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Procedures for STD Testing & Reporting

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For further details on recommendations for screening for STDs in MSM and women see guideline sections in “Screening for STDs in MSM” and “Screening for STDs in women.” The STD clinician, Sylvan Lowens, or the primary provider can perform the appropriate screening.

STD Reporting Procedures: click Here

Gonorrhea:

Pharyngeal: bacterial culture swab (blue top swab); send for r/o GC; indicate source

Rectal: bacterial culture swab; send for r/o GC; indicate source

Male urethral: 5-10 cc of first void urine can be sent for gonorrhea and chlamydia nucleic acid amplification test (NAT). If urethral discharge present, can perform a gram stain in clinic to detect intracellular gram negative cocci in pairs. Can also use Gen-probe urethral/cervical swab (located in the top side drawer on the exam table) for NAT for gonorrhea and chlamydia

Female cervical: if doing a pelvic examination it is best to send the Gen-probe urethral/cervical swab (located on the top side drawer of the exam table) which will test for both gonorrhea and chlamydia by NAT. If not doing a pelvic exam, send 5-10cc of first void urine for gonorrhea and chlamydia NAT.

Chlamydia:

Rectal: use white swab labeled “polyester fiber-tipped applicators” found in “STD kit” in front drawer of exam table and place swab in red top viral/Chlamydia media

Male urethral: 5-10 cc of first void urine can be sent for gonorrhea and Chlamydia NAT; can use Gen-probe urethral swab (located in top side drawer on exam table) for NAT for gonorrhea and Chlamydia.

Female cervical: if doing a pelvic examination best to send the gen-probe urethral/cervical swab (located in top side drawer on exam table) which will test for both gonorrhea and chlamydia by NAT; if not doing a pelvic exam, send 5-10 cc of first void urine for gonorrhea and chlamydia NAT.

HSV1+HSV2:

Unroof lesion and use Dacron swab located in side drawer of exam table; get viral transport media frozen in freezer in lab (a short tube with black top); thaw media and place swab in media.

Syphilis:

A stat RPR (draw in purple or red top tube) should be considered on any patient for whom you have a suspicion of syphilis, especially since the standard RPR can take up to 2 weeks to return. Rapid RPR can be performed through the STD clinic, 744-3590. Darkfield microscopy should be considered on any genital lesion suspicious for chancre of primary syphilis when the RPR may be negative (20%). STD Clinic recommends that the patient be sent directly for such testing instead of transporting the sample as the yield of treponemes may decrease en route.

Haemophilus ducreyi (chancroid):

This disease is very rare in the United States. To diagnose chancroid one can do a culture in chocolate agar or PCR technology may be available. If a concern arises, would recommend a call to the STD Clinic at 744-3590 for further information.

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