K Number
K080739

Validate with FDA (Live)

Date Cleared
2008-07-10

(115 days)

Product Code
Regulation Number
866.3120
Reference & Predicate Devices
Predicate For
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP AuthorizedThirdpartyExpeditedreview
Intended Use

The Abbott RealTime CT/NG assay is an in vitro polymerase chain reaction (PCR) assay for the direct, qualitative detection of the plasmid DNA of Chlamydia trachomatis and the genomic DNA of Neisseria gonorrhoeae. The assay may be used to test the following specimens from symptomatic individuals: clinician-collected vaginal swab and male urethral swab specimens; patient-collected vaginal swab specimens; and female and male urine specimens. The assay may be used to test the following specimens from asymptomatic individuals: male and female urine.

The Abbott multi-Collect Specimen Collection Kit is intended for the collection and transportation of malc and female swab and urine specimens for the detection of Chlamydia trachomatis and Neisseria gonorrheae per instructions provided.

Self-collected vaginal swab specimens are an option for screening women when a pelvic exam is not otherwise indicated. The Abbott multi-Collect Specimen Collection Kit is not intended for home use.

Device Description

Abbott RealTime CT/NG consists of two reagent kits:

  • . Abbott RealTime CT/NG Amplification Reagent Kit (List No. 8L07-90)
  • Abbott RealTime CT/NG Control Kit (List No. 8L07-80) .

The Abbott RealTime CT/NG assay uses PCR technology with homogenous real-time fluorescence detection on the m2000 System. The Abbott m2000 System consists of the Abbott m2000sp and Abbott m2000rt instruments. The Abbott m2000 System integrates sample preparation with nucleic acid amplification and detection to generate assay rcsults. The Abbott m2000sp is used for processing samples and the Abbott m2000rt is used for amplification and detection.

The Abbott multi-Collect Specimen Collection Kit can be used to collect either a swab or a urine specimen. Each Abbott multi -Collect Specimen Collection Kit (List No. 9K12) contains:

  • One Transport Tube containing 1.2 mL Specimen Transport Buffer .
  • . One Individually Packaged Sterile Specimen Collection Swab (Part No. CD650)
  • . One disposable transfer pipette.

The Specimen Transport Buffer consists of guanidine thiocyanate, a chaotropic salt, in Tris buffer and is used to stabilize DNA until sample preparation. The individually packaged sterile Specimen Collection Swab is used for swab sample collection and placed directly into the Transport Tube. The transfer pipette is used to add approximately 3 mL of urine to the Transport Tube. The Abbott multi -Collect Specimen Collection Kit is for single use only.

AI/ML Overview

Here's an analysis of the acceptance criteria and supporting studies for the Abbott RealTime CT/NG assay and Abbott multi-Collect Specimen Collection Kit, based on the provided text:

1. Table of Acceptance Criteria and Reported Device Performance

The acceptance criteria for this device are implied by the reported clinical performance. The goal is to achieve high sensitivity and specificity compared to reference methods. The specific acceptance thresholds are not explicitly stated as numerical targets for sensitivity and specificity in the provided text, but the reported performance values are presented as demonstrating effective detection.

Test TypeOrganismSpecimen TypeAcceptance Criteria (Implied)Reported Device Performance (Sensitivity (95% C.I.))Reported Device Performance (Specificity (95% C.I.))
Clinical PerformanceChlamydia trachomatisClinician-Collected Vaginal Swab (Symptomatic)High Sensitivity & Specificity92.5 (84.4, 97.2)98.8 (97.6, 99.5)
Self-Collected Vaginal Swab (Symptomatic)High Sensitivity & Specificity94.7 (86.9, 98.5)99.0 (97.9, 99.6)
Female Urine (Symptomatic)High Sensitivity & Specificity92.6 (84.6, 97.2)99.5 (98.7, 99.9)
Female Urine (Asymptomatic)High Sensitivity & Specificity95.7 (85.2, 99.5)99.2 (98.2, 99.7)
Male Urethral Swab (Symptomatic)High Sensitivity & Specificity93.3 (88.6, 96.5)98.3 (97.0, 99.1)
Male Urine (Symptomatic)High Sensitivity & Specificity97.3 (93.7, 99.1)99.7 (98.9, 100.0)
Male Urine (Asymptomatic)High Sensitivity & Specificity97.8 (92.3, 99.7)99.6 (98.7, 100.0)
Neisseria gonorrhoeaeClinician-Collected Vaginal Swab (Symptomatic)High Sensitivity & Specificity96.8 (83.3, 99.9)99.9 (99.2, 100.0)
Self-Collected Vaginal Swab (Symptomatic)High Sensitivity & Specificity96.7 (82.8, 99.9)99.7 (98.9, 100.0)
Female Urine (Symptomatic)High Sensitivity & Specificity93.8 (79.2, 99.2)99.7 (99.0, 100.0)
Female Urine (Asymptomatic)High Sensitivity & Specificity87.0 (66.4, 97.2)99.6 (98.7, 99.9)
Male Urethral Swab (Symptomatic)High Sensitivity & Specificity99.2 (97.0, 99.9)99.3 (98.3, 99.8)
Male Urine (Symptomatic)High Sensitivity & Specificity98.8 (96.4, 99.7)99.5 (98.5, 99.9)
Male Urine (Asymptomatic)High Sensitivity & Specificity100.0 (71.5, 100.0)100.0 (99.4, 100.0)
Analytical SensitivityChlamydia trachomatisN/ALOD of 320 copies/assay (95% probability)39 copies/assay (95% CI 33-51), confirmed at 320 copies/assay (100% detection)N/A
Neisseria gonorrhoeaeN/ALOD of 320 copies/assay (95% probability)192 copies/assay (95% CI 176-220), confirmed at 320 copies/assay (100% detection)N/A

2. Sample Size Used for the Test Set and Data Provenance

  • Sample Size for Test Set: A total of 3,832 male and female subjects were enrolled in the multi-center clinical study.
  • Data Provenance: The data was collected prospectively from subjects at 16 geographically diverse sites in the United States. The sites included physician private practices, public and private STD clinics, and a hospital emergency room.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of Those Experts

The document does not specify the number of experts or their qualifications for establishing the ground truth. It states that the ground truth was "determined based on the combined results from the reference assays." While these reference assays are commercially available NAATs and culture, the interpretation or consensus process by human experts is not described.

4. Adjudication Method (for the test set)

The adjudication method used to establish the "patient infected status" (ground truth) was a consensus-based approach using multiple reference assays:

  • For females: A subject was categorized as infected for CT or NG if a minimum of two positive results (at least one from each reference NAAT) were reported.
  • For males: A subject was categorized as infected for CT or NG if a minimum of two positive results were reported.
  • For NG specifically (both sexes): If the reference NG culture assay result was positive, the subject was categorized as infected regardless of NAAT results.
  • Not infected status:
    • Female: At least one of the reference NAATs reported negative results for all sample types.
    • Male: A total of at least two negative results were reported by the reference NAATs.
  • Subjects with missing and/or indeterminate results from reference assays were excluded (33 for CT, 35 for NG).

This represents a form of consensus ground truth, leaning towards a "2 out of X positive" rule for infection status, with culture having overriding power for NG.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance

No, a multi-reader multi-case (MRMC) comparative effectiveness study was not done. This device is an in vitro diagnostic (IVD) assay designed for direct, qualitative detection using PCR technology, not an AI-assisted diagnostic tool that would involve human readers interpreting AI output. Therefore, there is no discussion of human reader improvement with or without AI assistance.

6. If a Standalone (i.e. algorithm only without human-in-the-loop performance) was done

Yes, the clinical performance data presented (sensitivity and specificity tables) represents the standalone performance of the Abbott RealTime CT/NG assay (algorithm/device only). The assay itself performs the detection and reporting of qualitative results without a human interpretation loop of the assay's direct output.

7. The type of ground truth used (expert consensus, pathology, outcomes data, etc.)

The ground truth used was expert consensus based on multiple reference assays, specifically a combination of:

  • Two commercially available nucleic acid amplification tests (NAATs) for CT and NG.
  • Culture for NG.

8. The Sample Size for the Training Set

The document does not explicitly state a "training set" size for the clinical studies. For IVD assays like this, the development process typically involves internal analytical verification and validation, possibly using characterized samples or spiked samples, but these are generally not referred to as a "training set" in the same way as machine learning models. The reported clinical study of 3,832 subjects serves as the test set for performance evaluation.

9. How the Ground Truth for the Training Set was Established

Since a "training set" in the machine learning sense is not explicitly described or used for this IVD assay according to the provided text, the method for establishing its ground truth for training is not applicable. The device's "training," if interpreted as its development and optimization, would have involved extensive analytical studies (e.g., analytical sensitivity, specificity, interference) using well-characterized samples, which are distinct from the clinical performance evaluation.

