

Results for CT and/or GC will be reported as Positive, Negative (presumed negative for CT and/or GC) or Equivocal.  For specimens giving an Equivocal (indeterminate) result, a new specimen should be collected.

Panel Information

Chlamydia & Gonococcus

Icons & Photos

CHMG: Workday Order ITM-1190747

Non-SH: Supply form "STD Multi-Collection Kit"

OR ThinPrep Pap Container (Order via supply form)

Collection Instructions

Specimen Collection: Swab or Urine

Container(s): Alinity m Multi-Collect tube

 

Specimen Type: Female Genital Swab Alinity m Multi-Collect tube

 

  1. Specimens should be obtained with a swab using a speculum moistened with sterile warm water to facilitate collection.
  2. Lubricants other than water should not be used since they can be toxic to the organism.
  3. Discard disposable transfer pipette; it is not required for endocervical swab specimen collection
  4. Remove the sterile swab from the wrapper, taking care not to touch swab tip or lay it down on any surface
  5. Insert the white tip of the specimen collection swab into the endocervix canal.
  6. Gently rotate the swab for 15 – 30 seconds to ensure adequate sampling
  7. Withdraw the swab, carefully
  8. Handle the cap and tube carefully to avoid contamination, including the outside of the transport tube and cap. If necessary, change gloves.
  9. Unscrew the transport tube cap and immediately place the specimen collection swab into the transport tube so that the white tip is down.
  10. Carefully break the swab at the scored line on the shaft; use care to avoid splashing the contents
  11. Recap the transport tube. Ensure the cap seals tightly.
  12. Label the transport tube with sample ID, including date and time of collection.
  13. Transport to lab within 24 hours at room temperature or 14 days refrigerated.

 

Specimen Type: Male Genital Swab Alinity m Multi-Collect tube

 

  1. The patient must be instructed not to urinate at least 1 hour prior to sampling.
  2. Insert swab 2-4 cm into Urethra.
  3. Rotate swab for 3-5 seconds and withdraw swab.
  4. Insert swab into the Abbott multi-collect transport media. Snap off shaft of swab at the score line.
  5. Leave swab in tube. Cap tube and label specimen.
  6. Transport specimen within 24 hours at room temperature or 14 days refrigerated.

 

Specimen Type: Urine (First void)

 

Container(s): Sterile urine cup (with lid) or Alinity m multicollect sample kit

Preferred Volume to Collect: 30.0 mL
Minimum Volume to Collect: 10 mL if sterile cup is transported to lab; to fill line of Alinity m multicollect tube if transferred in office.

Aliquot: Yes - Transfer urine to Alinity m multicollect tube in office is preferred.

Collection Instructions:

  1. First void ("dirty") urine is included in this collection, this is collected before a UA specimen, if both are needed.
  2. Do not cleanse the genital area prior to specimen collection.
  3. Patient should not have urinated for at least one hour prior to sample collection.
  4. Follow directions above to obtain a first void urine specimen.
  5. Discard specimen collection swab, it is not required for urine specimen collection.
  6. Unscrew the transport tube cap, taking care not to spill the transport buffer within.
  7. Handle the cap and tube carefully to avoid contamination.
  8. Use the plastic transfer pipette to transfer urine from the collection cup into the transport tube until the liquid level in the tube falls within the clear fill window of the transport tube label or else a new specimen should be collected.
  9. Do not overfill. Slightly more than one full squeeze of the transfer pipette bulb may be required to transfer the necessary volume of urine specimen.
  10. Recap the transport tube carefully. Ensure the cap seals tightly.
  11. Label the transport tube with sample identification information, including date of collection. Take care not to obscure the fill window on the transport tube.

 

Transport Temperature:  Ambient (room temperature) or Refrigerated

 

NOTE:  Failure to collect a urine specimen, including the first part of the voiding, may decrease the sensitivity of this test. If the specimen cannot be delivered to the laboratory within a few hours after collection it should be stored and refrigerated until it can be delivered. Specimen must be received in laboratory for analysis within 24 hours of collection.
 

 

 

Specimen Type: Patient Self-Collect Swab

Self-collected vaginal swabs may be used as opposed to provider-collected swabs. Self-collected swabs are supported by current clinical guidelines as recent studies have shown their equivalence, if not superiority, in quality and their association with increased patient satisfaction.

NOTE: Self-collection must still take place in a healthcare setting and is not approved for at-home collection.

LINK: Self-Swab for Testing

LINK: References

 

 

Specimen Type: Oropharyngeal Swab 

 

1. Discard disposable transfer pipette; it is not required for oropharyngeal swab collection.

2. Remove the sterile swab from the wrapper, taking care not to touch swab tip or lay it down on any surface. 

3. The white tip of the swab should be rubbed against each tonsillar pillar and the posterior wall and rotated at least one time. Do NOT collect specimens from the tongue.

4. If pharyngeal exudate is present, this should also be sampled.

5. Withdraw the swab carefully. 

6. Handle the cap and tube carefully to avoid contamination, including the outside of the transport tube and cap. If necessary, change gloves.

7. Unscrew the transport tube cap and immediately place the specimen collection swab into the transport tube so that the white tip is down.

