Diagnosis of Chlamydia trachomatis urethral infection in symptomatic and asymptomatic men by testing first-void urine in a ligase chain reaction assay.
A multicenter study compared ligase chain reaction (LCR) of Chlamydia trachomatis plasmid DNA with culture of urethral swab specimens from 542 men (study A); a second study (B) compared LCR of first-void urine (FVU) with urethral swab cultures from 1043 men. Discordant results were resolved with direct fluorescent antibody staining of sediments from the FVU or urethral culture specimen and with a second LCR directed against a fragment of the major outer membrane protein gene. Test performance was calculated on the basis of an expanded reference standard. The LCR plasmid assay had a sensitivity of 98.0% in study A and 93.5% in study B; specificity was 99.8%-100%. The sensitivity of culturing urethral swabs from all study sites was 68.2% (range by sites, 40.0%-84.6%). The presence or absence of urethral symptoms did not alter the results. Use of this LCR test should allow more meaningful investigation and treatment of C. trachomatis infections in men.
McMaster University Regional Virology, St. Joseph's Hospital, Hamilton, Canada.
M A
MA
Chernesky
H
H
Lee
J
J
Schachter
J D
JD
Burczak
W E
WE
Stamm
W M
WM
McCormack
T C
TC
Quinn
D001437:Bacteriuria / Q000382:microbiology*; D002690:Chlamydia Infections / Q000175:diagnosis*; D002692:Chlamydia trachomatis / Q000235:genetics / Q000302:isolation & purification*; D011088:DNA Ligases; D004269:DNA, Bacterial / Q000032:analysis*; D005784:Gene Amplification; D006801:Humans; D008297:Male; D014521:Urethra / Q000382:microbiology; D014522:Urethral Diseases / Q000175:diagnosis*
D004269:DNA, Bacterial; D011088:DNA Ligases