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How to Swab for Gonorrhea and Chlamydia

Posted on Nov 22, 2016 10:53:47 AM


According to a new CDC report, the number of people infected with gonorrhea, chlamydia, and syphilis is at an all-time high. 

The rise of reported syphilis infections is particularly troubling as 23,872 cases were reported in 2015 for a 19 percent increase. Gonorrhea (395,216 cases) saw an increase of 13 percent, while chlamydia (1.5 million cases) increased by 6 percent.

These numbers are disturbing on their own; what's worse is the fact we're seeing a reverse of the recent downward trends in rates. The gonorrhea rate, for example, hit a historic low in 2009 with only 98 cases per 100,000 people. Just six years later that rate increased by 26 percent to nearly 124 cases per 100,000 people.

Now more than ever it's critical that clinics observe proper specimen collection and transport when testing for STDs.

Though syphilis is confirmed via blood test, both gonorrhea and chlamydia tests can be conducted with swab samples of the genitals, throat, or anus. That's why we've put together this basic primer on how to take various swab samples used to test for gonorrhea and chlamydia. 

*Please note: When collecting samples, it is recommended to wear appropriate personal protective equipment (gloves, surgical mask, eye protection). 

How to Collect an Endocervical Sample

A woman's endocervix, the area around the opening of the uterus, is the preferred site for specimens from females. It's recommended that specimen collection should be done with a sterile swab and not a cytobrush, as the harsher brushes may cause trauma and bleeding that can corrupt the specimen.

Two swabs are commonly used; one to clean the cervix to remove excess mucus, another to collect the sample. For gonorrhea testing, Puritan's Opti-Tranz, amies gel w/chacrcoal #ACH-62PR, is an ideal choice.

  1. Peel open the sterile pouch
  2. Remove plug from sterile tube and discard
  3. Remove swab applicator and collect specimen by rotating the swab against the wall of endocervical canal several times.
  4. Rotate the swab against the wall of the endocervical canal several times for 20-30 seconds
  5. Withdraw the swab without touching the vaginal surface
  6. Insert swab into the transport tube
  7. Record patient information in space provided on the label
  8. Transport specimen to laboratory to be processed

How to Collect a Urethral Sample 

The urethra is a tube that drains urine from the bladder. This is the preferred culture site in men, or in women with no cervix. Specimens should be taken no earlier than two hours after the patient has last voided his or her bladder. 
  1. Gently insert the swab into the urethra (1-2 cm for women, 2-4 cm for men)
  2. Rotate the swab in one direction for a minimum of 10 seconds
  3. Withdraw the swab
  4. Break the swab handle at scored breakpoint line
  5. Label the vial with appropriate patient information
  6. Seal the transport tube, allowing the specimen to be exposed to the appropriate transport media

How to Collect a Throat Swab

Chlamydia can be spread to the throat during oral sex, despite most frequently infecting the cervix, urethra or rectum. Pharyngeal swabbing is the preferred method of specimen collection, which involves swabbing the area behind the nasal cavities, mouth, and larynx. 

  1. Use a sterile flocked swab that comes with a transport medium filled vial, such as Uni-Tranz-RT Universal Transport Medium, #UT-306
  2. Have the patient tilt their head backwards, open their mouth, and stick out their tongue
  3. Without touching the side of the mouth, swab the posterior nasopharynx and the tonsillar arches
  4. Remove swab and insert into a vial containing 1-3 ml of transport media
  5. Break the swab handle at scored breakpoint line
  6. Label the vial with appropriate patient information

Download Throat Culture Guide

How to Collect a Rectal Swab

Gonorrhea and chlamydia often occur simultaneously because the risk factors are very similar. Patients who are suspected of having one of these sexually transmitted bacterial infections are usually tested for the other as well.

  1. Insert a sterile swab approximately 2.5 cm into the anal canal
  2. Move swab from side to side in the anal canal
  3. Allow swab to remain 10-30 seconds for absorption of organisms onto the swab
  4. Remove swab and insert into a vial containing 1-3 ml of viral transport media
  5. Label the vial with appropriate patient information

We hope this guide for specimen collection of gonorrhea and chlamydia is helpful in such dire times. For additional questions about which products to order for these or other procedures, feel free to contact our helpful product specialists today.

Topics: Diagnostic

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