Detection of Chlamydia trachomatis in urine specimens from women by ligase chain reaction

Abstract

The performance of a plasmid-based ligase chain reaction (LCR) with urine specimens was compared with those of cell culture of cervical swabs and enzyme immunoassay with urine specimens for the detection of Chlamydia trachomatis infection in women who had attended a family planning clinic. The prevalence of chlamydial infection determined by LCR was 3.1%. Discrepant results among the three assays were resolved by testing urine by a second LCR assay based on the C. trachomatis chromosomal gene encoding the major outer membrane protein. Sensitivity, specificity, and positive and negative predictive values for the cell cultures were 56.3, 100, 100, and 98.4%, respectively, whereas those for the enzyme immunoassay were 18.8, 100, 100, and 97.1%, respectively, and those for LCR were 87.5, 100, 100, and 99.5%, respectively. LCR thus provides a highly sensitive and specific noninvasive screening method for detecting genital chlamydial infections in women.

Evaluation of vaginal introital sampling as an alternative approach for the detection of genital Chlamydia trachomatis infection in women

“…Historically, these specimens have been successfully tested using cell culture in combination with direct immunofluorescence test (DIF) (1). Later, this diagnostic battery was complemented by enzyme immunoassay (EIA) (2,3), polymerase chain reaction (PCR) (4,5) and ligase chain reaction (LCR) (6,7).…”

“…Also, a proportion of women may harbor cervical infections only, in which case the urine would contain only limited numbers of organisms derived from cervical/vaginal secretions contaminating the urinary stream. Both male and female urine were proved to be satisfactory samples when tested by PCR or other amplification techniques (4,6,10,11). Despite the success of urine testing, inhibitors present in urine have been shown to limit the sensitivity of both PCR and LCR-based tests (12).…”

Antisperm antibodies and microorganisms in genital secretions-a clinically significant relationship?

“…The low isolation rate of C. trachomatis in endocervical material is in accordance with other studies in asymptomatic infertile women (Kane et al, 1984;Anestad et al, 1987;Eggert-Kruse et al, 198813;Sellors et al, 1988). Prevalences were slightly higher in women attending family planning clinics (3.1 "/o) (Bassiri et al, 1995)) and considerably higher in patients presenting in STD clinics ( > lo%), particularly when LCR screening is included (Schachter et al, 1994;Ridgway et al, 1996). For use in semen samples, McCoy cell culture is an inappropriate procedure to screen for C. trachomatis, and EIA is compounded by the low sensitivity, whereas LCR is a promising method to evaluate patients' ejaculates and urine.…”

Use of PCR for the detection of genital Chlamydia trachomatis infection on self-obtained mailed vaginal samples

“…(ii) Cell culture. Urethral and cervical samples were also tested by inoculation of the MacCoy cell culture as described earlier (12). To increase the sensitivity of the culture the blind passage was performed.…”