Original article
A comparison of urine and urethral swabbing for the diagnosis of C. trachomatis infection in males

https://doi.org/10.1016/0888-0786(90)90061-RGet rights and content

Abstract

First catch early morning urine (FCU) samples from a male population were compared with urethral swabbing to access the prevalence of symptomatic and asymptomatic Chlamydia trachomatis infection using an enzyme immunoassay (IDEIA). Syva “Microtrak” was used as the “gold” standard to detect C. trachomatis from smears prepared from all urine samples in this study. The sensitivity and specificity of the IDEIA assay compared to the “gold” standard was 97·7% and 98·6%, respectively. Of the 615 male patients screened for C. trachomatis 420 (68%) were asymptomatic and 179 (29%) patients were diagnosed as having non-gonococcal urethritis. A further 16 patients had minimal signs and symptoms. Overall C. trachomatis was detected in 103 (16·7%) male patients. Of the 195 patients presenting with symptoms 42% had C. trachomatis detected. Nine of the 103 positive patients failed to provide a FCU, therefore a valid comparison was made between FCU and urethra swabbing from 94 positive and 512 negative patients. Twenty-one of the 94 positive patients were asymptomatic and antigen was detected from 2021 in FCU compared with 721 from urethra swabs. In summary 9094 (95·7%) positive patients were diagnosed by examination of FCU compared with 5994 (62·7%) by examination of urethral swabs.

FCU is an ideal sample for the detection of C. trachomatis in both symptomatic and asymptomatic male patients. This non-invasive technique is more acceptable to the patient and clinician and would allow the widespread screening of C. trachomatis from the male population.

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