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3 site testing for STI

  • 1.  3 site testing for STI

    Posted 09-21-2020 11:52
    One more thing to blame on COVID.  Just what we all want to hear right?

    We are experiencing a shortage of the swabs used for 3 site testing (NAAT)  Our local labs have rationed them due to national supply shortage.

    We're continuing to do the 3 site testing, but with a twist, and I'm wondering if any other sites:
    1. have this supply issue
    2. have any literature or experience in alternate 3 site testing strategies
    3. other solutions.

    Here is what we've adapted to, using non NAAT testing swabs. 
    We do a urine (dirty catch).
    Have the patient swab there throat and put it in the urine cup (with urine)
    Have the patient swab their rectum and put in the urine cup (with urine)
    Mix the swabs in the urine, pipete the urine off and send.

    I know the treatment is the same regardless of site, so not concerned about that issue.  Just wondering if anyone has come across any literature on this?


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    John Phoenix
    Las Vegas NV
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  • 2.  RE: 3 site testing for STI

    Posted 09-23-2020 13:17
    See CDC.gov/std.  They have recommendations on the website

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    Michael Robinson
    Greenville NC
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  • 3.  RE: 3 site testing for STI

    Posted 09-25-2020 00:59
    We don't have issues in PHX and use the APTIMA swabs. Consider using the same Swab and do a throat and rectal
    With the same stick then only send that one stick for both sites? The issue with urine is that it notoriously is less accurate than the swabs, and diluting the swabs into the urine might not catch smaller samples amounts of the bacteria.

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    Randy Gelow
    Phoenix AZ
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  • 4.  RE: 3 site testing for STI

    Posted 12-13-2020 20:11

    I know this is an old post, but that's what we do,
    and boy does it work like a charm. Stir up the batch and send it off. 


    Amber



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    Amber Siegel MSN APRN AGNP-C
    Orlando, Florida
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  • 5.  RE: 3 site testing for STI

    Posted 02-27-2021 16:34
    This was something I adapted to doing prior to the shortage in regards to oral and urine. I work in a FQHC, I'm always trying to find ways to utilize my supplies cost effectively. The problem is now...no swabs for rectal G/C screenings. But looks like I'm going with your ideas for capturing the rectal sites until we get "back to normal".

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    Vickie Cobb-Lucien, APRN, FNP-BC, AACRN, AAHIVS
    Orlando, FL
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  • 6.  RE: 3 site testing for STI

    Posted 04-07-2021 13:14
    As Dr Gelow also from Phoenix mentioned, we are currently using the Aptima swabs and do not have a shortage. We also have patients self collect. (There are helpful posters from the following site:
    https://aidsetc.org/resource/test-yourself-visual-guide-self-collected-swab

    The only issue is that the new CDC guidelines recommend repeat testing for pharyngeal gonorrhea due to lower rates of clearance. So pooling the sources would interfer ewith this.

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    Ann Khalsa
    Maricopa Integrated Health System
    Phoenix AZ
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