Diagnosis of Chlamydia trachomatis genitourinary infection in women by ligase chain reaction assay of urine

Lee, H H; Chernesky, Max; Schachter, Julius; Burczak, John D.; Andrews, W. H.; Muldoon, Sharon; Leckie, Gregor; Stamm, Walter E.

doi:10.1016/s0140-6736(95)90221-x

Cited by 332 publications

(173 citation statements)

References 22 publications

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“…Similarly, the cell pellet obtained from 1 ml of a FVU specimen by centrifugation for 15 min at 17,000 ϫ g (Megafuge 1.0R; Hereaus, Osterode, Germany) was dissolved in 1 ml of LCx urine extraction buffer and heat treated as for the swab specimens. All assays were performed by experienced laboratory technicians with 100 l of sample per amplification according to the manufacturer's instructions (16,31). The remaining extracts of positive swabs and positive urine samples were stored at Ϫ80°C and tested by quantitative LCR (QLCR) within 2 months of collection.…”

Section: Study Participantsmentioning

confidence: 99%

“…A partially purified preparation of EBs from C. trachomatis (serovar L1), which is readily propagated in buffalo green monkey kidney cells, was provided by I. Clarke (University of Southampton, United Kingdom) and used as the standard for EB quantitation. Although most of the infected patients were likely to harbor C. trachomatis serovars D through K, the primer sets for both the LCR and QPCR assays correspond to conserved regions of the C. trachomatis cryptic plasmid and are therefore able to detect all C. trachomatis serovars (16,21,31). The EB concentration of the standard was determined by electron microscopy.…”

Section: Study Participantsmentioning

confidence: 99%

“…Infected cells are shed from the endocervix into the vagina and are present in vaginal secretions. Infected epithelial cells from the urethra and the associated C. trachomatis elementary bodies (EBs) can also be detected in first-void urine (FVU) (3,16). Potentially suitable clinical specimens for detection of chlamydial infection in women thus include urethral, vaginal, and endocervical swabs, self-inserted tampons, and FVU samples (3,12).…”

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confidence: 99%

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Chlamydia trachomatis Load at Matched Anatomic Sites: Implications for Screening Strategies

et al. 2007

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Urethral and endocervical swabs and self-collected vaginal swabs (SCVSs) and urine specimens are all used as samples for diagnosis of urogenital infection with Chlamydia trachomatis. We have now determined chlamydial organism load in matched specimens from different anatomic sites and examined its relation to clinical signs and symptoms in men and women. Organism load was measured with assays based on the ligase chain reaction or real-time PCR analysis. The mean organism loads in 58 infected men were 1,200 and 821 elementary bodies (EBs) per 100 l of sample for first-void urine (FVU) and urethral swabs, respectively (P > 0.05). Organism load in FVU samples or urethral swabs was positively associated with symptoms (P < 0.01) and clinical signs (P < 0.01) in men. The mean organism loads in 73 infected women were 2,231, 773, 162, and 47 EBs/100 l for endocervical swabs, SCVSs, urethral swabs, and FVU samples, respectively (P < 0.001 for each comparison). Only the presence of multiple symptoms or clinical signs was associated with organism load in women. These results show that FVU is a suitable noninvasive sample type for men, given the fact that its chlamydial load did not differ significantly from that of urethral swabs. Given their higher organism load compared with FVU, SCVSs are the preferred noninvasive sample type for women.Urogenital infection with Chlamydia trachomatis is the most commonly reported bacterial sexually transmitted infection (STI) and continues to be a major public health problem worldwide (4, 35). Given that most chlamydial infections are asymptomatic in both men and women, they often remain undiagnosed and untreated and therefore provide a reservoir for the disease (33). Infection of the upper genital tract may lead to complications, such as epididymitis in men and pelvic inflammatory disease in women. The inflammation and subsequent tissue scarring associated with the latter can lead to more serious sequelae (4).Effective control of chlamydial infection within a population requires early diagnosis and prompt treatment of asymptomatic individuals (28). Targeted and regular screening is also recommended for people in high-risk groups or with a past history of genital chlamydial infection (14). The most common sites of infection in women are the cervix and urethra. Infected cells are shed from the endocervix into the vagina and are present in vaginal secretions. Infected epithelial cells from the urethra and the associated C. trachomatis elementary bodies (EBs) can also be detected in first-void urine (FVU) (3, 16). Potentially suitable clinical specimens for detection of chlamydial infection in women thus include urethral, vaginal, and endocervical swabs, self-inserted tampons, and FVU samples (3, 12). For screening programs, noninvasive specimens, such as vaginal swabs, tampons, and FVU, are preferable to invasive urethral and endocervical swabs because they overcome several barriers associated with the traditional diagnostic pathway (5, 11). Sensitivity of C. trachomatis detection with vag...

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Section: Study Participantsmentioning

confidence: 99%

Section: Study Participantsmentioning

confidence: 99%

mentioning

confidence: 99%

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Chlamydia trachomatis Load at Matched Anatomic Sites: Implications for Screening Strategies

et al. 2007

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“…5 Nucleic acid amplification testing of urine specimens can now detect Neisseria gonorrhoeae and C trachomatis with high sensitivity and specificity. 6,7 Previous screening studies have demonstrated high prevalence rates of asymptomatic chlamydial infection in family planning centers, adolescent health facilities, detention centers, school-and community-based clinics, and military settings. [8][9][10][11][12][13][14][15] The emergency department represents another health care access site for identifying persons with asymptomatic STIs.…”

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confidence: 99%

Emergency department screening for asymptomatic sexually transmitted infections

Todd

Haase²,

Stoner³

2001

Am J Public Health

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OBJECTIVES: This study assessed the prevalence and correlates of asymptomatic genital tract infection with Neisseria gonorrhoeae and Chlamydia trachomatis among emergency department patients. METHODS: Individuals seeking emergency department evaluation for nongenitourinary complaints provided urine samples for N gonorrhoeae and C trachomatis testing by ligase chain reaction and completed a sociodemographic and behavioral questionnaire. RESULTS: Asymptomatic N gonorrhoeae or C trachomatis was found in 9.7% of persons tested. Correlates of C trachomatis infection included younger age, residence in high-morbidity zip code areas, previous history of N gonorrhoeae or C trachomatis, and number of sex partners in the past year. CONCLUSIONS: Urine-based screening of asymptomatic emergency department patients detected significant numbers of N gonorrhoeae and C trachomatis infections. Targeted screening programs may contribute to community-level prevention and control of sexually transmitted infections.

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“…New test systems that no longer require invasive collection of clinical specimens have been developed for both STDs and HIV infection. 26,27 Therefore, patients with infections or concerns about infections can be tested outside of clinical settings. This has implications for screening and outreach activities in many populations.…”

Section: Current Integration Effortsmentioning

confidence: 99%