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K080739

2.0 510(k) Summary

JUL 1 0 2008

Abbott® RealTime CT/NG assay and an ancillary kit called the Abbott® multi-Collect™ Specimen Collection Kit

Submitted By:Company Contact:
Abbott Molecular Inc.1300 E. Touhy AvenueDes Plaines, IL 60018phone: (224) 361-7000fax: (224) 361-7438)Paula MartinSenior Manager Regulatory and Clinical Affairs(224) 361-7333(224) 361-7438e-mail: paula.martin@abbott.com
Morteza MinaeeDirector of Regulatory and Clinical Affairs(224) 361-7468(224) 361-7438e-mail: mort.minaee@abbott.com
Trade Name:Abbott® RealTime CT/NG (List No. 8L07) andAbbott® multi-Collect™ Specimen Collection Kit (List No. 9K12)
Common Name:In vitro polymerase chain reaction (PCR) assay forChlamydia trachomatis and Neisseria gonorrhoeae andMicrobiological Specimen Collection and Transport Device

Classification Name: Nucleic acid test (NAT)

Classification Code: Product Codc: LSL, MKZ Registration Number: 866.3390 (Neisseria), 866.3120 (Chlamydia) Device Class: 2 (Neisseria), 1 (Chlamydia

Substantially Equivalent Devices:

GEN-PROBE® APTIMA® Combo 2 Assay (Assigned 510(k) No. K043224);

Becton Dickenson ProbeTec™ ET Chlamydia trachomatis /Neisseria gonorrhoeae Amplified DNA Assay (Assigned 510(k) No. K012351);

Gen-Probe® APTIMA™ Unisex Swab Specimen Collection Kit for Endoccrvical and Urethral Swab Specimens (K043224);

Gen-Probe APTIMA Urine Specimen Collection Kit for Male and Female Urine (Assigned 510(k) No. 043144);

Gen-Probe APTIMA Vaginal Swab Specimen Collection Kit (Assigned 510(k) No. K032554);

BD ProbeTec ET Urine Processing Kit Assigned 510(k) No. (K052224).

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2.1 Purpose of the Submission

The purpose of this 510(k) is to gain clearance to market the Abbott RealTime CT/NG (List No. 8L07) assay and the Abbott multi-Collect Specimen Collection Kit (List No. 9K12).

2.2 Date of Preparation

March 11, 2008.

2.3 Manufacturer:

Abbott Molecular Inc. is the legal manufacturer of the Abbott RealTime CT/NG (List No. 8L07) assay and the Abbott multi-Collect Specimen Collection Kit (List No. 9K12).

Name:Patrick Groody, PhD
Title:Vice President Quality Assurance and Operations
Telephone(224) 361-7424
Fax:(224) 361-7438
Email:patrick.groody@abbott.com
Address:Abbott Molecular Inc.1300 E. Touhy AvenueDes Plaines, IL 60018

Establishment Registration No.: 3005248192

The Abbott multi-Collect Specimen Collection Kit (List No. 9K12) is manufactured and assembled at the MML Diagnostic Packaging, Inc. facility indicated below:

Name: Lynn Creitz Title: Director Manufacturing Operations Telephone: (503) 666-8398 Fax: (503) 666-8510 lynnc@mmldiag.com Email:

MML Diagnostic Packaging, Inc. 1625 NW Sundial Road PO Box 458 Troutdale, OR 97060

Establishment Registration No .: 3018348

Abbott RealTime CT/NG // multi-Collect Specimen Collection Kit March 2008 Soc 2 511Kk) Summary_mw9

Volume l Section 2 Pagc 2

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2.4 Intended Use

The proposed intended use for the Abbott RealTime CT/NG assay is:

The Abbott RealTime CT/NG assay is an in vitro polymerase chain reaction (PCR) assay for the direct, qualitative detection of the plasmid DNA of Chlamydia trachomatis and the genomic DNA of Neisseria gonorrhoeae. The assay may be used to test the following specimens from symptomatic individuals: clinician-collected vaginal swab and male urethral swab specimens; patient-collected vaginal swab specimens; and female and male urine specimens. The assay may be used to test the following specimens from asymptomatic individuals: male and female urine.

The proposed intended use for the Abbott multi-Collect Specimen Collection Kit is:

The Abbott multi-Collect Specimen Collection Kit is intended for the collection and transportation of malc and female swab and urine specimens for the detection of Chlamydia trachomatis and Neisseria gonorrheae per instructions provided.

Self-collected vaginal swab specimens are an option for screening women when a pelvic exam is not otherwise indicated. The Abbott multi-Collect Specimen Collection Kit is not intended for home use.

2.5 Device Description

Abbott RealTime CT/NG consists of two reagent kits:

  • . Abbott RealTime CT/NG Amplification Reagent Kit (List No. 8L07-90)
  • Abbott RealTime CT/NG Control Kit (List No. 8L07-80) .

The Abbott RealTime CT/NG assay uses PCR technology with homogenous real-time fluorescence detection on the m2000 System. The Abbott m2000 System consists of the Abbott m2000sp and Abbott m2000rt instruments. The Abbott m2000 System integrates sample preparation with nucleic acid amplification and detection to generate assay rcsults. The Abbott m2000sp is used for processing samples and the Abbott m2000rt is used for amplification and detection.

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The Abbott multi-Collect Specimen Collection Kit can be used to collect either a swab or a urine specimen. Each Abbott multi -Collect Specimen Collection Kit (List No. 9K12) contains:

  • One Transport Tube containing 1.2 mL Specimen Transport Buffer .
  • . One Individually Packaged Sterile Specimen Collection Swab (Part No. CD650)
  • . One disposable transfer pipette.

The Specimen Transport Buffer consists of guanidine thiocyanate, a chaotropic salt, in Tris buffer and is used to stabilize DNA until sample preparation. The individually packaged sterile Specimen Collection Swab is used for swab sample collection and placed directly into the Transport Tube. The transfer pipette is used to add approximately 3 mL of urine to the Transport Tube. The Abbott multi -Collect Specimen Collection Kit is for single use only.

2.6 Background on Chlamydial and Gonorrheal Disease

Chlamydia are non-motile, Gram-negative, obligate intracellular parasites of eukaryotic cells. They form inclusions in the cytoplasm of the host cell. Chlamydia trachomatis, one of three chlamydial species, is the causative agent of the sexually transmitted disease (STD) chlamydia. Chlamydial infections of the urogenital tract are associated with salpingitis, ectopic pregnancies and tubal factor infertility in women as well as nongonococcal urethritis and epididymitis in men. 13. The genital site most commonly affected in women is the ccrvix, but the infection can be asymptomatic and, if untreated, is likely to ascend to the uterus, fallopian tubes and ovaries causing pelvic inflammatory disease (PID).4 Neonates born of infected mothers can contract inclusion conjunctivitis. nasopharyngeal infections, and pneumonia due to Chlamydia trachomatis.5 Infection by Chlamydia trachomatis in men is also often asymptomatic and, if untreated, may lead to epididymitis, a major complication.3 Patients infected with Chlamydia trachomatis may be co-infected with Neisseria gonorrhoeae, the causative agent of gonorrhea. Further, patients with treatment indications for gonorrhea but not chlamydia often harbor Chlamydia trachomatis. Chlamydia infections may not respond well to recommended regimens for treating Neisseria gonorrhoeae. Therefore, unless chlamydial infection has

Volume I Section 2 Page 4

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been ruled out in patients treated for gonorrhea, dual therapy for gonococcal and chlamydial infections is recommended.7

Cell culture, commonly used to detect Chlamydia trachomatis, has been replaced by more sensitive nucleic acid tests.8 Since a specific diagnosis of chlamydia may improve treatment compliance and cnhance partner notification, the use of these highly sensitive and specific tests is strongly recommended.7

Gonorrhea is one of the most common sexually transmitted diseases in the United States. Over 700,000 new infections of Neisseria gonorrhoeue are estimated to occur each year." In men, gonorthea infection usually results in acute anterior urethritis accompanied by a purulent exudate. "0.1 In women, the infection is most often found in the cervix, but the vagina and uterus also may be infected. Frequently the infection is asymptomatic. especially in women. Without treatment, local complications of gonococcal infection can occur including pelvic inflammatory disease (PID) or acute salpingitis for women and epididymitis for men.1011 Rarcly, disseminated gonococcal infection, DGI, may occur in untreated patients.13

Neisseria gonorrhoeae is a Gram-negative, oxidase-positive diplococcus without flagellae.12 Culture is commonly used for the detection of Neisseria gonorrhoeae. Presumptive diagnosis of gonorrhea is based on the morphological examination, Gram stain, and oxidase measurement of the culture isolate. Confirmation proccdures have been used for definitive identification of Neisseria gonorrhoeae including sugar fermentation, fluorescent antibody staining, nucleic acid hybridization, and agglutination.'4.15 Nucleic acid tests are widely available for the sensitive detection of Neisseria gonorrhoeae.

2.7 Technological Characteristics of the Device as Compared to the Predicate

The primary functional components of the Abbott RealTime CT/NG assay are substantially equivalent to other legally marketed nucleic acid amplification tests (NAAT) intended for the qualitative detection of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG).

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The Abbott RealTime CT/NG assay has the same general intended uses as the predicate devices. Although there are some technological differences between the Abbott RealTime CT/NG and the predicate devices, these differences do not raise new types of safety or effectiveness questions.

These devices are similar in that they are designed to prepare nucleic acids for amplification, amplify specific Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) sequences, detect the amplified products, and report qualitative results.

