Feasibility and Yield of Screening Urine for Chlamydia trachomatis by Polymerase Chain Reaction Among High-Risk Male Youth in Field-Based and Other Nonclinic Settings

Rietmeijer, Cornelis A.; Yamaguchi, Keith J.; Ortiz, Charlene; Montstream, Sydney A.; Leroux, Toby; Ehret, Josephine M.; Judson, Franklyn N.; Douglas, John M.

doi:10.1097/00007435-199708000-00008

Cited by 76 publications

(29 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This observation should enable the screening of men by testing their urine in these tests. This strategy for the control of C. trachomatis and N. gonorrhoeae infections in high-risk male youth has already been shown to be successful in clinic and nonclinic settings by testing FCU by PCR (20).…”

Section: Discussionmentioning

confidence: 99%

“…Because of the very high asymptomatic infection rates in both genders, there is great interest in establishing screening programs in select populations (12,16,20). Gen-Probe Incorporated has recently introduced a new family of assays (AP-TIMA) that uses their transcription-mediated amplification (TMA) technology.…”

Section: Infection Of the Lower Genital Tracts Of Men And Women Withmentioning

confidence: 99%

“…An advance in male testing was achieved by the recognition that first-void (catch) urine (FCU) samples tested in nucleic acid amplification (NAA) assays could identify C. trachomatis and N. gonorrhoeae infections in as many symptomatic and asymptomatic men as urethral swabbing could (3). All of the present commercial NAA tests have a claim for testing male urine, and in many settings this has become the standard of practice for diagnosing male infections.Because of the very high asymptomatic infection rates in both genders, there is great interest in establishing screening programs in select populations (12,16,20). Gen-Probe Incorporated has recently introduced a new family of assays (AP-TIMA) that uses their transcription-mediated amplification (TMA) technology.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Ability of New APTIMA CT and APTIMA GC Assays To Detect Chlamydia trachomatis and Neisseria gonorrhoeae in Male Urine and Urethral Swabs

et al. 2005

View full text Add to dashboard Cite

A clinical evaluation was conducted in six North American centers to determine the ability of APTIMA CT (ACT) and APTIMA GC (AGC) nucleic acid amplification assays to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections in 1,322 men by testing their urethral swabs and first-catch urine (FCU). The results obtained with ACT and AGC assays were compared to an infected patient status determined by testing the specimens with the APTIMA Combo 2 and the BD ProbeTec energy transfer multiplex assays. Symptoms did not influence the values. Positive and negative agreements of the ACT and AGC assays for individual specimens were high, with each comparator assay ranging between 94.3 and 100% for positives and 93.9 and 99.4% for negatives. The ACT and AGC assays performed on noninvasive specimens such as FCU effectively identified C. trachomatis or N. gonorrhoeae infections in symptomatic and asymptomatic men and should be suitable for screening male populations. Infection of the lower genital tracts of men and women withChlamydia trachomatis or Neisseria gonorrhoeae is a common occurrence worldwide. Most of these infections occur in sexually active younger patients without symptoms of urethritis or cervicitis (2). Undiagnosed and untreated infections lead to epidemic spread and a high risk of bacterial invasion of the upper genital tract. Upper genital tract infections in women are characterized by pelvic inflammatory disease, ectopic pregnancy, and tubal infertility. Traditional sampling of men involved collection of a urethral swab (US). Many infected men are asymptomatic (18,21). Asymptomatic men are unlikely to consent to collection of invasive swabs. An advance in male testing was achieved by the recognition that first-void (catch) urine (FCU) samples tested in nucleic acid amplification (NAA) assays could identify C. trachomatis and N. gonorrhoeae infections in as many symptomatic and asymptomatic men as urethral swabbing could (3). All of the present commercial NAA tests have a claim for testing male urine, and in many settings this has become the standard of practice for diagnosing male infections.Because of the very high asymptomatic infection rates in both genders, there is great interest in establishing screening programs in select populations (12,16,20). Gen-Probe Incorporated has recently introduced a new family of assays (AP-TIMA) that uses their transcription-mediated amplification (TMA) technology. These assays include the APTIMA CT (ACT) assay, which detects C. trachomatis; the APTIMA GC (AGC) assay for detecting N. gonorrhoeae; and the APTIMA Combo 2 (AC2) assay, which detects both organisms. They are second-generation NAA tests that utilize target capture, TMA, and hybridization protection assay technologies to remove potential inhibitors from samples, amplify target rRNA, and detect amplicons, respectively. The ACT and AGC use oligonucleotides that target rRNA sequences different from those of the AC2, but the procedures for the three assays are the same.We conducted a prospective multicenter...

