Health topic

Chlamydia trachomatis and Neisseria gonorrhoeae

Taking action to prevent silent transmission


The hidden costs of infection

Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are among the most common sexually transmitted infections (STIs), with new cases in adults totaling 127 million and 87 million, respectively.1

These infections are caused by two different bacterial pathogens which initially invade host tissue in the urethra, anus, or throat strictly through sexual contact. Once inside the urethra the bacteria invade or attach to host tissue and cause an inflammatory response often proceeded by a purulent discharge, which can be seen by the patient. These bacteria then have the potential to spread upwards through the urogenital tract of males and females. This may lead to complications in women affecting the urethra, cervix, fallopian tubes, and uterus, or the prostate in men which may cause infertility for both sexes. Along with urogenital symptoms, patients may experience discomfort, bleeding, or discharge from the anus and sores, redness, or lesions in the mouth. However, the majority of patients do not experience any symptoms at all.2

The total direct medical cost for chlamydia in the US is estimated to be $691 million per year, while the total direct medical cost for gonorrhoea in the US is estimated at $271 million per year.3

On top of these monetary costs, the asymptomatic nature of CT/NG adds to the complexity of treatment and infection control, as carriers may transmit the bacteria unknowingly. Approximately 85% of women and 40% of men with chlamydia are asymptomatic,1,4 while 30–80% of women and 5% of men with genital gonorrhoea are asymptomatic.1,5


Unique and complex challenges

If left untreated, CT/NG infections can cause severe complications in both men and women. Possible sequelae include pelvic inflammatory disease, adverse pregnancy outcomes, and infertility.6 Antimicrobial resistance further complicates our efforts to reduce the impact of STIs globally, particularly in people infected with NG.6

Neisseria gonorrhoeae has shown decreased susceptibility to “last line” treatment options, including oral and injectable cephalosporins. Together with known resistances to penicillins, sulphonamides, tetracyclines, quinolones, and macrolides, NG is considered a multidrug-resistant organism.7

Clinical microbiology labs play a major role in solidifying infection control. Effective screening of both asymptomatic and symptomatic populations using diagnostic tools can help to contain the silent disease transmission of CT/NG, reduce prevalence, and further improve the understanding of these infections.


Paving the way for improved CT/NG testing

In 1993, Roche introduced its first ever FDA-cleared polymerase chain reaction (PCR) test—a molecular test for CT. Three years later, Roche introduced a CT/NG test with internal controls.

With every generation, Roche has continued to improve CT/NG testing. Through advances in automation and accuracy, Roche instruments and assays make it easier to deliver faster, more reliable, and more accurate answers.





In 2018 CT Infections increased 5.0% overall as compared to 2017

The CDC has recommended annual screening for chlamydia among all women under the age of 25, for men who have sex with men and for men in high prevalence settings, such as correctional facilities.8 However, screening for CT and NG remains under-utilized with less than 60% of the recommended population getting testing.9

Vaginal and urine specimens for men are considered the optimal specimen types for CT and NG testing. These specimen types provide the patient with the opportunity to participate in their health care and reduce the requirement of a doctor or clinician for collection.

CT infections



  1. Update source - WHO Report on global sexually transmitted infection surveillance 2018. Accessed February 4, 2021
  2. CD Sexually Transmitted Disease Surveillanc 2018. Accessed 02-04-21
  3. Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention. Accessed February 4, 2021
  4. Stamm WE, Holmes KK. Chlamydia trachomatis infections in the adult. In: Holmes KK, Mardh PA, Sparling PF, et al., eds. Sexually transmitted diseases. 2nd ed. New York, NY: McGraw-Hill; 1980:181-193.
  5. Judson FN. Gonorrhoea. Med Clin North Am. 1990; 1353-1367.
  6. World Health Organization. Sexually transmitted infections (STIs). Accessed 10-25-2018.
  7. World Health Organization, Department of Reproductive Health and Research. Global action plan to control the spread and impact of antimicrobial resistance in Neisseria gonorrhoeae. Published 2012. Accessed 10-25-2018.
  8. Sexually Transmitted Diseases Treatment Guidelines, MMWR, Recommendations and Reports / Vol. 64 / No. 3 June 5, 2015 
  9. The State of Health Care Quality 2016, HEDIS Measure of Care 
  10. Sexually Transmitted Disease Surveillance 2017, Division of STD Prevention, September 2018, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of STD Prevention, Atlanta, Georgia, 30329–4027
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