The primary similarities and differences between the Abbott RealTime CT/NG assay and the NAAT predicate devices are shown in Table 2.1.

The primary functional components of the Abbott multi-CollectSpecimen Collection Kit are substantially equivalent to other legally marketed devices intended for the collection and transportation of clinical specimens for the direct, qualitative detection of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG).

The Abbott multi-Collect Specimen Collection Kit has the same general intended use as the predicate devices. Although there are some technological differences between the Abbott multi-Collect Specimen Collection Kit and the prodicate devices, these differences do not raise new types of safety or effectiveness questions.

These devices are similar in that they are designed to collect urogenital specimens and to stabilize the nucleic acid of the specimen during transport and storage prior to nucleic acid testing.

The primary similarities and differences between the Abbott multi-Collect Specimen Collection Kit and the predicate devices are shown in Tables 2.2 through 2.4.

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Current ApplicationAmplified Nucleic Acid Predicate Devices
FeatureAbbott RealTime CT/NGGen-Probe Aptima Combo 2Becton Dickenson ProbeTec ET
Assay TypeQualitative •Qualitative •Qualitative •
CT AnalyteTargetsCT cryptic plasmidDNA •CT ribosomal RNA •CT cryptic plasmid DNA •
NG AnalyteTargetsNG genomic DNA •NG ribosomal RNA •NG genomic DNA •
Input SampleTypesSelf-collected vaginalswab specimens •Endocervical swab specimens •Self-collected vaginal swabspecimens •Clinician-collected vaginal swabspecimens •Endocervical swab specimens •Male urethral swab specimens •Male and female urine specimens •
Clinician-collectedvaginal swabspecimens •Male urethral swabspecimens •Male and female urinespecimens •PreservCyt liquid Pap specimens •Male urethral swab specimens •Male and female urine specimens. •
SamplePreparationProcedureAutomated •Semi-automated/automated •Manual/ semi-automated •
AmplificationTechnologyReal-time PCR •TMA •SDA •
Assay ControlsNegative Control •Cutoff Control •Internal Control •Negative Control •Positive Control •Negative Control •Positive Control •

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Similarities and Differences between Abbott multi-Collect Specimen Collection Kit and the Predicate Devices (Urine Specimen Collection) ・・

Current ApplicationPredicate Devices for Urine Specimens
FeatureAbbott multi-CollectSpecimen Collection KitGen-Probe AptimaUrine Specimen Collection KitBDProbeTecUrine Processing Kit
Device DescriptionContains a transfer pipette for addingapproximately 3.0 mL of urine to theTransport Tube. The Transport Tubecontains 1.2 mL of Specimen TransportBuffer and is used to stabilize DNA untilsample preparation.Contains a disposable transferpipette for adding approximately 2mL of urine to a SpecimenTransport Tube containing2.0 mL of Transport Buffer.Contains a disposable transferpipette for adding approximately2.5 to 3.5 mL of urine to oneUrine Preservative Transport orUrine Processing Pouch.

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Current ApplicationPredicate Device for Male Urethral Swab Specimens
Table 2.3Similarities and Differences between Abbott multi-Collect Specimen Collection Kit and the Predicate Devices(Urethral Swab Specimen Collection)
Gen-Probe Aptima Unisex SwabSpecimen Collection Kit for
FeatureAbbott multi-Collect Specimen Collection KitEndocervical and Male UrethralSwab Specimens
Device DescriptionContains an individually packaged sterile SpecimenCollection Swab that is placed into the TransportTube after swab sampling. The Transport Tubecontains 1.2 mL of Specimen Transport Buffer andis used to stabilize DNA until sample preparation.Contains an individually packaged sterile EndocervicalCleaning Swab and an individually packaged sterileSpecimen Collection Swab that is placed into theTransport Tube after swab sampling. The TransportTube contains 2.9 mL of Specimen Transport Bufferand is used to stabilize DNA until sample preparation.The Gen-Probe Aptima Unisex Swab SpecimenCollection Kit can be used to collect eitherEndocervical or Male Urethral Swab specimens.

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Table 2.4 Similarities and Differences between Abbott multi-Collect Specimen Collection Kit and the Predicate Devices (Vaginal Swab Specimen Collection)

Current ApplicationPredicate Device for Vaginal Swab Specimens
FeatureAbbott multi-Collect Specimen Collection KitGen-Probe Aptima Vaginal SwabSpecimen Collection Kit
DeviceDescriptionThe Abbott multi-Collect Specimen Collection Kitcontains a transfer pipette for adding approximately 3.0mL of urine to the Transport Tube and an individuallypackaged sterile Specimen Collection Swab that is placedinto the Transport Tube after swab sampling. TheTransport Tube contains1.2 mL of Specimen Transport Buffer and is used tostabilize DNA until sample preparation. The Abbott multi-Collect Specimen Collection Kit can be used to collecteither a swab or a urine specimen.The Gen-Probe Aptima Vaginal Swab SpecimenCollection Kit contains an individually packaged sterileSpecimen Collection Swab that is placed into theTransport Tube after swab sampling. The Transport Tubecontains 2.9 mL of Specimen Transport Buffer and isused to stabilize DNA until sample preparation. The Gen-Probe Aptima Vaginal Swab Specimen Collection Kit isused to collect Vaginal Swab Specimens.

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2.8 Summary of Nonclinical Studies

Analytical Sensitivity

The analytical sensitivity of the Abbott RealTime CT/NG assay was determined by testing dilutions of Chlamydia trachomatis (CT) target DNA and Neisseria gonorrhoeae (NG) target DNA. Testing was performed with three lots of amplification reagents on three m2000 Systems. Probit analysis of the data determined that the concentration of CT DNA detected with 95% probability was 39 copies/assay (95% CI 33 - 51), and the concentration of NG DNA detected with 95% probability was 192 copies/assay (95% CI 176-220).

The limit of detection (LOD) claim for the RealTime CT/NG assay is 320 copies of CT target DNA and 320 copies of NG target DNA per assay. The limit of detection (LOD) is defined as the CT and NG DNA concentration detected with a probability of 95% or greater.

The CTNG assay targets the Chlamydia cryptic plasmid (present at approximately 7 to 10 copies per Chlumydia organism) and the multicopy opacity gene of Neisseria gonorrhoeae (repeated up to 11 times per organism). Thus, 320 copics of target DNA translates to approximately 30 to 40 organisms per assay.

The claimed LOD for the Abbott RealTime CT/NG assay was confirmed by testing a sample containing 320 copies of CT target DNA and 320 copies of NG target DNA per assay. The detection rate was 100% (403/403) for both CT and NG in the assay.

A study was conducted to challenge the performance of the Abbott RealTime CT/NG assay in samples containing high target numbers of either CT or NG in the presence of low target numbers of the opposite analyte. The detection rate of 320 copies of CT DNA in the presence of high NG target was 100% (400/400). The detection rate of 320 copies of NG DNA in the presence of high CT target was 98.5% (398/404).

The analytical sensitivity of the Abbott RealTime CT/NG assay for detecting Chlamydia trachomatis serovars A through L was determined by testing dilutions of each serovar.

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Serovars A through K, L1, and L2 were detected at less than 1 Inclusion Forming Units (IFU) per assay and scrovar L3 was detected at less than 3 IFU/assay.

The analytical sensitivity of the Abbott RealTime CT/NG assay for detecting 28 different isolates of Neisseria gonorrhoeae was determined by testing dilutions of cach isolate. All isolates were detected at less than I Colony Forming Unit (CFU)/assay.

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Evaluation of Potential Cross-Reactants

A total of 111 strains of bacteria, viruses, parasites, yeast, and fungi were tested for potential cross reactivity in the Abbott RealTime CT/NG assay (Table 2.5). These included organisms that are phylogenctically related to CT and NG, and those that can be found in the urogenital tract. Purified DNA or RNA was diluted to a final concentration of 1 x 10' copies/assay. HBV DNA and HCV RNA were added directly into the PCR reaction at approximately 3 x 105 and 9 x 106 copies per reaction, respectively. All results were negative for both CT and NG.

A total of 32 culture isolates were tested for potential cross reactivity in the Abbott RealTime assay. Thesc included 27 organisms listed in Table 7.5, and Neisseria cinerea, Neisseria lactamica, Neisseria sicca, Ca Ski cells containing HPV 16, and Hela cells containing HPV 18. Ca Ski cells containing HPV 16 and Hela cells containing HPV 18 wcre tested at 105 cells per assay, C. pneumoniae and C. psittaci were tested at 10° EB per assay. HSV-1 and HSV-2 were tested at 106 genomes per assay, and the rest of the organisms were tested at 106 Colony Forming Units (CFU) per assay. All results were negative for both CT and NG.

