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Chlamydia/Gonorrhea, Urine

The Chlamydia/Gonorrhea Urine Test uses nucleic acid amplification to detect C. trachomatis and N. gonorrhoeae in first-catch urine, providing a non-invasive method for screening and diagnosis. It is ordered for routine screening in at-risk populations, investigation of urethritis or cervicitis, and partner notification, with results guiding antimicrobial therapy and public-health interventions.

2

Biomarkers

Urine (random)

Sample

3–5 business days

Turnaround

No

Fasting

What is the CT/NG Urine test?

The Chlamydia/Gonorrhea Urine Test employs nucleic acid amplification to detect Chlamydia trachomatis and Neisseria gonorrhoeae in a non-invasive urine specimen. Urine NAAT has become a cornerstone of sexually transmitted infection screening and diagnosis because it avoids the need for a pelvic examination or urethral swab, improving both patient acceptability and programme reach. Practitioners order this dual assay to screen asymptomatic sexually active individuals at risk, to investigate symptoms of urethritis or cervicitis, and to fulfil public-health screening recommendations in adolescents and young adults. Because both infections are frequently asymptomatic and co-infection is common, testing for chlamydia and gonorrhoea together maximises yield and ensures that treatment covers both pathogens when either is detected.

What does the CT/NG Urine test measure?

1
CT RNA(Chlamydia trachomatis nucleic acid)
Range: Not DetectedOptimal: Not DetectedQualitative (Detected/Not Detected)

Chlamydia trachomatis is an obligate intracellular bacterium that infects columnar epithelial cells of the genital tract, rectum, and oropharynx. The organism replicates within host cells, forming characteristic inclusions, and is shed in urine and genital secretions. Detection of its nucleic acid by nucleic acid amplification testing (NAAT) is the diagnostic standard, offering superior sensitivity to culture or antigen methods.

C. trachomatis is the most frequently reported bacterial sexually transmitted infection in many countries. Infection is often asymptomatic, particularly in women, yet untreated disease can ascend to cause pelvic inflammatory disease, tubal infertility, ectopic pregnancy, and chronic pelvic pain. In men, urethritis and epididymitis are the principal sequelae. NAAT-based detection enables diagnosis in both symptomatic and screening contexts, guiding treatment and partner notification to interrupt transmission.

2
NG RNA(Neisseria gonorrhoeae nucleic acid)
Range: Not DetectedOptimal: Not DetectedQualitative (Detected/Not Detected)

Neisseria gonorrhoeae is a Gram-negative diplococcus that infects mucosal surfaces lined by columnar epithelium, principally the urethra, endocervix, rectum, pharynx, and conjunctiva. The organism attaches to epithelial cells via pili and other surface proteins, provoking an acute inflammatory response. Nucleic acid amplification from urine captures urethral shedding in men and, with somewhat lower sensitivity, cervical shedding in women.

Gonorrhoea remains a major public-health concern, with rising incidence and the global spread of antimicrobial resistance. Untreated infection causes urethritis, cervicitis, and pelvic inflammatory disease, and disseminated gonococcal infection can produce septic arthritis and skin lesions. Co-infection with C. trachomatis is common, so dual testing is standard. Timely NAAT diagnosis permits targeted therapy, resistance-guided treatment adjustments, and partner management.

Why is the CT/NG Urine test ordered?

  • Annual screening of sexually active women aged under 25 years, as recommended by national and international guidelines
  • Screening of men who have sex with men and other individuals at elevated risk, including those with new or multiple partners
  • Investigation of urethritis, dysuria, or urethral discharge in men, and of cervicitis, vaginal discharge, or pelvic pain in women
  • Pre-conception and antenatal screening to prevent vertical transmission and neonatal complications
  • Partner notification and testing following a confirmed case of chlamydia or gonorrhoea
  • Opportunistic screening in emergency departments, sexual health clinics, or primary care when risk factors are identified
  • Post-exposure evaluation in cases of sexual assault or high-risk contact
  • Test-of-cure three weeks after treatment in cases of persistent symptoms, pregnancy, or suspected antimicrobial resistance

Sample collection and turnaround

Sample type

Urine (random)

Fasting required

No

Collection method

At-home collection kit

Turnaround

3–5 business days

Collection notes

First-catch urine (the initial 10–30 mL of the void) should be collected into the sterile container provided. Patients should not have voided for at least one hour before collection to maximise urethral cell yield. The specimen is stabilised with the transport medium included in the kit and returned by prepaid courier to Access Medical Laboratories. Detailed written instructions accompany the kit.

