Diagnosis of Chlamydia trachomatis infections in men and women by testing first-void urine by ligase chain reaction.
From April to September 1993, 305 men and 447 women in Hamilton, Canada, consented to the collection of a urethral or cervical swab, respectively, for culture and 20 ml of first-void urine (FVU) for testing by the enzyme immunoassay Chlamydiazyme and by ligase chain reaction (LCR) in the form of a kit from Abbott Laboratories called LCx Chlamydia trachomatis. Evaluation of test performance with each specimen was calculated on the basis of an expanded "gold standard" of a patient found to be positive by culture or by a confirmed nonculture test. By using this expanded standard, the prevalence of infection was determined to be 6% (27/447) for the women and 18.4% (56/305) for the men. LCR testing of FVU in both studies was the most sensitive approach (96%). The performance of Chlamydiazyme was as follows: cervical swab, 78.3% sensitivity; female FVU, 37% sensitivity; and male FVU, 67.9% sensitivity. Culture was the least sensitive approach to diagnosis: female cervix, 55.6%; and male urethra, 37.5%. LCR testing of FVU from men or women diagnosed the greatest number of genitourinary tract infections with no false positives.
McMaster University Regional Virology and Chlamydiology Laboratory, Hamilton, Ontario, Canada.
M A
MA
Chernesky
D
D
Jang
H
H
Lee
J D
JD
Burczak
H
H
Hu
J
J
Sellors
S J
SJ
Tomazic-Allen
J B
JB
Mahony
D001437:Bacteriuria / Q000382:microbiology*; D001483:Base Sequence; D002584:Cervix Uteri / Q000382:microbiology; D002690:Chlamydia Infections / Q000175:diagnosis*; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D005260:Female; D005784:Gene Amplification; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008969:Molecular Sequence Data; D011933:Reagent Kits, Diagnostic; D014521:Urethra / Q000382:microbiology
D011933:Reagent Kits, Diagnostic