Comparison of cervical, urethral, and urine specimens for detection of Chlamydia trachomatis in women

Article Abstract:

Chlamydia trachomatis is a bacteria-like organism that causes pelvic infections, which may result in infertility. Although testing for C. trachomatis infection is cost-effective, the most appropriate testing methods and sites of sampling have not been clarified. Infection with C. trachomatis may be detected by obtaining a sample of tissue from the cervix, the urethra, or the day's first voided urine (FVU). The samples are tested for the growth of C. trachomatis in culture, a laboratory procedure in which the growth of the organism is enhanced. In addition, infection can also be determined by using enzyme immunoassay (EIA) methods to identify the presence of antigens, or elements of the organism that can trigger an immune response. The effectiveness of sampling the cervix, urethra, and FVU was assessed in 937 women by using culture and EIA techniques. According to culture results or EIA, C. trachomatis was detected at either the cervix or urethra in 67 cases, the cervix in 64 cases, and the urethra in 40 cases. Of the 67 infections, C. trachomatis was confirmed in both cervical and urethral tissue in 37 specimens; from only urethral tissue in 3 specimens and in only the FVU in none. Of the 67 women who tested positive for C. trachomatis infection, only 25 had positive tests using the FVU sample. The combined use of cervical culture and EIA detected C. trachomatis infection in 95.5 percent of cases, compared with 76.1 percent of infections detected by culture and 79.1 percent by EIA of cervical tissue. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Reproductive organs, Female, Female genitalia

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Screening urine with a leukocyte esterase strip and subsequent chlamydial testing of asymptomatic men attending primary care practitioners

Article Abstract:

A cost-effective and efficient means of screening asymptomatic men for Chlamydia trachomatis or Neisseria gonorrhoeae infection is to test a urine specimen with a leukocyte esterase (LE) strip. The leukocyte esterase (LE) strips screen for elevated white blood cell counts which could indicate infections. Men with positive LE results can then be referred for further enzyme immunoassay testing and treatment. Results of LE analysis of urine samples of 882 sexually active men on routine visits to their doctors varied according to which cutoff value was used. The lower the cutoff value, the greater the accuracy in predicting that chlamydia would be diagnosed by the more sensitive enzyme immunoassay method. One percent of the men screened with LE strips tested positive. The cost of one screening by LE strip was estimated at 1.70 Canadian dollars and the enzyme screening was estimated at 15.51 Canadian dollars.

Economic aspects, Neisseria gonorrhoeae, Enzyme-linked immunosorbent assay, Diagnosis, Laboratory, Laboratory diagnosis

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Detection of Chlamydia trachomatis antigens in male urethral swabs and urines with a microparticle enzyme immunoassay

Article Abstract:

A new test appears effective in detecting chlamydia infection of the male urethra in urine samples and urethral swabs. Two urethral swabs and a urine specimen were collected from 203 men attending a sexually transmitted disease clinic. One swab was cultured, the best currently known method of diagnosis, and the other underwent the IMX Select Chlamydia immunoassay. The urine specimen underwent the IMX Select assay as well as other assays for comparison purposes. Using urethral swabs, the IMX Select assay correctly identified 93.8% of infected men compared with swab culture results. Testing the urine sample, the IMX assay correctly identified 81.3% of infected men compared with swab culture results. The IMX Select assay has the advantages of providing results within two hours, and it shows promise of being the first noninvasive diagnostic test for chlamydia infections in men.

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