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Microorganism/Virus
Achromobacter xerosisHaemophilus ducreyi*Proteus vulgaris
Acinetobacter calcoaceticusHaemophilus influenzaeProvidencia stuartii
Acinetobacter lwoffiiHelicobacter pyloriPseudomonas aeruginosa*
Actinomyces israeliiHepatitis B virus (HBV)Pseudomonas putida
Aerococcus viridansHepatitis C virus (HCV)Rahnella aquatilis
Aeromonas hydrophilaHerpes Simplex Virus, type I*Rhizobium radiobacter
Alcaligenes faecalisHerpes Simplex Virus, type II*Rhodospirillum rubrum
Arcanobacterium pyogenesHuman immunodeficiency virus (HIV-1)Ruminococcus productus
Bacillus subtilisHuman Papilloma Virus 16Salmonella choleraesuis
Bacteroides fragilisHuman Papilloma Virus 18Salmonella enterica
Bacteroides ureolyticusKingella denifricansSerratia marcescens*
Bifidobacterium adolescentisKingella kingaeStaphylococcus aureus*
Bifidobacterium breveKlebsiella oxytocaStaphylococcus epidermidis*
Brevibacterium linensKlebsiella pneumoniaeStaphylococcus saprophyticus*
Campylobacter jejuniLactobacillus acidophilus*Streptococcus agalactiae*
Candida albicans*Lactobacillus brevis*Streptococcus hovis
Candida glabrataLactobacillus delbrueckii subsp. lactisStreptococcus mitis
Candida parapsilosisLactobacillus jenseniiStreptococcus mutans
Candida tropicalisLegionella pneumophilaStreptococcus pneumoniae
Chlamydia pneumoniae*Listeria monocytogenesStreptococcus pyogenes
Chlamydia psittaci*Micrococcus luteus*Streptococcus salivarius
Chromobacterium violaceumMobiluncus mulierisStreptococcus sanguinis
ChryseobacteriummeningosepticumMoraxella (Branhamella) catarrhalisStreptomyces griseinus
Citrobacter freundiiMoraxella lacunataTrichomonas vaginalis
Clostridium perfringensMoraxella osloensisUreaplasma urealyticum
Corynebacterium genitalium*Morganella morganiiVeillonella parvula
Corynebacterium xerosisMycobacterium gordonaeVibrio parahaemolyticus
Cryptococcus neoformansMycobacterium smegmatis*Weissella paramesenteroides
CytomegalovirusMycoplasma genitaliumYersinia enterocolitica

Table 2.5 Potentially Cross-Reactive Microorganisms/Viruses

  • Tested with purified DNA or RNA und with culture isolates.

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Table 2.5 (Continued)

Potentially Cross-Reactive Microorganisms/Viruses

Microorganism/VirusMicroorganism/Virus
Deinococcus radioduransMycoplasma hominis
Derxia gummosaNeisseria flava*
Eikenella corrodensNeisseria meningitidis-A*
Enterobacter cloacae*Neisseria meningitidis-B*
Enterobacter aerogenesNeisseria meningitidis-C*
Enterococcus aviumNeisseria meningitidis-D*
Enterococcus faecalis*Neisseria perflava*
Enterococcus faeciumPuntoea agglomerans
Escherichia coli*Peptostreptococcus anaerobius
Fusobacterium nucleatumPlesiomonas shigelloides
Gardnerella vaginalisPropionibacterium acnes
Gemella haemolysansProteus mirabilis*
  • Tested with purified DNA or RNA and with culture isolates.

Abbott RealTime CT/NG // multi-Collect Specimen Collection Kit March 2008
Soc 2 110(k) Summary_mw9

Volume I
Section 2
Page I S

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Evaluation of Potentially Interfering Substances

The potential for interference in the Abbott RealTime CT/NG assay was assessed with substances that may be found in swab and/or urine specimens. Substances were spiked into a swab and/or urinc matrix containing 320 copies of CT and NG target DNA per assay, and into a swab and/or urine matrix without CT or NG DNA.

No interference in the performance of the Abbott RealTime CT/NG assay was observed in the presence of the substances listed in Table 2.6.

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SubstanceMatrixHighest Concentration Tested
Zovirax® Cream 5%Swab0.25
CLOTRIMAZOLE Vaginal Cream (2%)Swab0.25%
Delfen®Swab0.25%
KY® JellySwab0.25%
Lubrin®Swab0.25%
Metrogel-Vaginal®Swab0.25%
Miconazole® 3 SuppositorySwab0.25%
Monostat-IT™ Dosc Treatment (tioconazole ointment)Swab0.25%
Norforms® Deodorant SuppositoriesSwab0.25%
Terazol-3® Vaginal CreamSwab0.25%
Vagi gard® Povidone-Iodine Medicated DoucheSwab0.25%
Vagi gard® Moisturizing GelSwab0.25%
Vagisil® Anti-itch CremeSwab0.25%
Vagisil® Intimate LubricantSwab0.25%
Yeast gard®Swab0.25%
BilirubinUrinc10 mg/mL
GlucoseUrinc10 mg/mL
pH 4 (acidic) UrineUrineN/A
pH 9 (alkaline) UrineUrineN/A
Protein: BGGUrine5%
BloodSwab and Urine5%
LeukocytesSwab and Urine1 x 10° cell/mL

Table 2.6

Substances That Do Not Interfere with the Abbott RealTime CT/NG Assay

Interference in the performance of the Abbott RealTime CT/NG assay may be observed with the following substances:

  • Talcum powder at concentrations greater than 0.1% in urine specimens. .
  • Phenazopyridine hydrochloride (the active ingredient in URISTAT) at concentrations . greater than 3 mg/mL in urine specimens.
  • Mucus at concentrations greater than 0.1% for urine specimens and 1% for swab . specimens.

{17}------------------------------------------------

2.9 Precision Study

A precision study was performed at three sites, two external and onc internal. Each site was provided with a nine-member panel that was prepared targeting different combinations of CT and NG concentrations. The targeted concentration for CT ranged from 0 to 4,500 IFU/assay and for NG from 0 to 2,000 CFU/assay. Five replicates of each panel member were tested in each run. Thirty runs (10 per site) were performed for a total of 150 replicates of each pancl member. The study included three amplification reagent lots. Each site tested two amplification reagent lots. A variance components analysis for a nested model was performed on delta cycle (DC) values, and the results are summarized in Tables 2.7 and 2.8, respectively.

{18}------------------------------------------------

PanelMemberaNo.TestedbNo.PositiveMeanDeltaCycleWithin-RunComponentSDcBetween-RunComponentSDcBetween-LotComponentSDcBetween-SiteComponentSDcTotalSDc,d
115015014.780.3000.1940.0660.1370.388
214914915.150.3850.1390.2850.0000.499
31491493.120.5910.2410.0000.0470.640
41501508.890.3850.1560.1690.1620.477
51480..................
614814816.880.1670.2070.1490.2150.373
71500..................
814910.67...............
91481031.090.6370.0000.1920.0000.665
Table 2.7
---------------------

Precision Study: CT Results

2 CT concentrations were urgeted approximately to 4500 IFU/assay in members 1, 2, and 6 and to 45 IFU/assay in e of othermanent was argeted upproximately to 0.75 IFU/assay and member 9 to 0.2 IFU/assay both below the claimed assay LOD. Members 5, 7, and 8 did not contain any CT organisms.

Invalid replicates were excluded from the unalysis.

& The SD is based on positive replicates only. For member 9, analysis of all replicates with a cycle number (n=133),

including those beyond the assay cutoff, resulted in a total SD of 0.966.

d The total variability contains within-run, between-lot, and between-site variability.

Table 2.8

PanelMemberaNo.TestedbNo.PositiveMeanDeltaCycleWithin-RunComponentSDcBetween-RunComponentSDcBetween-LotComponentSDcBetween-SiteComponentSDcTotalSDc,d
115015013.430.3820.1720.0000.1470.444
21491497.890.4300.0640.0970.1660.475
31491498.240.2700.1490.0570.0600.319
41500..................
51481487.800.2310.1980.0400.1850.358
61470..................
715015013.590.5390.1910.0000.2050.608
81490..................
9148560.580.3860.0000.0000.1200.404

Precision Study: NG Results

° NG concentrations were targeted approximately to 2000 CFU/assay in members I and 7; to 20 CFU/assay in nembers 2, 3, und 5. Member 9 was targeted to 0.1 CFU/assay, below the claimed assay LOD. Members 4, 6, and 8 did not contain any NG organisms.

b Invalid replicates were excluded from the analysis.

& The SD is based on positive replicates only. For member 9, analysis of all replicates with a cycle number (n-148), including those beyond the assay cutoff, resulted in a total SD of 0.978.
4 The total variability contains within-run, between-lot, and between-site variability.

^d The total variability contains within-run, between-run, between-lot, and between-site variability.

Abbott RcalTime CT/NG // multi-Collect Specimen Collection Kit March 2008 Sec 2 510(k) Summary_mus9

Volume I Section 2 Page 19

{19}------------------------------------------------

Summary of Clinical Studies 2.10

Performance charactcristics of the Abbott RealTime CT/NG assay were established in a multi-center clinical study conducted in the United States. Specimens were prospectively collected from subjects at 16 geographically diverse sites that included physician private practices, public and private STD clinics, and a hospital cmergency room. A total of 3,832 malc and female, asymptomatic and symptomatic subjects were enrolled. Study subjects were classified as symptomatic if the subject reported STD-related symptoms. Specimens collected from cach female subject included urine, endocervical swabs, selfcollected vaginal swab, and clinician-collected vaginal swabs. Specimens collected from each male subject included urine and urethral swabs. Specimen testing methods included the Abbott RealTime CT/NG assay, two commercially available nucleic acid amplification tests (NAAT) for CT and NG, and culture for NG. The NAATs and the NG culture were used as reference assays in the clinical study.

