Diagnosis of genital Chlamydia trachomatis infections in asymptomatic males by testing urine by PCR

Domeika, Marius; Bassiri, Mansour; Mårdh, Per‐Anders

doi:10.1128/jcm.32.10.2350-2352.1994

Cited by 37 publications

(15 citation statements)

References 25 publications

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“…Our results show that PCR testing of FVU specimens appears to overcome these concerns raised about screening asymptomatic men by EIA testing of FVU specimens. Other studies with populations with higher prevalences of chlamydial infections have also reported similar findings (9,12,25). Initial experience with another DNA amplification technique, the ligase chain reaction, also indicates that it is highly sensitive when it is used on FVU specimens from men, even if they are asymptomatic (8).…”

Section: Discussionmentioning

confidence: 56%

Diagnosis of Chlamydia trachomatis infections in asymptomatic men and women by PCR assay

Toye¹,

Peeling²,

Jessamine³

et al. 1996

J Clin Microbiol

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A PCR assay was evaluated for its ability to detect genital chlamydial infection in asymptomatic men and women. Urethral swab specimens were collected from 472 men for culture and PCR assay, and first-void urine (FVU) specimens were collected from 379 of these men for enzyme immunoassay (EIA) and PCR assay. Cervical swab specimens were collected from 242 women for culture, EIA, and PCR assay. Patients were considered infected if they were culture positive or positive by PCR with both plasmid-and major outer membrane protein-based primers. By using this extended ''gold standard,'' the prevalence of infection in this population was 7.6% for men and 7.9% for women. For men, the sensitivities of urethral swab specimen culture and PCR and FVU specimen EIA and PCR were 61, 72, 55, and 91%, respectively. All assays had specificities of >99.8%. The positive and negative predictive values for PCR testing of FVU specimens were 100 and 99.4%, respectively, compared with values of 96.3 and 97.8%, respectively, for PCR of urethral swab specimens. The sensitivities of cervical swab specimen culture and PCR testing were 42 and 90%, respectively, with corresponding specificities of 100 and 99.3%. All cervical swabs were negative by EIA. Molecular techniques such as PCR assays are valuable tools for the detection of asymptomatic genital chlamydial infection. In particular, PCR assays of FVU specimens from men offer a highly sensitive, noninvasive screening tool that will likely improve patient compliance for diagnostic testing.

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Section: Discussionmentioning

confidence: 56%

Diagnosis of Chlamydia trachomatis infections in asymptomatic men and women by PCR assay

Toye¹,

Peeling²,

Jessamine³

et al. 1996

J Clin Microbiol

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“…The package insert did not recommend retesting specimens in a gray zone. Amplicor Chlamydia (Roche Molecular Systems, Branchburg, N.J.) PCR was performed according to the manufacturer's instructions and has been described in previous reports (6,9,17). Specimens with absorbances of 0.5 or above were considered positive, and those with absorbances below 0.2 were considered negative.…”

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confidence: 99%

Ability of commercial ligase chain reaction and PCR assays to diagnose Chlamydia trachomatis infections in men by testing first-void urine

et al. 1997

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A total of 287 men (37.6% with symptoms of urethritis) attending a hospital-based sexually transmitted disease clinic had urethral swabs tested by culture and by direct fluorescent-antibody assay. First-void urine (FVU) was tested for Chlamydia trachomatis by commercially available ligase chain reaction (LCR) and PCR assays. By using an expanded reference standard, 35 men (12.2%) were found to be positive. By performing LCR and PCR, the infection prevalence was found to be approximately twice (11.5 and 12.2%, respectively) that determined by swab testing. The sensitivity values were 94.3% for LCR and 100% for PCR. One of the two positive specimens missed by LCR contained inhibitors. PCR produced five false-positive results and LCR produced one. Although antigen detection assays have been effective for diagnosing men who are infected with Chlamydia trachomatis by testing concentrated first-void urine (FVU) (3, 8, 10, 11, 14, 15), limitations in sensitivity have restricted the identification of infected individuals with few or no symptoms of urethritis. Both PCR (6, 9, 12, 13, 16) and ligase chain reaction (LCR) (4, 5) have been shown to be sensitive for identifying infected men by the testing of FVU. This study compared LCR and PCR detection of C. trachomatis by using commercially available kits to test FVU from 287 men attending a sexually transmitted disease clinic. Assay performance was compared to culture and direct fluorescentantibody (DFA) staining of a urethral swab collected at the same clinic visit. An expanded reference standard (9) was used as described below. The study was performed from September 1993 to February 1995 during which time 287 men were enrolled with consents which were approved by the McMaster University Research Ethics Committee Hospital Network. The men were attending a hospital-based sexually transmitted disease clinic and each had an FVU sample (20 ml) collected in a sterile 30-ml screw-cap plastic jar. A urethral swab specimen was collected by inserting a narrow-shafted cotton-tipped swab 2 to 3 cm into the urethra. The order of collection of swabs and FVU was reversed halfway through the study. The swabs were placed into transport tubes containing minimal essential medium with 5% sorbitol, 3% fetal bovine serum, and 2 mM L-glutamine at 4ЊC. The swabs were transported to the laboratory and set up in cell cultures within 24 h. FVU specimens were held at 4ЊC and tested by LCR or PCR within 3 days. Urethral swabs from the men were inoculated onto McCoy cell monolayers in 96-well microculture plates, with a blind passage and iodine staining (2). Swabs were processed and tested by DFA. The urethral swabs were smeared according to the Microtrak DFA (Syva) package insert. A sample was con

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“…Many asymptomatic individuals are also reluctant to undergo urethral sampling. Culture has a low sensitivity with voided urine (8)(9)(10)17). Gene-based nonamplification techniques have proved to be as sensitive as EIAs when they are used to detect C. trachomatis in urine.…”

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confidence: 99%

Detection of Chlamydia trachomatis in urine specimens from women by ligase chain reaction

Bassiri

Domeika

et al. 1995

J Clin Microbiol

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The performance of a plasmid-based ligase chain reaction (LCR) with urine specimens was compared with those of cell culture of cervical swabs and enzyme immunoassay with urine specimens for the detection of Chlamydia trachomatis infection in women who had attended a family planning clinic. The prevalence of chlamydial infection determined by LCR was 3.1%. Discrepant results among the three assays were resolved by testing urine by a second LCR assay based on the C. trachomatis chromosomal gene encoding the major outer membrane protein. Sensitivity, specificity, and positive and negative predictive values for the cell cultures were 56.3, 100, 100, and 98.4%, respectively, whereas those for the enzyme immunoassay were 18.8, 100, 100, and 97.1%, respectively, and those for LCR were 87.5, 100, 100, and 99.5%, respectively. LCR thus provides a highly sensitive and specific noninvasive screening method for detecting genital chlamydial infections in women.

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Diagnosis of genital Chlamydia trachomatis infections in asymptomatic males by testing urine by PCR

Cited by 37 publications

References 25 publications

Diagnosis of Chlamydia trachomatis infections in asymptomatic men and women by PCR assay

Diagnosis of Chlamydia trachomatis infections in asymptomatic men and women by PCR assay

Ability of commercial ligase chain reaction and PCR assays to diagnose Chlamydia trachomatis infections in men by testing first-void urine

Detection of Chlamydia trachomatis in urine specimens from women by ligase chain reaction

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