Detection of Chlamydia trachomatis in first catch urine samples from symptomatic and asymptomatic males.

Abstract

Non-invasive tests are needed to detect Chlamydia trachomatis in the genital tract. For men, urine appears to be a useful specimen for chlamydial antigen or nucleic acid detection. To evaluate enzyme immunoassays (EIA) for chlamydial antigens in first catch urine (FCU) from symptomatic and asymptomatic men. We conducted five different studies; FCUs and urethral swabs were collected from 1,341 symptomatic and 816 asymptomatic males. Four EIAs (SureCell, Chlamydiazyme, MicroTrak and IDEIA) were tested on the FCU sediments. Prevalence of chlamydia by tissue culture isolation was 6% for asymptomatic and 14% for symptomatic men. With symptomatic males, the EIA sensitivities and specificities were: SureCell 85% and 97%, IDEIA 82% and 98%, MicroTrak 86% and 99%, and Chlamydiazyme 91% and 95%. For asymptomatic men, Chlamydiazyme sensitivity was 35% with frozen urine vs 77% with fresh urine. Overall, tissue culture sensitivity was about 90%. EIA results on FCU sediments are comparable to that of tissue culture isolation on urethral swabs. In many settings, FCU may be the specimen of choice for diagnosing chlamydial infections in men.