For females, self-collected vaginal swab and urine specimens were collected first, followed by endocervical swab for culture. Remaining swab specimen collection was randomized to minimize bias. For males, urethral swab for culture was collected first. Remaining swab specimen collection was randomized to minimize bias. Urine specimen was collected after the swab specimens.

For each subject, a patient infected status was determined based on the combined results from the reference assays. A female subject was categorized as infected for CT or NG if a minimum of two positive results (at least one from each reference NAAT) were reported. A male subject was categorized as infected for CT or NG if a minimum of two positive results were reported. If the reference NG culture assay result was positive, the subject was categorized as infected regardless of NAAT results.

A female subject was categorized as not infected with CT or NG if at least one of the reference NAATs reported negative results for all sample types. A male subject was categorized as not infected with CT or NG if a total of at least two negative results were reported by the reference NAATs.

{20}------------------------------------------------

If patient infected status could not be determined due to missing and/or indeterminate results from the reference assays, the subject was excluded from the analysis. Patient infected status could not be determincd for 33 subjects for CT and 35 subjects for NG.

Tables 2.9 through 2.28 summarize the clinical trial data.

Abbott RealTime CT/NG // multi-Collect Sqecimen Collection Kit March 2008 Sec 2 510(k) Summary .cnw9

Volume I Section 2
Pagc 21

{21}------------------------------------------------

Abbott RealTime CT/NG // multi-Collect Specimen Collection KitVo
March 2008
Soc 2 510(k) Summary_mw9
Arouning8
-
ਤੇિત્વ
Female Specimens
SpecimenSymptomsnTrue PosFalse PosTrue NegFalse NegSensitivity (95% C.I.)Specificity (95% C.I.)
Clinician-CollectedVaginal SwabSymptomatic732748644692.5 (84.4, 97.2)99.8 (97.6, 99.5)
Self-CollectedVaginal SwabSymptomatic699716618494.7 (86.9, 98.5)99.0 (97.9, 99.6)
UrineSymptomatic746753662692.6 (84.6, 97.2)99.5 (98.7, 99.9)
Asymptomatic692445641295.7 (85.2, 99.5)99.2 (98.2, 99.7)

Table 2.9 Chlamydia trachomatis Clinical Sensitivity and Specificity

Female Specimens

{22}------------------------------------------------

SpecimenSymptomsnTrue PosFalse PosTrue NegFalse NegSensitivity (95% C.I.)Specificity (95% C.I.)
UrethralSwabSymptomatic825167116351293.3 (88.6, 96.5)98.3 (97.0, 99.1)
UrineSymptomatic8391782654597.3 (93.7, 99.1)99.7 (98.9, 100.0)
Asymptomatic659892566297.8 (92.3, 99.7)99.6 (98.7, 100.0)

.

$\frac{8}{3}$

ຽງ ແຜ່ນວັລ
ປີ ແລະມວລຽ

{23}------------------------------------------------

/s

SpecimenSymptoms
Clinician-CollectedVaginal SwabSymptomatic
Self-CollectedVaginal SwabSymptomatic
UrineSymptomatic

Table 2.11 Neisseria gonorrhoeae Clinical Sensitivity and Specificity Female Specimens

SymptomsnTruePosFalsePosTrueNegFalseNegSensitivity (95% C.I.)Specificity (95% C.I.)
Symptomatic733301701196.8 (83.3, 99.9)99.9 (99.2, 100.0)
Symptomatic700292688196.7 (82.8, 99.9)99.7 (98.9, 100.0)
Symptomatic746302712293.8 (79.2, 99.2)99.7 (99.0, 100.0)
Asymptomatic693203667387.0 (66.4, 97.2)99.6 (98.7, 99.9)

{24}------------------------------------------------

SpecimenSymptomsnTrue PosFalse PosTrue NegFalse NegSensitivity (95% C.I.)Specificity (95% C.I.)
Urethral SwabSymptomatic8292344589299.2 (97.0, 99.9)99.3 (98.3, 99.8)
UrineSymptomatic8402373597398.8 (96.4, 99.7)99.5 (98.5, 99.9)
Asymptomatic6581106470100.0 (71.5, 100.0)100.0 (99.4, 100.0)

.

1 อัตรา 1 อัลบี 1 เมตร 1 เมตร 1 เมตร 2 เวลา 1

.
6

{25}------------------------------------------------

CT Clinical Sensitivity and Specificity by Clinical Testing Site
SpecimenTestingSitenTruePosFalsePosTrueNegFalseNegSensitivity (95% C.I.)Specificity (95% C.I.)
Clinician-CollectedVaginalSwab1391414342491.1 (78.8-97.5)98.8 (97.1 - 99.7)
Clinician-CollectedVaginalSwab2229222203291.7 (73.0-99.0)99.0 (96.5 -99.9)
Clinician-CollectedVaginalSwab3112112990100.0 (71.5 - 100.0)98.0 (93.0-99.8)
Clinician-CollectedVaginalSwabAll732748644692.5 (84.4-97.2)98.8 (97.6 - 99.5)
Self-CollectedVaginalSwab1373384329295.0 (83.1 - 99.4)98.8 (97.0 - 99.7)
Self-CollectedVaginalSwab2220221195291.7 (73.0-99.0)99.5 (97.2 - 100.0)
Self-CollectedVaginalSwab3106111940100.0 (71.5 - 100.0)98.9 (94.3 - 100.0)
Self-CollectedVaginalSwabAll699716618494.7 (86.9 - 98.5)99.0 (97.9-99.6)
FemaleUrine1751744669494.9 (87.4 - 98.6)99.4 (98.5 - 99.8)
FemaleUrine2388281357293.3 (77.9 - 99.2)99.7 (98.5 - 100.0)
FemaleUrine3299173277289.5 (66.9 - 98.7)98.9 (96.9 - 99.8)
FemaleUrineAll143811981303893.7 (88.0-97.2)99.4 (98.8 - 99.7)

Table 2.13 1 < ificity by Clinical Tacting Site : 43- ----

ວຽງຈາກບາງວຽງ

{26}------------------------------------------------

CT Clinical Sensitivity and Specificity by Clinical Testing Site
SpecimenTestingSitenTruePosFalsePosTrueNegFalseNegSensitivity (95% C.I.)Specificity (95% C.I.)
MaleUrethralSwab15741246440496.9 (92.2 – 99.1)98.7 (97.1 – 99.5)
211523282874.2 (55.4 – 88.1)97.6 (91.7 – 99.7)
31362031130100.0 (83.2 – 100.0)97.4 (92.6 – 99.5)
All825167116351293.3 (88.6 – 96.5)98.3 (97.0 – 99.1)
MaleUrine19361841746597.4 (93.9 – 99.1)99.9 (99.3 – 100.0)
2221403177197.6 (87.1 – 99.9)98.3 (95.2 – 99.7)
3341430297197.7 (88.0 – 99.9)100.0 (98.8 – 100.0)
All149826741220797.4 (94.8 – 99.0)99.7 (99.2 – 99.9)

Table 2.13 (Continued)

​ປະ​ທາ​ລາ​ວ​ສິ​​ສ​ລັງ​
ປະ​ທາ​ລະ​ສັກ​ສາ​ລັດ​ນາ​ລະ​ດັບ​ ​

{27}------------------------------------------------

NG Clinical Sensitivity and Specificity by Clinical Testing Site
SpecimenTesting SitenTrue PosFalse PosTrue NegFalse NegSensitivity (95% C.I.)Specificity (95% C.I.)
Clinician-CollectedVaginalSwab13911303780100.0 (75.3 - 100.0)100.0 (99.0 - 100.0)
2230131215192.9 (66.1 - 99.8)99.5 (97.4 - 100.0)
3112401080100.0 (39.8 - 100.0)100.0 (96.6 - 100.0)
All733301701196.8 (83.3 - 99.9)99.9 (99.2 - 100.0)
Self-CollectedVaginalSwab13761203640100.0 (73.5 - 100.0)100.0 (99.0 - 100.0)
2219132203192.9 (66.1 - 99.8)99.0 (96.5 - 99.9)
3105401010100.0 (39.8 - 100.0)100.0 (96.4 - 100.0)
All700292668196.7 (82.8 - 99.9)99.7 (98.9 - 100.0)
FemaleUrine1754264720486.7 (69.3 - 96.2)99.4 (98.6 - 99.8)
2388181368194.7 (74.0 - 99.9)99.7 (98.5 - 100.0)
3297602910100.0 (54.1 - 100.0)100.0 (98.7 - 100.0)
All14395051379590.9 (80.0 - 97.0)99.6 (99.2 - 99.9)

:

Table 2.14 a c ーベーストー הים חומ G ﻟﻤﺸﺎﺭﻛﺔ ﻣ CHILLE CALL

:

