Authors
Ashley McEwan, Jay Lucidarme, Thomas Whitfield, Rachel Buttery, Peter Tilston, Nicholas Machin, Malcolm Guiver
Published in
Epidemiology and infection. Volume 154. Pages e123. Oct 14, 2026. Epub Oct 14, 2026.
Abstract
Sensitive and high-throughput testing for Neisseria gonorrhoeae (NG) is widely underpinned by automated commercial solutions using nucleic acid amplification tests. We outline our experience of using Roche Cobas 8800 CT/NG (Cobas NG) for primary testing of NG at scale. Over 360000 specimens were tested over a three-year period. A disproportionate number of 'indeterminate' oropharyngeal swabs (25%) tested positive by Cobas NG but failed to confirm by Xpert CT/NG, significantly higher than genital samples (4%) (chi-square p-value <0.05). Such samples are highly problematic, as they fail to provide a definitive result for the patient. To investigate this non-specificity, publicly available sequences for Cobas NG DR-9 targets were aligned with Neisseria genome databases. We found a strain of Neisseria lactamica (PubMLST 49718), isolated from a throat swab, which was predicted to cross-react with Cobas NG. We subsequently confirmed a Cobas NG false-positive result with this isolate. BLAST analysis showed the target gene NG DR-9 was rare among available non-NG Neisseria whole genome sequences. This may suggest the existence of an as-yet unknown and difficult to cultivate oral commensal that contains NG DR-9. Our findings further highlight the need for NG confirmatory testing of oropharyngeal samples screened with Cobas NG.
PMID:
42870587
Bibliographic data and abstract were imported from PubMed on 14 Oct 2026.
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