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Infection Of the Lower Genital Tracts Of Men And Women Withmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Ability of New APTIMA CT and APTIMA GC Assays To Detect Chlamydia trachomatis and Neisseria gonorrhoeae in Male Urine and Urethral Swabs

et al. 2005

View full text Add to dashboard Cite

show abstract

“…In turn, these simplified specimen collection procedures now permit highly sensitive [1][2][3][4] testing for treatable sexually transmitted diseases (STDs) in nonclinical sites and at other locations of convenience where at-risk persons might congregate. [5][6][7][8] A growing literature supports the association between drugs (including alcohol) and high-risk sexual behavior. [9][10][11][12] Most of these studies, however, focused on persons who were actively using drugs.…”

Section: Introductionmentioning

confidence: 99%

Risk and prevalence of treatable sexually transmitted diseases at a Birmingham substance abuse treatment facility

Bachmann

Lewis²,

Allen³

et al. 2000

Am J Public Health

View full text Add to dashboard Cite

OBJECTIVES: We evaluated the prevalence of gonorrhea, chlamydia, trichomoniasis, and syphilis in patients entering residential drug treatment. METHODS: Data on sexual and substance abuse histories were collected. Participants provided specimens for chlamydia and gonorrhea ligase chain reaction testing. Trichomonas vaginalis culture, and syphilis serologic testing. RESULTS: Of 311 patients, crack cocaine use was reported by 67% and multisubstance use was reported by 71%. Sexually transmitted disease (STD) risk behaviors were common. The prevalence of infection was as follows: Chlamydia trachomatis, 2.3%; Neisseria gonorrhoeae, 1.6%; trichomoniasis, 43%; and syphilis, 6%. CONCLUSIONS: STD counseling and screening may be a useful adjunct to inpatient drug treatment.

show abstract

“…Nucleic acid amplification tests (NAAT), including PCR, ligase chain reaction (LCR), strand displacement assay, and transcription-mediated amplification, are more sensitive for the diagnosis of C. trachomatis than culture, nonamplified DNA probe, and antigen detection tests and maintain relatively high specificity (1, 2). Equally important, the ability to perform NAAT on urine and self-collected vaginal swabs has expanded opportunities for screening men and women (7,10,11,14,21,26,28,29).…”

mentioning

confidence: 99%

Impact of Patient Characteristics on Performance of Nucleic Acid Amplification Tests and DNA Probe for Detection of Chlamydia trachomatis in Women with Genital Infections

et al. 2005

View full text Add to dashboard Cite

The performance of nucleic acid amplified tests (NAAT) for Chlamydia trachomatis at the cervix and in urine was examined in 3,551 women, and the impacts of clinical findings (age, endocervical and urethral inflammation, menses, and gonococcal coinfection) were assessed. Ligase chain reaction (LCR) and first-generation uniplex PCR were studied relative to an unamplified DNA probe (PACE2) and to an expanded, independent diagnostic reference standard. Relative to the expanded standard, cervical or urine LCR was generally the most sensitive test in most subgroups. Increased detection by NAAT of cervical C. trachomatis over PACE2 was highest among women without mucopurulent endocervical discharge versus those with (relative increase in positivity with cervical LCR, 46%) and among women >20 years old versus younger women (relative increase in positivity with cervical LCR, 45%). The sensitivity of cervical PCR was highest when mucopurulent endocervical discharge was present (84%) and highest for cervical LCR when cervical gonococcal coinfection was detected (91%). Urethral inflammation was associated with higher sensitivities of urine LCR (86 compared to 70% when inflammation was absent) and PCR (82 compared to 62% when inflammation was absent). Menses had no effect on test performance. The effects of patient characteristics on test specificities were less pronounced and were closely related to observed sensitivities. These findings support expanded use of NAAT for screening and diagnosis of C. trachomatis in diverse clinical populations of women.Genital infection with Chlamydia trachomatis is the most commonly reported bacterial disease in the United States and has well-established adverse effects on the reproductive health of women (4, 23). Nucleic acid amplification tests (NAAT), including PCR, ligase chain reaction (LCR), strand displacement assay, and transcription-mediated amplification, are more sensitive for the diagnosis of C. trachomatis than culture, nonamplified DNA probe, and antigen detection tests and maintain relatively high specificity (1, 2). Equally important, the ability to perform NAAT on urine and self-collected vaginal swabs has expanded opportunities for screening men and women (7,10,11,14,21,26,28,29).Our understanding of the clinical manifestations of chlamydial infections in women, including endocervical and urethral inflammation, has been based largely on studies using non-NAAT for detection of infection. Similarly, selective screening criteria for identifying cervical chlamydial infection have been based on risk factors as defined by various non-NAAT. NAAT, however, can detect the presence of fewer chlamydial elementary bodies than non-NAAT (1). Accordingly, among men with urethral chlamydial infection, NAAT demonstrate the greatest increase in sensitivity over non-NAAT in asymptomatic men without urethral inflammation (22). One possible explanation for this is that the quantity of elementary bodies appears to correlate directly with signs of inflammation in men and women and with the prese...

show abstract

Feasibility and Yield of Screening Urine for Chlamydia trachomatis by Polymerase Chain Reaction Among High-Risk Male Youth in Field-Based and Other Nonclinic Settings

Cited by 76 publications

References 7 publications

Ability of New APTIMA CT and APTIMA GC Assays To Detect Chlamydia trachomatis and Neisseria gonorrhoeae in Male Urine and Urethral Swabs

Ability of New APTIMA CT and APTIMA GC Assays To Detect Chlamydia trachomatis and Neisseria gonorrhoeae in Male Urine and Urethral Swabs

Risk and prevalence of treatable sexually transmitted diseases at a Birmingham substance abuse treatment facility

Impact of Patient Characteristics on Performance of Nucleic Acid Amplification Tests and DNA Probe for Detection of Chlamydia trachomatis in Women with Genital Infections

Contact Info

Product

Resources

About