Abstract
In a study of 1,486 men attending two sexually transmitted disease clinics, of whom 891 had no symptoms of urethritis, we compared an enzyme immunoassay (EIA) (Baxter-Bartels, formerly Northumbria AntigEnz) of urine sediment to urethral culture for the detection of Chlamydia trachomatis. C. trachomatis prevalence by culture alone was 7.7% in asymptomatic men and 10.9% in symptomatic men. Discrepant results between EIA of urine and urethral culture were evaluated by direct fluorescent-antibody staining (DFA) for elementary bodies in urine sediment or in culture transport media. When chlamydial infection was defined as either a positive urethral culture or positive EIA confirmed by DFA, chlamydia prevalence increased to 8.9% in asymptomatic men and 11.6% in symptomatic men. The urine EIA sensitivity, specificity, and positive and negative predictive values for chlamydia detection in asymptomatic men were 84.8, 99.3, 91.8, and 98.5%, respectively, with nearly identical results for symptomatic men. The sensitivities of urethral culture alone compared with the combination of urethral culture and urine EIA (with DFA confirmation) were 87.3 and 94.3% for asymptomatic and symptomatic men, respectively. The present EIA of urine sediment is both highly sensitive and specific for the detection of C. trachomatis in asymptomatic men, thus providing a noninvasive screening method for chlamydia infection in asymptomatic men attending sexually transmitted disease clinics.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Adger H., Shafer M. A., Sweet R. L., Schachter J. Screening for Chlamydia trachomatis and Neisseria gonorrhoeae in adolescent males: value of first-catch urine examination. Lancet. 1984 Oct 27;2(8409):944–945. doi: 10.1016/s0140-6736(84)91164-4. [DOI] [PubMed] [Google Scholar]
- Ferris D. G., Martin W. H., Mathis D. M., Steele J. C., Fischer P. M., Styslinger K. M. Noninvasive detection of Chlamydia trachomatis urethritis in men by a rapid enzyme immunoassay test. J Fam Pract. 1991 Jul;33(1):73–78. [PubMed] [Google Scholar]
- Genç M., Stary A., Bergman S., Mårdh P. A. Detection of Chlamydia trachomatis in first-void urine collected from men and women attending a venereal clinic. APMIS. 1991 May;99(5):455–459. [PubMed] [Google Scholar]
- Hay P. E., Thomas B. J., Gilchrist C., Palmer H. M., Gilroy C. B., Taylor-Robinson D. The value of urine samples from men with non-gonococcal urethritis for the detection of Chlamydia trachomatis. Genitourin Med. 1991 Apr;67(2):124–128. doi: 10.1136/sti.67.2.124. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jaschek G., Gaydos C. A., Welsh L. E., Quinn T. C. Direct detection of Chlamydia trachomatis in urine specimens from symptomatic and asymptomatic men by using a rapid polymerase chain reaction assay. J Clin Microbiol. 1993 May;31(5):1209–1212. doi: 10.1128/jcm.31.5.1209-1212.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jensen I. P. A comparison of urine sample to urethral swab for detection of Chlamydia trachomatis in asymptomatic young men using two enzyme immunoassays. Sex Transm Dis. 1992 May-Jun;19(3):165–169. [PubMed] [Google Scholar]
- Palmer H. M., Gilroy C. B., Thomas B. J., Hay P. E., Gilchrist C., Taylor-Robinson D. Detection of Chlamydia trachomatis by the polymerase chain reaction in swabs and urine from men with non-gonococcal urethritis. J Clin Pathol. 1991 Apr;44(4):321–325. doi: 10.1136/jcp.44.4.321. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Paul I. D., Caul E. O. Evaluation of three Chlamydia trachomatis immunoassays with an unbiased, noninvasive clinical sample. J Clin Microbiol. 1990 Feb;28(2):220–222. doi: 10.1128/jcm.28.2.220-222.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Podgore J. K., Holmes K. K., Alexander E. R. Asymptomatic urethral infections due to Chlamydia trachomatis in male U.S. military personnel. J Infect Dis. 1982 Dec;146(6):828–828. doi: 10.1093/infdis/146.6.828. [DOI] [PubMed] [Google Scholar]
- Rietmeijer C. A., Judson F. N., Van Hensbroek M. B., Ehret J. M., Douglas J. M., Jr Unsuspected Chlamydia trachomatis infection in heterosexual men attending a sexually transmitted diseases clinic: evaluation of risk factors and screening methods. Sex Transm Dis. 1991 Jan-Mar;18(1):28–35. doi: 10.1097/00007435-199101000-00007. [DOI] [PubMed] [Google Scholar]
- Schachter J., Stamm W. E., Chernesky M. A., Hook E. W., 3rd, Jones R. B., Judson F. N., Kellogg J. A., LeBar B., Mårdh P. A., McCormack W. M. Nonculture tests for genital tract chlamydial infection. What does the package insert mean, and will it mean the same thing tomorrow? Sex Transm Dis. 1992 Sep-Oct;19(5):243–244. [PubMed] [Google Scholar]
- Schachter J. Why we need a program for the control of Chlamydia trachomatis. N Engl J Med. 1989 Mar 23;320(12):802–804. doi: 10.1056/NEJM198903233201210. [DOI] [PubMed] [Google Scholar]
- Schwebke J. R., Clark A. M., Pettinger M. B., Nsubga P., Stamm W. E. Use of a urine enzyme immunoassay as a diagnostic tool for Chlamydia trachomatis urethritis in men. J Clin Microbiol. 1991 Nov;29(11):2446–2449. doi: 10.1128/jcm.29.11.2446-2449.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sellors J., Mahony J., Jang D., Pickard L., Castriciano S., Landis S., Stewart I., Seidelman W., Cunningham I., Chernesky M. Rapid, on-site diagnosis of chlamydial urethritis in men by detection of antigens in urethral swabs and urine. J Clin Microbiol. 1991 Feb;29(2):407–409. doi: 10.1128/jcm.29.2.407-409.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Shafer M. A., Prager V., Shalwitz J., Vaughan E., Moscicki B., Brown R., Wibbelsman C., Schachter J. Prevalence of urethral Chlamydia trachomatis and Neisseria gonorrhoeae among asymptomatic, sexually active adolescent boys. J Infect Dis. 1987 Jul;156(1):223–224. doi: 10.1093/infdis/156.1.223. [DOI] [PubMed] [Google Scholar]
- Shafer M. A., Schachter J., Moscicki A. B., Weiss A., Shalwitz J., Vaughan E., Millstein S. G. Urinary leukocyte esterase screening test for asymptomatic chlamydial and gonococcal infections in males. JAMA. 1989 Nov 10;262(18):2562–2566. [PubMed] [Google Scholar]
- Stamm W. E., Cole B. Asymptomatic Chlamydia trachomatis urethritis in men. Sex Transm Dis. 1986 Jul-Sep;13(3):163–165. doi: 10.1097/00007435-198607000-00010. [DOI] [PubMed] [Google Scholar]
- Stamm W. E. Diagnosis of Chlamydia trachomatis genitourinary infections. Ann Intern Med. 1988 May;108(5):710–717. doi: 10.7326/0003-4819-108-5-710. [DOI] [PubMed] [Google Scholar]