Detection of Chlamydia trachomatis in urine samples by nucleic acid tests: comparison with culture and enzyme immunoassay of genital swab specimens.
Two commercially available nucleic acid-based tests, ligase chain reaction (LCR; Abbott Laboratories) and PCR (Roche Diagnostics), for the detection of Chlamydia trachomatis in male and female urine samples were compared with culture and enzyme immunoassay (EIA) (Microtrak; Syva) for C. trachomatis detection in genital samples. The samples were collected from 1,005 patients who attended a sexually transmitted disease clinic. In this study population, the prevalence of the infection was 4%. Specimens which were reactive in any of the tests were retested with a different PCR test using primers directed against the major outer membrane protein gene. With a "gold standard" of a positive culture, or any other positive test result if it was confirmed by an independent test, the Roche PCR (95% sensitive, 99.9% specific) was more sensitive than the LCR (75% sensitive, 100% specific) (chi2, P < 0.0001) while both tests were more sensitive than culture (58% sensitive, 100% specific) or EIA (45% sensitive, 100% specific) (chi2, P < 0.001). The Roche PCR and Abbott LCR tests of urine identified 65% and 30% more positive patients, respectively, than did testing by culture of urethral or cervical specimens. Nucleic acid testing of urine specimens for C. trachomatis is a more sensitive and convenient method for the detection of genital infection.
Schepetiuk
S
S
Infectious Diseases Laboratories, Institute of Medical and Veterinary Science, Adelaide, South Australia.
Kok
T
T
Martin
L
L
Waddell
R
R
Higgins
G
G
D001431:Bacteriological Techniques / Q000706:statistics & numerical data; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000235:genetics* / Q000302:isolation & purification*; D005069:Evaluation Studies as Topic; D005260:Female; D005835:Genitalia / Q000382:microbiology; D006801:Humans; D007124:Immunoenzyme Techniques / Q000706:statistics & numerical data; D008297:Male; D021141:Nucleic Acid Amplification Techniques; D016133:Polymerase Chain Reaction / Q000379:methods / Q000706:statistics & numerical data; D011118:Polynucleotide Ligases; D012680:Sensitivity and Specificity; D014556:Urine / Q000382:microbiology
D011118:Polynucleotide Ligases