Background/introduction:
Pharyngeal testing for CT/GC is generally not recommended for heterosexual men whose only sexual exposure is cunnilingus. However, some clinicians in this service also started sending self-taken swabs from heterosexual men when self-taken swabs became routine practice for MSM in 2014. 

Aim(s)/objectives:
To measure the utility of pharyngeal CT/GC swabs in heterosexual men

Methods:
A retrospective case-note review of all heterosexual men who had been coded as having had a pharyngeal swab for CT/GC NAAT between July 2014 and August 2015.

Results:
1374 eligible patients were identified. 25/1374(1.8%) of these were GC NAAT +ve of which 4/25 (16%) were +ve in the pharynx, the others being +ve in the urine. 3/4 pharyngeal +ve specimens were GC NAAT +ve in the pharynx only, 1 was positive in the urine also. 110/1374 (8%) patients were CT NAAT +ve of which 1/110 (0.9%) was in the pharynx only, the rest being from urine specimens 

Discussion/conclusion:
Out of 1374 pharyngeal swabs sent, only 5 (0.4%) were CT or GC +ve, of which 1 was also +ve in the urine. The 3 lone +ve pharyngeal GC NAAT specimens could be false-positive e.g. due to a cross-reaction with non-pathogenic Neisseria sp. Similarly the single CT+ve may be a false +ve assay.  Alternatively, some of those patients with a +ve test may be MSM who had not revealed their status.  Whatever the explanation, the very low pick-up rate does not justify taking pharyngeal CT/GC swabs in men who identify as being exclusively heterosexual.

Are pharyngeal swabs for CT/GC of value in heterosexual men?. A retrospective review of a clinic cohort.