ວການໄປ Virgin ແລະເປວົ ແລະແມ່ລະດຽວ 22 ເວລາໄດ້ - international 2002 ປີ 2010 ປີ 10:10
ປີ 2011 ປີ 2011 ປີ 11:11 ຊອງປີ 2011 ປີ 11:10 ຊຶມ 2017 ປີ 2017 ປີ 2017 ປີ 2017 ປີ 2017 ປີ 20

l

ປີ ແລ່ນວັນ ປີ 2008 ປີ 2008 ປີ 2000 ປີ 2000 ປີ 2000 ປີ 2000 ປີ 2000 ປີ 2000 ປີ 2000 ປີ 2000 ປີ 2000 ປີ 2000 ປີ 2000 ປີ 2000 ປີ 2000 ປີ 2000 ປີ 2000 ປີ 2000 ປີ 2000 ປີ 2000 ປີ

{28}------------------------------------------------

NG Clinical Sensitivity and Specificity by Clinical Testing Site
SpecimenTestingSitenTruePosFalsePosTrueNegFalseNegSensitivity (95% C.I.)Specificity (95% C.I.)
MaleUrethralSwab15741643406199.4 (96.7 - 100.0)99.3 (97.9 - 99.8)
211633181197.1 (84.7 - 99.9)98.8 (93.4 - 100.0)
31393701020100.0 (90.5 - 100.0)100.0 (96.4 - 100.0)
All8292344589299.2 (97.0 - 99.9)99.3 (98.3 - 99.8)
MaleUrine19361733758298.9 (95.9 - 99.9)99.6 (98.9 - 99.9)
22223901830100.0 (91.0 - 100.0)100.0 (98.0 - 100.0)
3340360303197.3 (85.8 - 99.9)100.0 (98.8 - 100.0)
All149824831244398.8 (96.5 - 99.8)99.8 (99.3 - 100.0)

Table 2.14 (Continued)

{29}------------------------------------------------

NAAT 1NAAT 2RealTime CT/NGNo. of Subjects
ECCVFUEFUCCVSCVFUSymptomatic(SCV/CCV/U)Asymptomatic(Urine Only)Total
++++++++533083
++++NA+++101
++++NA+NA+202
++NA+NA++NA011
+++NA++++101
++++++NA+213
+++++NANA+101
++++++++224
++++++++224
++++++++202
++-+++++101
+++-++++112
-+++++++101
-+-+-+++011
--++++++011
++++-+++303
++++NA++-101
++-++++-112
-+-++++-101
+++-+-NA+101
-++-+--+101
+-+-+--+101
--+NA+--+011
--+-+--+358
-+--++--011

CT Analysis According to Patient Infected Status INFECTED FEMALE Subjects

E = Endocervical Swab Specimen; CCV = Clinician-Collected Vaginal Swab Specimen; FU = Female Urine Specimen; SCV = Self-Collected Vaginal Swab Specimen; U = Urine.

{30}------------------------------------------------

NAAT 1 NAAT 2 RealTime CT/NG No. of Subjects Symptomatic Asymptomatic 区 CCV FU D FU CCV SCV FU (SCV/CCV/U) (Urine Only) Total --ー ー 1. - 224 528 1052 ---u -NA ﺴ -રેરે 33 88 --ﺖ ﺳﮯ -NA --NA 2 l 3 ー NA NA 2 l 3 --ー ---2 l 3 ---NA NA --1 : --l 0 一 -NA NA ー NA NA 9 ·28 37 ー ・・ -ー --l -NA 0 l --। NA ---l l -NA -NA ー NA 0 --NA ー ----0 l l 2 ー NA 1 l ---0 2 NA ----NA 0 l l l --7 ﺖ ﺳ --— 2 9 NA -17 ------NA --30 47 7 -NA -6 । उ -ー --ー --3 2 5 ----NA NA ---NA l 2 ? --NA 2 ー -ー --NA NA ー 11 13 ---+ -l 2 3 l l --ー NA キ l 0 --+ ---5 0 5 ----+ 0 l l -NA = -------+ -NA l 0 l t --2 -----0 2 --+ --NA NA l 0 l — 3 5 -+ ー --ー -2 ---+ ---NA -0 l l + -— ---ﺖ 2 2 4 -+ 0 + ------2 2

CT Analysis According to Patient Infected Status NON-INFECTED FEMALE Subjects

E = Endocervical Swab Specimen; CCV = Clinician-Collected Vaginal Swab Specimen; FU = Female Urine Specimen; SCV = Self-Collected Vaginal Swab Specimen; U = Urine.

{31}------------------------------------------------

Table 2.16 (Continued)

CT Analysis According to Patient Infected Status NON-INFECTED FEMALE Subjects T ﻧﮯ ﻣﯿﮟ ﻣﯿﮟ ﻣ -

NAAT 1NAAT 2RealTime CT/NGNo. of Subjects
ECCVFUEFUCCVSCVFUSymptomatic(SCV/CCV/U)Asymptomatic(Urine Only)Total
-------+112
--+----+022
-+----NA+101
----NA-+-101
------+-213
-+----+-011
-+---NA+-011
----NA+--101
-----+--112
-----+NA-101
-+---+NA-101
++---+-+011
-++--+NA+101
-+---++-101
++---++-134
+++--++NA101
+++--+++011

E = Endocervical Swab Specimen; CCV = Clinician-Collected Vaginal Swab Specimen; FU = Female Urine Specimen; SCV = Self-Collected Vaginal Swab Specimen; U = Urine.

NA includes "indeterminate" results from reference assays, specimens not available, or missing results.

T

{32}------------------------------------------------

NAAT 1NAAT 2RealTime CT/NGNo. of Subjects
MUSMUMUMUSMUSymptomatic(SCV/CCV/U)Asymptomatic(Urine Only)Total
+++++14470214
++NA++729
NA++++101
+++NA+336
++-++9312
++-+NA101
++-NA+202
+-+++101
-++++022
++++-101
++-+-303
+-++-011
+-+++8311
-++-+369
++---112

CT Analysis According to Patient Infected Status INFECTED MALE Subjects

MUS = Male Urcthral Swab Specimen; MU = Male Urine Specimen; U = Urine.

{33}------------------------------------------------

NAAT 1NAAT 2RealTime CT/NGNo. of Subjects
MUSMUMUMUSMUSymptomatic(SCV/CCV/U)Asymptomatic(Urine Only)Total
MUSMUMUMUSMU5825101092
--NA--333972
--NANA-112
-NA---202
NA--NA-101
----NA325
---NA-11415
--+--325
-+---426
+----729
+--NA-011
----+101
--+-+011
-+--+011
---+-527
--NA+-011
--++-202
+--+-325
--+++101

CT Analysis According to Patient Infected Status NON-INFECTED MALE Subjects

MUS = Malc Urethral Swab Specimen; MU = Male Urine Specimen; U = Urine.

{34}------------------------------------------------

CultureNAAT 1NAAT 2RealTime CT/NGNo. of Subjects
EECCVFUEFUCCVSCVFUSymptomatic(SCV/CCV/U)Asymptomatic(Urine Only)Total
+++++++++12820
+++++NA+NA+101
++++++NANA+101
+++++-+++011
-++++++++5813
-++++++++404
-+++-++++101
-NA++-++++011
+-+-+++++101
-++-+NA+++101
-++--++++101
-++--++++101
--+-+NA+++011
--+-+-+++101
+++-+NA++-011
+++-+-++-011
-++++-++-101
-++-+-+++112
--+--+--+112

NG Analysis According to Patient Infected Status INFECTED FEMALE Subjects

E = Endocervical Swab Specimen; CCV = Clinician-Collected Vaginal Swab Specimen; FU = Female Urine Specimen; SCV = Self-Collected Vaginal Swab Specimen; U = Urine.

{35}------------------------------------------------

CultureNAAT 1NAAT 2RealTime CT/NGNo. of Subjects
EECCVFUEFUCCVSCVFUSymptomatic(SCV/CCV/U)Asymptomatic(Urine Only)Total
---------5465381084
-----NA---653499
-----NANA--213
-----NA-NA-303
-----NA--NA101
-----NA---82735
-----NA-NANA011
NA----NA---033
NA----NANA--011
--NA------022
NA-NA------011
-NA----NA--011
NA--------012
--------NA4812
-------NA-311647
------NA--5712
-------NANA336
------NA-NA145
------NANA-13316
----+----261844
----+--NA-314

NG Analysis According to Patient Infected Status NON-INFECTED FEMALE Subjects

F = Endocervical Swab Specimen; CCV = Clinician-Collected Vaginal Swab Specimen; FU = Female Urine Specimen; SCV = Self-Collected Vaginal Swab Specimen; U = Urinc.

{36}------------------------------------------------

Table 2.20 (Continued)

NG Analysis According to Patient Infected Status
NON-INFECTED FEMALE Subjects
CultureNAAT 1NAAT 2RealTime CT/NGNo. of SubjectsTotal
ECCVFUEFUCCVSCVFUSymptomatic(SCV/CCV/U)Asymptomatic(Urine Only)
---+----268
---+NA--NA101
--+-----112
-+------202
-+------213
-+---NA--101
--+++---011
--+----+033
-++---NA+101
-++---+-101
-----+--011
----NA+--011
--+--+--011
-++--+--011
-+++-+++101

E = Endocervical Swab Specimen; CCV = Clinician-Collected Vaginal Swab Specimen; FU = Female Urine Specimen; SCV = Self-Collected Vaginal Swab Specimen; U = Urine.

