DETECTION OF CHLAMYDIA-TRACHOMATIS IN URINE SAMPLES BY NUCLEIC-ACID TESTS - COMPARISON WITH CULTURE AND ENZYME-IMMUNOASSAY OF GENITAL SWAB SPECIMENS

Two commercially available nucleic acid-based tests, ligase chain reac tion (LCR; Abbott Laboratories) and PCR (Roche Diagnostics), for the d etection of Chlamydia trachomatis in male and female urine samples wer e compared with culture and enzyme immunoassay (EIA) (Microtrak; Syva) for C. trachomatis detection in genital samples, The samples were col lected from 1,005 patients who attended a sexually transmitted disease clinic, In this study population, the prevalence of the infection was 4%, Specimens which were reactive in any of the tests were retested w ith a different PCR test using primers directed against the major oute r membrane protein gene, With a ''gold standard'' of a positive cultur e, or any other positive test result if it was confirmed by an indepen dent test, the Roche PCR (95% sensitive, 99.9% specific) was more sens itive than the LCR (75% sensitive, 100% specific) (chi(2), P < 0.0001) while both tests were more sensitive than culture (58% sensitive, 100 % specific) or EIA (45% sensitive, 100% specific) (chi(2), P < 0.001), The Roche PCR and Abbott LCR tests of urine identified 65% and 30% mo re positive patients, respectively, than did testing by culture of ure thral or cervical specimens, Nucleic acid testing of urine specimens f or C. trachomatis is a more sensitive and convenient method for the de tection of genital infection.