DIAGNOSIS OF MALE CHLAMYDIA-TRACHOMATIS URETHRITIS BY POLYMERASE CHAIN-REACTION

Background and Objectives: A quick and highly sensitive diagnostic tes t would be valuable in the diagnosis of Chlamydia trachomatis. Goal of this Study: We compared a new polymerase chain reaction (PCR) techniq ue to Chlamydiazyme (Abbott, North Chicago, IL) in the detection of ma le chlamydial urethritis, and evaluated the performance of PCR on urin e samples. Study Design: Urethral samples for analysis by PCR and Chla mydiazyme were obtained from 474 unselected patients attending a sexua lly transmitted diseases (STD) clinic. Urine samples were analyzed by PCR from 362 of these patients. Results: Twenty seven (5.7%) urethral samples were positive by Chlamydiazyme, while 64 (13.5%) were positive by PCR. After resolution of discrepant results, the sensitivity of PC R on urethral swabs was 98.4% and the specificity was 99.0%, with posi tive and negative predictive values of 93.8% and 99.8%, respectively. These same measures for Chlamydiazyme were 43.5%, 100%, 100%, and 92.2 %, respectively. The sensitivity of PCR on urine samples was 87.1%, th e specificity was 98.0%, and the positive and negative predictive valu es were 90.0% and 97.4%,respectively. Conclusions: This PCR test is mo re sensitive than Chlamydiazyme in detecting male urethral chlamydial infections in an STD clinic population, and appears to be equally effi cacious on urethral swabs and urine samples.