DETECTION OF CHLAMYDIA-TRACHOMATIS BY POLYMERASE CHAIN-REACTION ASSAYIN NONBACTERIAL PROSTATITIS

Objective To evaluate the sensitivity and specificity of polymerase ch ain reaction (PCR) technique in comparison with diethylaminoethyl-dext ran (DEAE-dextran)-treated HeLa cell culture method for detection of c hlamydia trachomatis in nonbacterial prostatitis. Methods Thirty patie nts had symptoms of prostatitis for at least three months. None of the m had evidence of urethritis on urethral Gram stain or recurrent bacte ria. Routine localization of bacteria was negative. White blood cell c ount in expressed prostatic secretion (EPS) was more than 10 per high- power field (10/HPF). None of these patients had received antibiotics during the six weeks before the study, although all had received multi ple courses of antibiotics for treatment of prostatitis syndrome. The EPS specimens from these patients were placed in 0.5-ml Eppendorf tube s and stored at -70 degrees C until they were processed for PCR and DE AE-dextran-treated HeLa cell culture. Results Six specimens were posit ive for C. trachomatis by both PCR and culture, and 21 were negative b y both tests. There were three specimens with discrepant results, incl uding two that were positive by PCR and negative by culture, and one t hat was positive by culture and negative by PCR. Comparing PCR techniq ue with culture method, the sensitivity, specificity, positive predict ive value and negative predictive value of the former were 85.7%, 91.3 %, 75.0% and 95.5% respectively. Conclusions PCR analysis of EPS is a highly sensitive and specific noninvasive technique for detection of c hlamydia trachomatis. II provides a unique opportunity for early ident ification of or rapid screening for chlamydia trachomatis infection in patients with nonbacterial prostatitis. The reliability of PCR assay offers clinicians a clear indication for the initiation of treatment o f chlamydia trachomatis infection.