The Laboratory's Role in Evaluating Sexually Transmitted Diseases as a Result of Sexual Abuse

The microbiology laboratory is involved in the evaluation of patients for presumed sexual abuse when children are examined for the presence of a sexually transmitted disease (STD). Cultures for Chlamydia trachomatis and Neisseria gonorrhoeae are currently used as the forensic standard when sexual abuse is suspected. Culture methods for both of these agents are insensitive in this patient population and may require invasive sampling for adequate specimen collection. Until recently, the utility of nucleic acid amplification tests in the evaluation of children who might have been sexually abused has not been adequately evaluated. The sensitivity of these assays also allows them to be performed with non-invasive sample types, such as urine and vaginal specimens. This article reviews the performance of molecular assays for the diagnosis of common sexually transmitted infections associated with child abuse.