Specimen requirements

Minimum 10 mL first-catch urine in the collection device supplied. The specimen must be transferred into the stabilisation tube and mixed by inversion. Stabilised urine is stable at ambient temperature for the transport period specified by the laboratory; do not refrigerate or freeze before dispatch.

What can affect CT/NG Urine results?

reducesTiming of specimen collection after void

First-catch urine (the initial 10–30 mL of the stream) contains the highest concentration of urethral cells and pathogen nucleic acid; mid-stream or dilute urine reduces sensitivity.

reducesRecent antimicrobial therapy

Antibiotics with activity against chlamydia or gonorrhoea can clear the organism or reduce bacterial load, yielding false-negative results if the specimen is collected too soon after treatment.

variableMenstruation and vaginal contamination

Blood or vaginal discharge can contain PCR inhibitors or dilute the specimen, though modern assays are robust; collection during menses is not contraindicated but may occasionally affect result interpretation.

variableInadequate specimen volume or handling

Insufficient urine, prolonged delay before stabilisation, or exposure to extreme temperatures can degrade nucleic acid or inhibit amplification, leading to invalid or false-negative results.

elevatesCross-reactivity with non-pathogenic Neisseria species

Older or poorly validated assays could cross-react with commensal Neisseria in the pharynx or genital tract; contemporary NAATs use species-specific targets to minimise this risk.

What do CT/NG Urine results mean?

Elevated

Detection of C. trachomatis or N. gonorrhoeae nucleic acid indicates active infection requiring antimicrobial treatment, partner notification, and counselling on safe sexual practices. Co-detection of both pathogens is common and mandates dual therapy. Clinicians should consult current local or national treatment guidelines, which increasingly recommend culture and susceptibility testing for gonorrhoea owing to antimicrobial resistance.

Normal

'Not Detected' for both pathogens indicates no evidence of chlamydia or gonorrhoea in the specimen at the time of collection. A negative result does not exclude infection at other anatomical sites (pharynx, rectum) if exposure history or symptoms suggest extragenital involvement, nor does it exclude other sexually transmitted infections.

Reduced

Not applicable for a qualitative nucleic acid test.

Note: Urine NAAT performs best in men; sensitivity in women is slightly lower than that of endocervical or vaginal swabs, so a vaginal swab (clinician- or self-collected) may be preferred when available. Test-of-cure is not routinely recommended after uncomplicated chlamydia treatment but should be performed for gonorrhoea if symptoms persist, in pregnancy, or when resistance is suspected. Repeat screening three months after treatment is advised because of the high risk of reinfection.

Frequently asked questions

Co-infection is common, both are frequently asymptomatic, and testing together ensures that treatment covers both pathogens when either is detected, improving outcomes and reducing onward transmission.

How to access the CT/NG Urine test

The CT/NG Urine reference page is free and open to all practitioners. Create a free practitioner account to see pricing, save tests to your list, and generate requisition forms. Verification takes 1–2 business days.

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About this page

Published: October 7, 2026

Last reviewed: October 7, 2026

References:
  1. Workowski KA, et al. Sexually transmitted infections treatment guidelines, 2021. Centers for Disease Control and Prevention MMWR Recomm Rep. (2021)
  2. European guideline on the diagnosis and treatment of gonorrhoea in adults. International Union against Sexually Transmitted Infections (IUSTI). (2020)
  3. UK National Guideline on the Management of Chlamydia trachomatis Genital Tract Infection. British Association for Sexual Health and HIV (BASHH). (2018)
  4. Canadian Guidelines on Sexually Transmitted Infections. Public Health Agency of Canada. (2022)
  5. Papp JR, et al. Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae. MMWR Recomm Rep. (2014)

This content is for licensed healthcare practitioners only and does not constitute medical advice. Clinical decisions should be based on the full clinical picture and not on any single test result.