Techniques for specimen collection with testing females for STIs

A Cervical screening test is taken first if due or indicated.

Method

1. A cotton tipped swab is inserted into the cervical canal only 0.5 cm and
   1. smeared on a slide and air dried for gram stain
   2. placed in a transport medium for gonorrhoea culture
2. a second cotton tipped swab is inserted 0.5 to 1 cm into the cervical canal and kept in place for 10 to 15 seconds and rotated 1 to 2 times for chlamydia NAAT and gonorrhoea NAAT and mycoplasma genitalium NAAT testing
3. place in a transport container provided by the lab.

From the lateral vaginal wall with a cotton tipped swab:

• smeared on a slide and air dried for gram stain for bacterial vaginosis and candida
• placed in a transport medium for gonorrhoea culture and candida culture.

From the posterior fornix with a cotton tipped swab for:

• pH performed on a pH strip at the time
• wet preparation for trichomonas
  • smear on to a slide and place a drop of normal saline on slide - must be read immediately
    • trichomas vaginalis NAAT if indicated.

Sample for chlamydia and gonorrhoea NAAT in asymptomatic female using cotton tipped swab and transported in a container provided by the lab.

These are taken if clinically indicated.

Proctoscopy should be performed to inspect for lumps, ulcers, pus, bleeding and specimen collection.

Swabs are taken for:

• gonorrhoea culture (plate or transport medium)
• chlamydia NAAT and gonorrhoea NAAT (dry or moistened cotton tipped swab)
• herpes simplex NAAT if indicated.

These are taken routinely in sex workers and samples are collected.

Swabs are taken from each tonsillar fossa for:

• gonorrhoea culture if suspected or NAAT positive
• chlamydia and gonorrhoea NAAT for screening.

• Dry or moist cotton tipped swabs taken from the ulcer base can be tested for herpes simplex virus (HSV) NAAT
• swabs are transported in an empty transport container or in viral culture medium
• syphilis NAAT using cotton tipped dry swab if indicated.

Can be performed if no endocervical swabs are available and samples:

• should not pass urine for at least 2 hours before the sample collection
• first 10 ml of urine is collected
• voiding within 30 minutes prior to sample collection should be considered in interpreting results
• tests for chlamydia NAAT, gonorrhoea NAAT, mycolplasma genitalium NAAT and trichomonas vagnilais NAAT as indicated.