What’s the best test to diagnose chlamydia?

Highlights from MMWR:

  • NAAT testing is the gold standard. Who even gets cultures anymore? And serologies are useless.
  • Vaginal swabs are preferred for women; cervical swabs have equal sensitivity. Urine tests may be up to 10% less sensitive but are also specific.
  • For heterosexual men, there are no specific recommendations, but you might as well get it as part of STI screening. First-catch urine samples are superior to clean-catch.
  • For certain populations, such as those who have anal intercourse, a rectal swab is appropriate. An oropharyngeal swab may be appropriate, too, especially in prepubescent girls or children who have been sexually assaulted; also in those with suspected treatment-resistant gonorrhea because of the rates of co-infection.

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