title: Direct urine polymerase chain reaction for chlamydia and gonorrhoea: a simple means of bringing high-throughput rapid testing to remote settings?
abstract: Background Rapid point-of-care tests (POCTs) for chlamydia (Chlamydia trachomatis) and gonorrhoea (Neisseria gonorrhoeae) have the potential to confer health benefits in certain populations even at moderate sensitivities; however, suitable POCTs for these organisms are currently lacking.
  
  
  METHODS
  In this study, we investigated the use of direct urine polymerase chain reaction (PCR), with the view of implementing a simplified PCR strategy for high-throughput chlamydia and gonorrhoea screening in remote settings. Briefly, a simple dilution of the urine was performed before adding it directly to a real-time PCR reaction. The method was evaluated using 134 stored urine specimens that had been submitted for chlamydia and gonorrhoea testing and had been tested using a commercial C. trachomatis and N. gonorrhoeae PCR method. These included samples that were PCR-positive for chlamydia (n=87), gonorrhoea (n=16) or both (n=2). Direct urine testing was conducted using previously described in-house real-time PCR methods for C. trachomatis and N. gonorrhoeae as well as for recognised N.gonorrhoeae antimicrobial resistance mechanisms.
  
  
  RESULTS
  The overall sensitivities and specificities of the direct urine PCR were 78% and 100% for chlamydia, and 83% and 100% for gonorrhoea. N.gonorrhoeae penicillin and quinolone resistance mechanisms were characterised in 14 of the 18 N. gonorrhoeae-positive samples.
  
  
  CONCLUSIONS
  The results of this study show that the simplified PCR strategy may be a feasible approach for rapid screening and improving chlamydia and gonorrhoea treatment in remote settings.
authors: Queensland Paediatric Infectious Diseases Laboratory, Queensland Children's Medical Research Institute, Children's Health Service District, Brisbane, Qld 4029, Australia.
authors: Frashta
authors: F
authors: Rahimi
authors: Namraj
authors: N
authors: Goire
authors: Rebecca
authors: R
authors: Guy
authors: John M
authors: JM
authors: Kaldor
authors: James
authors: J
authors: Ward
authors: Michael D
authors: MD
authors: Nissen
authors: Theo P
authors: TP
authors: Sloots
authors: David M
authors: DM
authors: Whiley
mesh_terms: D002690:Chlamydia Infections / Q000175:diagnosis; D002692:Chlamydia trachomatis / Q000235:genetics; D006069:Gonorrhea / Q000175:diagnosis; D006801:Humans; D009344:Neisseria gonorrhoeae / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D012680:Sensitivity and Specificity