Introduction: The Cepheid GeneXpert® provides near-patient molecular detection of CT/NG, with results available in 90 minutes. Previous studies have illustrated the benefits to asymptomatic individuals and their partners in reducing time to detection and treatment of CT/NG.

Methods: A case-control study was undertaken to investigate the impact of introducing GeneXpert to a Level 3 symptomatic service. 100 patients diagnosed with CT and/or NG before and after introduction of the GeneXpert were identified. Time from attendance to treatment was measured. Using self-report in the previous three months and assuming that rate of new sexual partners remained the same and spaced equally in time, we modelled the number of partners spared exposure due to earlier treatment of CT/NG.  

Results: Characteristics of the study populations, and of the time to treatment and partners spared analyses are shown below:

Pre-implementation of GeneXpert (n=100)/Post-implementation of GeneXpert (n=100)
Male (%) 40/61
Age (median [range]) 28.1 [15-69]/30.6 [14-70]
MSM/WSW (%) 33/0 / 37/1
Symptomatic (%) 50/28
Time to treatment (days (mean) [SD]) 9.5 [13.23]/3.3 [4.94]
Sexual partners in preceding 3 months (mean [SD]) 2 [1.71]/4.0 [10.48]
Partners exposed in interval between test and treatment (total) 19.9/9.12

The time from testing to treatment was reduced by 6.2 days. The number of partners spared exposed/100 index patients was 19.9 pre-GeneXpert vs. 9.12 post-GeneXpert.

Discussion: Use of the Cepheid GeneXpert reduced time to treatment by 66%, and 54% fewer partners were exposed to CT/NG. This study supports the personal and public health benefits of innovative, near-patient molecular diagnostics coupled with effective recall mechanisms

Cutting the time to treatment of <i>Chlamydia trachomatis</i> (CT) and <i>Neisseria gonorrhoeae</i> (NG) with near-patient molecular diagnostics: the utility of the Cepheid GeneXpert system

The Joint Annual Conference of the British Association for Sexual Health and HIV & the Society for the Study of Sexually Transmitted Diseases in Ireland

Cutting the time to treatment of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) with near-patient molecular diagnostics: the utility of the Cepheid GeneXpert system