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.