Is gram stain test reliable indicator of STD

I am a 39yo male who recently started feeling some discomfort in my Urethra after having sex with 49yo female it kinda has the same feeling that I had before when I was diagnosed with NGU 7 years ago this recent episode was an episode of unprotected vaginal sex and I started having the symptoms 4 days after the sexual encounter, I don't have any pain with urination I went to the STD clinic today and they did a gram stain test and NAAT culture they said that they did not find anything on the gram stain I was told to come back in 2 weeks for the results of the NAAT I received no treatment today I spoke with the woman I had sex with and of course she denies having any STD's as I am writing this question right now I am feeling no discomfort in my Urethra and I haven't felt any this evening please help me am I just being paranoid or is there something to my anxiety? Thanks for your time and for taking my question. When I was last diagnosed with NGU it came up right away on the swab and they treated me that day.

[Edward W Hook, MD]

Welcome to the Forum. The Gram stain is an excellent rapid test an, In fact, the only way to diagnose NGU which, by definition, has increased numbers of white blood cells seen on gram stain.  The NAAT test was one because a small proportion of men with chlamydial infection do not have WBCs on gram stain. Several other additional comments:

1.  Gram stains can be falsely negative if there was not at least an hour since you last urinated.  If you had voided sooner than that, an if the symptoms persist, you may want to request another gram stain after not voiding. If the symptoms improve, I suspect there is little to worry about.
2.  Discomfort on urination in the absence of other signs of infection is pretty non-specific an could be due to lots of things including careful attention to whether or not there is discomfort (i.e. we are all a bit suggestible on issues such as this)
3.  I suspect your NAATs results will be available sooner than in two weeks. I'd call back in about a week.
4.  With a negative gram stain, the chances that you have an STD are very small.

Hope these comments help. EWH