8. Carefully break the swab at the scored line on the shaft; use care to avoid splashing of contents.

9. Recap the transport tube carefully. Ensure the cap seals tightly or leakage may occur.

10. Label the transport tube with sample identification information, including date of collection using an adhesive label.

 

 

Specimen Type: Rectal Swab

 

1. Discard disposable transfer pipette; it is not required for oropharyngeal swab collection.

2. Remove the sterile swab from the wrapper, taking care not to touch swab tip or lay it down on any surface. 

3. The white tip of the swab should be inserted 1-2.5 cm into the anal canal and rotated at least one time. 

4. Withdraw the swab carefully. 

5. Handle the cap and tube carefully to avoid contamination, including the outside of the transport tube and cap. If necessary, change gloves. 

6. Unscrew the transport tube cap and immediately place the specimen collection swab into the transport tube so that the white tip is down. 

7. Carefully break the swab at the scored line on the shaft; use care to avoid splashing of contents. 

8. Recap the transport tube carefully. Ensure the cap seals tightly or leakage may occur.

9. Specimens discolored by stool or blood are acceptable.

10. Label the transport tube with sample identification information, including date of collection using an adhesive label.

 

Specimen Type: Cervical Cytology Specimens

Specimen Type: Cervical cytology specimen

Container/Tube: ThinPrep Vial

Collection Instructions: Brush or Broom

Brush collection:

  1. Obtain an adequate sampling from the ectocervix using a plastic spatula. If desired, use lukewarm water to warm and lubricate the speculum. Water-soluble gel lubricant sparingly applied to the posterior blade of the speculum can be used if necessary. Select contoured end of plastic spatula and rotate it 360 degrees around the entire exocervix while maintaining tight contact with exocervical surface.
  2. Rinse the spatula as quickly as possible into the PreservCyt solution in the ThinPrep vial by swirling the spatula vigorously in the vial 10 times. Discard the spatula.
  3. Obtain as adequate sampling from the endocervix using an endocervical brush device. Insert the brush into the cervix until only the bottom-most fibers are exposed. Slowly rotate 1/4 or 1/2 turn in one direction. Do not over-rotate.
  4. Rinse the brush as quickly as possible into the PreservCyt solution in the ThinPrep vial by rotating the device in the solution 10 times while pushing against the PreservCyt vial wall. Swirl the brush vigorously to further release material. Discard the brush
  5. Tighten the cap so that the torque line on the cap passes the torque line on the vial
  6. Record the patient’s name and date of birth on the vial.

Broom collection:

  1. Obtain an adequate sampling from the cervix by inserting the central bristles of the broom into the endocervical canal deep enough to allow the shorter bristles to fully contact the ectocervix.  Push gently, and rotate the broom in a clockwise direction five times.
  2. Rinse the broom in the PreservCyt solution in the ThinPrep vial by pushing the broom into the bottom of the vial 10 times, forcing the bristles apart.
  3. As a final step, swirl the broom vigorously to further release the material.
  4. Discard the collection device.
  5. Tighten the cap on the ThinPrep vial so that the torque line on the cap passes the torque line on the vial.
  6. Record the patient’s name and date of birth on the vial.

Rejection Criteria

  • Leaky specimen
  • QNS
  • Urines in sterile cup not received into lab within 24 hours.
  • Add on request after pap test has been preformed.

Specimen Stability

For swabs:

  • Ambient: 14 days 2oC -30oC in Alinity m multi-collect  specimen container
  • Refrigerate: 14 days 2oC – 30oC in Alinity m multi-collect specimen container
  • Laboratory Retention: 7 days

 

For Urine:
If the urine is put directly in the Alinity m collection tube, the following applies:

  • Ambient: 14 days 2oC – 30oC in Alinity m multi-collect  specimen container
  • Refrigerate: 14 days 2oC – 30oC  in Alinity m multi-collect  specimen container
  • Laboratory Retention: 7 days

If only a urine cup is received

  • Refrigerate: 24 hours
  • Laboratory Retention: 24 hours

Test Frequency

Available Monday through Friday.

Usual TAT 2-5 days

Reference Range

Negative

Performing Department

Molecular Diagnostics

Performing Department Laboratory Location

Corewell Health Advanced Technology Laboratory (ATL), Grand Rapids, MI

Methodology

Polymerase chain reaction (PCR)

CPT

87591, 87491

CDM Code

3068759102, 3068749101

Epic Test ID

1230102553

LOINC

CHLAMYDIA MDI RESULT: N/A

CHLAMYDIA PCR GENITAL: 4993-2

GONOCOCCUS MDI RESULT: N/A

GONOCOCCUS PCR GENITAL: 24111-7

 

CHLAMYDIA MDI RESULT: N/A

CHLAMYDIA PCR URINE: 4993-2

GONOCOCCUS MDI RESULT: N/A

GONOCOCCUS PCR URINE: 24111-7

Mayo Access Code

Current unavailable

Reviewed Date

6/22/2023

Updated Date

8/26/2024 - Added Thin Prep Collection Instructions

10/17/2024 - Important note. Rejection criteria.