HIGH PREVALENCE OF CHLAMYDIA-TRACHOMATIS INFECTIONS IN ADOLESCENT FEMALES NOT HAVING PELVIC EXAMINATIONS - UTILITY OF PCR-BASED URINE SCREENING IN URBAN ADOLESCENT CLINIC SETTING

To determine utility of polymerase chain reaction (PCR)-based urine sc reening for Chlamydia trachomatis in the care of adolescent females in an urban clinic. Methods: Females greater than or equal to 15 years o f age attending an adolescent clinic were approached consecutively. Ea ch enrollee was interviewed to determine the primary reason(s) for the clinic visit and was queried about genitourinary symptoms. Nonsterile voided urine specimens were tested for C. trachomatis using PCR-based analysis. Endocervical C. trachomatis cultures were obtained from the subjects who had a pelvic examination. Main outcome measures were chl amydia infection rates in clinic attendees whether a pelvic examinatio n was performed or not. Results: A total of 315 (99.4%) of 317 patient s approached agreed to participate. Overall, 47 (14.9%) patients had p ositive urine FCR tests. The chlamydia infection rate detected by urin e PCR was 22.1% (19 of 86) among those who had pelvic examinations per formed and 12.2% (28 of 229) among those who did not (p =.03; odds rat io 2.04; 95% confidence interval 1.02, 4.06). Sixty percent (28 of 47) of chlamydia infections identified during the study period were ident ified by the urine screening test. Conclusion: Urine screening was acc epted by vast majority of female adolescents attending the clinic irre spective of reason for the clinic visit, and was highly effective in i dentifying unsuspected C. trachomatis infections, particularly among g irls attending the clinic for reasons unrelated to reproductive health care and as an interim screening tool for adolescent family-planning clients. (C) Society for Adolescent Medicine, 1997.