A previously documented Neisseria macacae isolate providing a false-positive result with Roche cobas 4800 CT/NG does not cross-react with the later generation cobas 6800 CT/NG assay

Many diagnostic nucleic acid tests (NAATs) for Neisseria gonorrhoeae (NG), particularly earlier generation tests, have been beset with specificity problems associated with cross-reaction with commensal Neisseria species. The problem has been most pronounced when testing oropharyngeal swabs, where commensal Neisseria species are ubiquitous [1,2,3,4,5,6,7]. NAATs are used widely and recommended for screening for NG urogenital infection, and more recently for oropharyngeal and anorectal swabs, particularly in high-risk patients [8, 9]. However, until recently, many diagnostic nucleic acid tests (NAATs) for NG were not validated nor marketed for testing extragenital sites, including oropharyngeal swabs because of the risk of false-positive results. To help facilitate testing in these sites, supplementary testing (whereby samples testing positive in a screening NAAT are confirmed by a second NAAT) has been advocated in many jurisdictions. This conservative strategy has been in routine use in Australia since 2005 and in New Zealand since 2012 [1, 4].