Rapid, on-site diagnosis of chlamydial urethritis in men by detection of antigens in urethral swabs and urine

Sellors, John; Mahony, James B.; Jang, Dan; Pickard, Laura; Castriciano, Santina; Landis, Stephan J.; Stewart, Iain O.; Seidelman, William E.; Cunningham, Ian; Chernesky, Max

doi:10.1128/jcm.29.2.407-409.1991

Cited by 30 publications

(19 citation statements)

References 8 publications

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“…A urethral swab was taken from each patient and examined for C . trachomatis and urethral leukocytes; men with more than 4 leukocytes/hpf, which could indicate urethritis (Bowie, 1978;Swartz et al, 1978), were also excluded from the study. VB,, VB2, post-prostatic massage urine specimens (VB,), and expressed prostatic secretions (EPS) were cultured quantitatively for U. urealyticum and for common bacteria.…”

Section: Methodsmentioning

confidence: 99%

Ureaplasma urealyticum in the Urogenital Tract of Patients with Chronic Prostatitis or Related Symptomatology

Ohkawa

Yamaguchi²,

Tokunaga³

et al. 1993

British Journal of Urology

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To elucidate the role of Ureaplasma urealyticum as a causative organism in chronic prostatitis we investigated its incidence in the urogenital tract in 131 chronic prostatitis patients and 120 prostatodynia patients; the presence of common bacteria or Chlamydia trachomatis was also recorded. According to the 4-glass localisation test, U. urealyticum (> or = 10(3) ccu/ml) was isolated from the prostates of 16 prostatitis patients and 2 prostatodynia patients; 5 of these prostatitis patients (but neither of the prostatodynia patients) had other bacteria in specimens after prostatic massage. Thus U. urealyticum was the sole organism isolated from the prostates of 11 prostatitis and 2 prostatodynia patients, which suggests that it is an aetiological agent in some cases of chronic non-bacterial prostatitis.

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Section: Methodsmentioning

confidence: 99%

Ureaplasma urealyticum in the Urogenital Tract of Patients with Chronic Prostatitis or Related Symptomatology

Ohkawa

Yamaguchi²,

Tokunaga³

et al. 1993

British Journal of Urology

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“…The idea of using self-taken, noninvasive specimens such as urine, especially when combined with antigen detection tests such as the enzyme immunoassay (EIA), has resulted in a move away from routine use of urethral swabs. Comparative studies have shown that although urethral swabs gave higher rates of detection than first void urine for both sensitivity and specificity (81.0% vs 76.2% and 99.0% vs 95.5%, respectively) when an EIA test was used (Sellors et al, 1991), the difference between the specimens was reduced when a nucleic acid amplification test (NAAT) was used (96.2% vs 92.5% and 100% vs 100%, respectively) (Carroll et al, 1998). A recent systematic review has confirmed the latter finding (Cook et al, 2005).…”

Section: Which Specimen?mentioning

confidence: 99%

How to Detect Chlamydia trachomatis in Males?

Eley¹

2010

Journal of Andrology

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Much is known about the role of Chlamydia trachomatis in female infertility, although the same cannot be said about the organism's role in male infertility. Recently a number of researchers have provided a possible explanation of the pathogenesis of C trachomatis in male infertility and have suggested further studies. Unfortunately, current screening recommendations for C trachomatis in an infertile couple are vague and unhelpful, and many do not even mention this type of screening in the male. To enable any progress to be made in this field, it is essential that investigators know how best to detect C trachomatis, especially in the male. It is important, therefore, to know which specimen is best for C trachomatis detection, with respective strengths and weaknesses of each specimen. Similarly, it is equally important to have knowledge of which test is appropriate for the type of specimen being examined. First void urine is currently the specimen of choice for the routine detection of C trachomatis in males. Moreover, the best detection protocols in the developed world are based on molecular diagnosis of first void urine. These methods provide the best combination of sensitivity and specificity that is currently available on a clinical sample that can be self-taken. Interestingly, because semen is routinely collected for analysis in men of infertile couples, it has been suggested that protocols be developed for the optimal detection of C trachomatis in this specimen. Semen might provide additional information on infection of the upper genital tract, which may not be detected in first void urine. Finally, the importance of comparing tests for C trachomatis detection in updating our knowledge has been highlighted by the inability of some molecular methods to detect the new variant strain of C trachomatis.

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“…The only other evaluation of the Testpack Chlamydia assay with FVU specimens from men was published by Sellors et al (17). They compared the results of the test with FVU specimens to the results of urethral swab cultures and showed that the Testpack Chlamydia assay was 76.2% sensitive and 95.5% specific, whereas the Chlamydiazyme assay was 81.0% sensitive and 96.5% specific.…”

Section: Discussionmentioning

confidence: 99%

Impact of Reference Standard Sensitivity on Accuracy of Rapid Antigen Detection Assays and a Leukocyte Esterase Dipstick for Diagnosis of Chlamydia trachomatis Infection in First-Void Urine Specimens from Men

et al. 1999

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A total of 128 previously frozen first-void urine (FVU) specimens from selected asymptomatic men were centrifuged and tested by threeChlamydia trachomatis rapid antigen detection tests and with a leukocyte esterase (LE) dipstick. When the results were compared to those of a reference standard of positivity determined by the Chlamydiazyme enzyme immunoassay as confirmed by a blocking assay, the sensitivities of the Testpack Chlamydia (Abbott), Clearview Chlamydia (Unipath), and Surecell Chlamydia (Kodak) tests and the LE dipstick test were 76.4, 76.4, 67.3, and 88.6%, respectively. Use of the ligase chain reaction (LCR), whose results were confirmed by direct fluorescent-antibody staining of elementary bodies, as the reference standard reduced the sensitivities to 70.9, 67.7, 62.9, and 87.5%, respectively. The specificities by use of LCR as the reference standard were 95.5, 95.5, 100, and 92.4%, respectively. These rapid chlamydial antigen tests performed reasonably well with FVU specimens, but the simple LE dipstick test, which had the highest sensitivity, would have enabled treatment of the greatest number of infected male patients.

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Rapid, on-site diagnosis of chlamydial urethritis in men by detection of antigens in urethral swabs and urine

Cited by 30 publications

References 8 publications

Ureaplasma urealyticum in the Urogenital Tract of Patients with Chronic Prostatitis or Related Symptomatology

Ureaplasma urealyticum in the Urogenital Tract of Patients with Chronic Prostatitis or Related Symptomatology

How to Detect Chlamydia trachomatis in Males?

Impact of Reference Standard Sensitivity on Accuracy of Rapid Antigen Detection Assays and a Leukocyte Esterase Dipstick for Diagnosis of Chlamydia trachomatis Infection in First-Void Urine Specimens from Men

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