{37}------------------------------------------------

CultureNAAT 1NAAT 2RealTime CT/NGNo. of Subjects
MUSMUSMUMUMUSMUSymptomatic(SCV/CCV/U)Asymptomatic(Urine Only)Total
++++++1692171
+++NA++314
++NANA+NA101
++NA+++101
NA+++++606
++++NA+606
++++++909
++++++202
-+++++35641
+++NA+NA101
-+NA+++202
-NA++++101
-+++++101
+--+++101
-+++++101
++--+-101
++++-+101
--++++022
+-----101

NG Analysis According to Patient Infected Status INFECTED MALE Subjects

MUS = Male Urethral Swab Specimen; MU = Male Urine Specimen; U = Urine. NA includes "indeterminate" results from reference assays, specimens not available, or missing results.

·

{38}------------------------------------------------

CultureNAAT 1NAAT 2RealTimeCT/NGNo. of Subjects
MUSMUSMUMUMUSMUSymptomatic(SCV/CCV/U)Asymptomatic(Urine Only)Total
MUS-----5165591075
---NA--404282
---NANA-112
--NA---101
-NA----112
-NA--NA-101
NA-----7613
-----NA347
----NA-8614
---+--162541
NA--+--011
--+---235
-+----224
-----+101
----+-011
-+--+-202
---+++101
-+--++101

NG Analysis According to Patient Infected Status NON-INFECTED MALE Subjects

MUS = Male Urethral Swab Specimen; MU = Male Urine Specimen; U = Urine.

{39}------------------------------------------------

Prevalence of C. trachomatis and/or N. gonorrhoeae by Collection Site: Symptomatic and Asymptomatic Female Urine Specimens

Female Urine
% Prevalence (Number Positive/Number Tested)
SiteaCT+/NG+CT+/NG-bCT-/NG+b
10.0 (0/61)0.0 (0/61)0.0 (0/61)
31.6 (3/183)4.4 (8/183)1.1 (2/183)
40.0 (0/50)8.0 (4/50)2.0 (1/50)
50.0 (0/21)0.0 (0/21)0.0 (0/21)
60.0 (0/16)6.3 (1/16)6.3 (1/16)
73.1 (9/295)8.5 (25/295)3.7 (11/295)
80.0 (0/56)7.1 (4/56)3.6 (2/56)
94.6 (3/65)16.9 (11/65)6.2 (4/65)
102.4 (4/168)10.7 (18/168)1.8 (3/168)
112.1 (6/289)9.3 (27/289)1.4 (4/289)
120.0 (0/11)0.0 (0/11)0.0 (0/11)
130.0 (0/71)0.0 (0/71)0.0 (0/71)
140.0 (0/80)3.8 (3/80)0.0 (0/80)
151.7 (1/60)0.0 (0/60)0.0 (0/60)
160.0 (0/25)0.0 (0/25)4.0 (1/25)
All1.8 (26/1451)7.0 (101/1451)2.0 (29/1451)

ª No evaluable results were available from Site 2.

b Does not include specimens that were positive for both CT and NG.

{40}------------------------------------------------

Clinician-Collected Vaginal SwabSelf-Collected Vaginal Swab
SiteaCT+/NG+CT+/NG-bCT-/NG+bCT+/NG+CT+/NG-bCT-/NG+b
10.0(0/23)0.0(0/23)0.0(0/23)0.0(0/24)0.0(0/24)0.0(0/24)
32.3(2/88)4.5(4/88)2.3(2/88)2.4(2/84)4.8(4/84)2.4(2/84)
40.0(0/42)9.5(4/42)2.4(1/42)0.0(0/37)10.8(4/37)2.7(1/37)
50.0(0/15)0.0(0/15)0.0(0/15)0.0(0/15)0.0(0/15)0.0(0/15)
60.0(0/16)12.5(2/16)6.3(1/16)0.0(0/14)7.1(1/14)7.1(1/14)
73.4(7/207)10.6(22/207)3.4(7/207)3.6(7/196)10.2(20/196)4.1(8/196)
80.0(0/47)6.4(3/47)2.1(1/47)0.0(0/49)8.2(4/49)2.0(1/49)
97.0(3/43)14.0(6/43)0.0(0/43)5.6(2/36)11.1(4/36)0.0(0/36)
102.4(3/125)11.2(14/125)1.6(2/125)2.5(3/120)12.5(15/120)1.7(2/120)
112.9(1/34)23.5(8/34)2.9(1/34)2.9(1/34)23.5(8/34)2.9(1/34)
120.0(0/10)0.0(0/10)0.0(0/10)0.0(0/10)0.0(0/10)0.0(0/10)
130.0(0/17)0.0(0/17)0.0(0/17)0.0(0/17)0.0(0/17)0.0(0/17)
140.0(0/38)5.3(2/38)0.0(0/38)0.0(0/36)2.8(1/36)0.0(0/36)
153.7(1/27)0.0(0/27)0.0(0/27)3.6(1/28)0.0(0/28)0.0(0/28)
160.0(0/12)0.0(0/12)0.0(0/12)0.0(0/12)0.0(0/12)0.0(0/12)
All2.3(17/744)8.7(65/744)2.0(15/744)2.2(16/712)8.6(61/712)2.2(16/712)

ອການໄປ ປະກວດຄວາມອົງ ການສະໜາລິດ ເວລາໄດ້ ປະເທດໄທ ປີ ເປັນຕົວ ຈາກເປັນນາງງາມ ແລະປິດສາຫານ

ເປນນັກງານປ່ຽງ ແລະແນວລາວ ການປະກວດຄວາມງາມ ແລະ ເພນາ ລາຍສະຖານ ເປັນນັ້ນ ແລະປິດ
ເປນນັກສະແດງ ແລະ

"No evaluable results were available from Site 2.

  • No evaluable results were available from Site 2.
  • Does not include specimens that were positive for both CT and NG.

{41}------------------------------------------------

ડ્ટેટ ગવદ્યુ

dry& landterU elsM oitemotqmyS :ว่าริ แบบุว่าวอllog yd อยออกเขาอมารถ M 10/6แห รัฐมหาวิทยา

Urethral Swab% Prevalence (Number Positive/Number Tested)CT+/NG+CT+/NG-CT-/NG+Sitea,b
14.2 (17/120)13.3 (16/120)19.2 (23/120)3
9.0 (6/67)6.0 (4/67)9.0 (6/67)4
0.0 (0/23)8.7 (2/23)4.3 (1/23)5
0.0 (0/11)18.2 (2/11)9.1 (1/11)6
9.5 (9/95)17.9 (17/95)20.0 (19/95)7
7.3 (13/178)16.3 (29/178)20.2 (36/178)8
12.0 (20/167)13.8 (23/167)37.1 (62/167)9
4.9 (4/81)18.5 (15/81)12.3 (10/81)10
0.0 (0/3)0.0 (0/3)0.0 (0/3)12
0.0 (0/26)3.8 (1/26)0.0 (0/26)13
0.0 (0/15)0.0 (0/15)13.3 (2/15)14
0.0 (0/7)0.0 (0/7)0.0 (0/7)15
3.0 (1/33)0.0 (0/33)18.2 (6/33)16
8.5 (70/826)13.2 (109/826)20.1 (166/826)All

. I

. DN bns TO dood of evirisod arew tedt susmisses abulari 100 seen 2 .[ I bus 2 sits mort aldelieve arew susmisser demission of the

{42}------------------------------------------------

97.7 એવા પ

รตอนที่วอประจากทาง จโรไท วิทิ่หนึ่งขันที่สุรรค :ອຸບັບ ແບ່ນ້າງອຸປິດ 7 vd ອຸດອອກສຽງຄວາມ ເປັນສະໜາດການປະກວດນັ້ນ ວັນ ອວການສຽງຈາກ

SiteCT+/NG+CT+/NG-bCT-/NG+b
20.0 (0/6)0.0 (0/6)0.0 (0/6)
313.7 (25/183)9.8 (18/183)12.6 (23/183)
44.0 (4/101)5.9 (6/101)6.9 (7/101)
50.0 (0/34)5.9 (2/34)2.9 (1/34)
60.0 (0/53)18.9 (10/53)1.9 (1/53)
76.7 (12/179)16.8 (30/179)10.1 (18/179)
84.8 (14/291)14.8 (43/291)12.7 (37/291)
910.1 (21/208)20.2 (42/208)31.3 (65/208)
102.8 (4/145)21.4 (31/145)6.9 (10/145)
110.0 (0/2)100.0 (2/2)0.0 (0/2)
120.0 (0/3)0.0 (0/3)0.0 (0/3)
130.0 (0/60)1.7 (1/60)0.0 (0/60)
140.0 (0/75)1.3 (1/75)2.7 (2/75)
150.0 (0/55)3.6 (2/55)0.0 (0/55)
160.0 (0/101)2.0 (2/101)5.9 (6/101)
All5.3 (80/1496)12.7 (190/1496)11.4 (170/1496)

. I

. OM bus TO drod 101 avidisoq arew tech snamicsas abslubri 100 2900 a

{43}------------------------------------------------

PrevalenceRate(%)Sensitivity(%)Specificity(%)PositivePredictiveValue (%)NegativePredictiveValue (%)
0.595.099.237.4100.0
1.095.099.254.599.9
2.095.099.270.899.9
5.095.099.286.299.7
10.095.099.293.099.4
15.095.099.295.499.1
20.095.099.296.798.8
25.095.099.297.598.3
30.095.099.298.197.9

Positive and Negative Predictive Values for Hypothetical Prevalence Rates for Chlamydia trachomatis

Table 2.28

Positive and Negative Predictive Values for Hypothetical Prevalence Rates for Neisseria gonorrhoeae

PrevalenceRate(%)Sensitivity(%)Specificity(%)PositivePredictiveValue (%)NegativePredictiveValue (%)
0.598.099.762.1100.0
1.098.099.776.7100.0
2.098.099.787.0100.0
5.098.099.794.599.9
10.098.099.797.399.8
15.098.099.798.399.6
20.098.099.798.899.5
25.098.099.799.199.3
30.098.099.799.399.1

{44}------------------------------------------------

2.11 Conclusion Drawn from Clinical Studies

The submitted material in this premarket notification is complete and supports a substantial equivalence decision.

