Intensive Care Medicine (ICM) Practice Exam

Which test is the most sensitive for detecting both chlamydia and gonorrhea?

1. Routine genital culture

2. Species-specific urine culture

3. Nucleic acid amplification tests

4. Physical examination

The correct answer is: Nucleic acid amplification tests

The most sensitive test for detecting both chlamydia and gonorrhea is nucleic acid amplification tests (NAATs). These tests work by amplifying the genetic material of the pathogens, which allows for the detection of even minute quantities of the bacteria responsible for these infections. NAATs are highly sensitive because they can identify the DNA or RNA of chlamydia trachomatis and neisseria gonorrhoeae directly from urine or genital samples. This high sensitivity means that NAATs are far more effective in diagnosing these sexually transmitted infections than conventional methods like cultures, which can miss infections in certain circumstances. In particular, NAATs can be performed on urine samples, making them easier to use in various clinical settings while still providing accurate results. Other testing options, while useful in certain contexts, do not provide the same level of sensitivity as NAATs. For example, routine genital culture may not always pick up infections that are present, particularly during the early stages or in asymptomatic individuals. Similarly, species-specific urine culture might not be as broadly applicable for both chlamydia and gonorrhea. Physical examination, while important for clinical evaluation, is not sufficient to confirm the presence of these infections. Thus, NAATs represent