title: Screening for Chlamydia trachomatis and Neisseria gonorrhoeae in adolescent males: value of first-catch urine examination.
abstract: 50 adolescent males attending a general teen clinic (aged 13-21) were evaluated for urethritis. After examination of sediment from the initial 15-20 ml of voided urine, first-catch urine (FCU), specimen urethral swabs were taken for culture of Chlamydia trachomatis and Neisseria gonorrhoeae. 21 of 23 (91%) males with greater than 10 leucocytes per high-power field of resuspended sediment (FCU-positive) had positive urethral cultures for C trachomatis or N gonorrhoeae compared with only 1 of 27 (4%) FCU-negative subjects (p less than 0.001). 12 of 22 culture-positive subjects had no genitourinary symptoms and 11 of the 12 had C trachomatis infections. The sensitivity of FCU examination in identifying culture-positive urethritis was 95%, the specificity 93%, and the predictive value of a positive FCU 91%. FCU examination is a useful, noninvasive screening test to detect urethritis associated with C trachomatis and N gonorrhoeae. The test may be especially helpful in identifying symptom-free males with chlamydia-associated urethritis.
mesh_terms: D000293:Adolescent; D000328:Adult; D001437:Bacteriuria; D002690:Chlamydia Infections / Q000175:diagnosis; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D006069:Gonorrhea / Q000175:diagnosis; D006801:Humans; D008297:Male; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification*; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000382:microbiology; D013048:Specimen Handling / Q000379:methods; D014526:Urethritis / Q000175:diagnosis