Chlamydia Trachomatis Infection In Men Research Articles

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

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 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.

Diagnosis of Chlamydia trachomatis infections in men and women by testing first-void urine by ligase chain reaction

From April to September 1993, 305 men and 447 women in Hamilton, Canada, consented to the collection of a urethral or cervical swab, respectively, for culture and 20 ml of first-void urine (FVU) for testing by the enzyme immunoassay Chlamydiazyme and by ligase chain reaction (LCR) in the form of a kit from Abbott Laboratories called LCx Chlamydia trachomatis. Evaluation of test performance with each specimen was calculated on the basis of an expanded "gold standard" of a patient found to be positive by culture or by a confirmed nonculture test. By using this expanded standard, the prevalence of infection was determined to be 6% (27/447) for the women and 18.4% (56/305) for the men. LCR testing of FVU in both studies was the most sensitive approach (96%). The performance of Chlamydiazyme was as follows: cervical swab, 78.3% sensitivity; female FVU, 37% sensitivity; and male FVU, 67.9% sensitivity. Culture was the least sensitive approach to diagnosis: female cervix, 55.6%; and male urethra, 37.5%. LCR testing of FVU from men or women diagnosed the greatest number of genitourinary tract infections with no false positives.

Detection of Chlamydia trachomatis in urine using enzyme immunoassay and DNA amplification

The suitability of urine specimens for the detection of Chlamydia trachomatis infections in men was assessed. Urethral swabs from 301 patients were cultured for C. trachomatis, and the results were compared with results obtained from Chlamydiazyme. The results of 298 specimens were also compared with results obtained from PCR analysis of first-void urine specimens. The sensitivity of confirmed chlamydiazyme analysis was 93% and the specificity was greater than 99% compared with culture. The sensitivity of the PCR method was 100% compared with culture. Chlamydia trachomatis was detected by PCR in an additional three specimens from which C. trachomatis could not be cultured. Urine appears to be an appropriate specimen for the detection of C. trachomatis antigens and nucleic acids.

Direct detection of Chlamydia trachomatis in urine specimens from symptomatic and asymptomatic men by using a rapid polymerase chain reaction assay

Screening for Chlamydia trachomatis infection in men has traditionally been limited to men who present with urethral symptoms, thereby limiting the detection of asymptomatic chlamydia infection in men. In order to effectively screen both symptomatic and asymptomatic men, we evaluated a newly developed polymerase chain reaction (PCR) assay, Amplicor C. trachomatis, from Roche Molecular Systems for the detection of C. trachomatis in urine specimens in comparison with urethral culture. A total of 530 male urine specimens were collected from 322 symptomatic and 208 asymptomatic men attending two sexually transmitted disease clinics in Baltimore, Md. The prevalence of C. trachomatis by culture was 9.8% (10.6% in symptomatic men and 8.2% in asymptomatic men). Compared with culture, the sensitivity of the PCR was 92.8%, the specificity was 94.7%, the positive predictive value was 68.4%, and the negative predictive value was 99.1%. Discrepant results between culture and PCR were further analyzed by direct fluorescent-antibody staining of elementary bodies in urine sediment and in culture transport vials and by major outer membrane protein PCR of transport media for specimens with negative culture. The revised sensitivity and specificity of PCR for urine were 95.0 and 99.8%, respectively, and the positive and negative predictive values were 98.7 and 99.1%, respectively. The sensitivity of culture compared with PCR and/or direct fluorescent-antibody staining was 68.4%. These results indicate that the PCR assay is a highly sensitive and specific assay for the detection of C. trachomatis in male urine specimens and provides a noninvasive technique for routine screening of chlamydia infection in both symptomatic and asymptomatic men.

Unselected urine samples in the diagnosis of genital Chlamydia trachomatis infection in men

Unselected urine samples in the diagnosis of genital Chlamydia trachomatis infection in men

Effect of amoxicillin on simultaneous chlamydia trachomatis infection in men with gonococcal urethritis: Comparison of three dosage regimens : Csango PA, Gundersen T, Martinsen IM. Sex Trans Dis 1985; 12: 93–96

Effect of amoxicillin on simultaneous chlamydia trachomatis infection in men with gonococcal urethritis: Comparison of three dosage regimens : Csango PA, Gundersen T, Martinsen IM. Sex Trans Dis 1985; 12: 93–96

Chlamydia trachomatis infections in men with Reiter's syndrome.

Chlamydia trachomatis was isolated from 9 of 19 men with acute, nondiarrheal Reiter's syndrome who had not recently taken antibiotics. None of 8 untreated men with other forms of arthritis were infected with this organism. Chlamydia trachomatis-specific antibody titers and cellular immune responses were positive significantly more often in 35 treated and untreated men with acute, nondiarrheal Reiter's syndrome than in 7 men with diarrhea-associated Reiter's syndrome and 8 men with other forms of arthritis. Mean peak chlamydial antibody titers and mean lymphocyte transformation stimulation indices were significantly higher in C. trachomatis-infected men with Reiter's syndrome than in C. trachomatis-infected men with uncomplicated nongonococcal urethritis. We concluded that C. trachomatis is capable of "triggering" Reiter's syndrome in susceptible men and that an exaggerated immune response to this organism may play a role in the pathogenesis of the disease.