Abbott RealTune CT/NG // multi-Collect Specimen Collection Kit Sec 2 21(x)(x) Sunwary_mwy
See 2 21(x)(x) Sunwary_mwy
2008 21(x(x) Sunwary_mwy
1

Volume I
Sceion 2 Page 45

{45}------------------------------------------------

2.12 References

    1. Schachter J. Chlamydial infections. West J Med 1990;153(5):523-34.
    1. Cates W Jr. Wasserheit JN. Genital chlamydial infections: epidemiology and reproductive sequelae. Am J Obstet Gynecol 1991;164(6 Pt 2):1771-81.
    1. Berger RE, Alexander ER, Harnisch JP, et al. Etiology, manifestations and therapy of acute epididymitis: prospective study of 50 cases. J Urol 1979;121(6):750-4.
    1. Brunham RC, Paavonen J, Stevens CE, et al. Mucopurulent cervicitis-the ignored counterpart in women of urcthritis in men. N Eng J Med 1984;311(1):1-6.
    1. Alexander ER, Harrison HR. Role of Chlamydia trachomatis in pcrinatal infection. Rev Infect Dis 1983;5(4):713-9.
    1. Lyss SB, Kamb ML, Peterman TA, et al. Chlamydia trachomatis among patients infected with and treated for Neisseria gonorrhoeae in sexually transmitted disease clinics in the United States. Ann Intern Med 2003;139(3):178-85.
    1. MMWR. Sexually transmitted diseases treatment guidelines 2002. Morb Mortal WRly Rep [serial online] 2002;51 (RR-06). Available at http://www.cdc.gov/STD/treatmcnt/4-2002TG.htm. Accessed 01/31/2005.
    1. Johnson RE, Newhall WJ, Papp JR, et al. Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections-2002. MMRW Recomm Rep 2002;51 (RR-15):1-27.
    1. Bøvre K. Family VIII Neisseriaceae Prévot 1933; 119. In: Krieg NR, Holt JG, editors. Bergey's Manual of Systematic Bacteriology. Baltimore, MD: Williams and Wilkins; 1984:288-96.
    1. Hook EW, and Hansfield HH. Gonococcal infection in the adult. In: Holmes KK, Mardh PA, Sparling PF, Lemon SM, Stamm WE, Piot P, Wasserheit J, (ed.) Sexually Transmitted Diseases. 31d Ed. New York, NY: McGraw-Hill Book Co. 1999:451-66.
    1. Sparling PF, Handsficld HH, Neisseria gonorrhoeae. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennet's Principles and Practice of Infectious Diseases. 5th Ed. Philadelphia, PA: Churchill Livingstone, Inc. 2000:2242-રજ.
    1. Eisenstein BI, Masi AT. Disseminated gonococcal infection (DGI) and gonococcal arthritis (GCA): I. Bacteriology, epidemiology, host factors, pathogen factors, and pathology. Semin Arthritis Rheum 1981;10(3):155-72.
    1. Janda WM, Knapp JS. Neisseria and Morexclla catarrhalis. In: Murray PR, Baron EJ, Jorgensen JH, Pfaller MA, Yolken RH, (ed.) Manual of Clinical Microbiology. 8th Ed. Washington DC: Amer. Soc. for Microbiology, 2003;585-608.

{46}------------------------------------------------

    1. Hale YM, Melton ME, Lewis JS, et al. Evaluation of the PACE 2 Neisseria gonorrhoeae assay by three public health laboratories. J Clin Microbiol 1993;31(2):451-3.
    1. Palmer L, Falkow S. A common plasmid of Chlamydia trachomatis. Plasmid 1986;16(1):52-62.

Abbott RealTime CT/NG // multi-Collect Specimen Collection Kit March 2008 Scc 2 510(k) Summary 18w9

Volume 1 Section 2 Page 47

{47}------------------------------------------------

Image /page/47/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized eagle with three stripes forming its body and wings. The eagle is facing right. Encircling the eagle is the text "DEPARTMENT OF HEALTH & HUMAN SERVICES. USA" in a circular arrangement.

Public Health Service

Food and Drug Administration 2098 Gaither Road Rockville MD 20850

Ms. Paula Martin Senior Manager, Regulatory and Clinical Affairs Abbott Molecular Inc. 1300 East Touhy Avenue Des Plaines, IL 60018

JUL 1 0 2008

Re: K080739

Trade/Device Name: Regulation Number: 21 CFR 866.3120/866.3390 Regulation Name: Chlamydia trachomatis reagents/Neisseria gonorrhoeae reagents, Regulatory Class: Class I/II Product Code: MKZ/LSL Dated: March 12, 2008 Received: March 17, 2008

Dear Paula Martin:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration. Ilsting of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting your device can be found in Title 21, Code of Federal Regulations (CFR), Parts 800 to 895. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Parts 801 and 809); and good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820). This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed

{48}------------------------------------------------

Page 2 -

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Office of In Vitro Diagnostic Device Evaluation and Safety at 240-276-0450. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding postmarket surveillance, please contact CDRH's Office of Surveillance and Biometric's (OSB's) Division of Postmarket Surveillance at 240-276-3474. For questions regarding the reporting of device adverse events (Medical Device Reporting (MDR)), please contact the Division of Surveillance Systems at 240-276-3464. You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (240) 276-3150 or at its Internet address http://www.fda.gov/cdrh/industry/support/index.html.

Sincerely yours,

Sally attayma

Sally A. Hojvat, M.Sc., Ph.D. Director Division of Microbiology Devices Office of In Vitro Diagnostic Device Evaluation and Safety Center for Devices and Radiological Health

Enclosure

{49}------------------------------------------------

1.0 Indications of Use Statement

510(k) Number

Device Name: Abbott RealTime CT/NG assay and

Abbott multi-Collect Specimen Collection Kit

The Abbott RealTime CT/NG assay is an in vitro polymerase chain reaction (PCR) assay for the direct, qualitative detection of the plasmid DNA of Chlamydia trachomatis and the genomic DNA of Neisseria gonorrhoeae. The assay may be used to test the following specimens from symptomatic individuals: clinician-collected vaginal swab and male urethral swab specimens; patient-collected vaginal swab specimens; and female and male urine specimens. The assay may be used to test the following specimens from asymptomatic individuals: male and female urine.

The Abbott multi-Collect Specimen Collection Kit is intended for the collection and transportation of male and female swab and urine specimens for the detection of Chlamydia trachomatis and Neisseria gonorrheae per instructions provided. Refer to the specimen collection procedure in the package insert for specimen collection instructions for specific sample types.

Self-collected vaginal swab specimens are an option for screening women when a pelvic exam is not otherwise indicated. The Abbott multi-Collect Specimen Collection Kit is not intended for home use.

Prescription Use X (Per 21 CFR 801.119) AND/OR

Over-The-Counter Use (Per 21 CFR Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED

Concurrence of CDRH, Office of Device Evaluation (ODE)

Division Sign-Off

Page 1 of 1

(Posted November 13, 2003

Office of In Vitro Diagnostic Device Evaluation and Safety

Abbott RealTime CT/NG // multi-Collect Specimen Collection July 2008 Sec I Ladications of Use Statement_mw3

Volume I Section I Page 1

§ 866.3120 Chlamydia serological reagents.

(a)
Identification. Chlamydia serological reagents are devices that consist of antigens and antisera used in serological tests to identify antibodies to chlamydia in serum. Additionally, some of these reagents consist of chlamydia antisera conjugated with a fluorescent dye used to identify chlamydia directly from clinical specimens or cultured isolates derived from clinical specimens. The identification aids in the diagnosis of disease caused by bacteria belonging to the genusChlamydia and provides epidemiological information on these diseases. Chlamydia are the causative agents of psittacosis (a form of pneumonia), lymphogranuloma venereum (a venereal disease), and trachoma (a chronic disease of the eye and eyelid).(b)
Classification. Class I (general controls).