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Pilot study to assess the presence of Chlamydia trachomatis in urine from 18-30-year-old males using EIA/IF and PCR
  1. Adriana Basarab, MRCP, MRCPath, Consultant Medical Microbiology,
  2. David Browning, AIBMS, Medical Laboratory Scientific Officer,
  3. Stuart Lanham, MSc, PhD, Researcher and
  4. Susan O'Connell, LRCPSI, DipClinMicro, Associate Specialist in Medical Microbiology
  1. Southampton General Hospital, Southampton, UK
  1. Correspondence Dr Adriana Basarab, Public Health Laboratory, Level B, Laboratory and Pathology Block, Southampton General Hospital, Southampton SO16 6YD, UK. Email: Adriana.Basarab{at}suht.swest.nhs.uk

Abstract

Context To increase detection, urine samples from young males could be opportunistically tested for Chlamydia trachomatis.

Objective To determine C. trachomatis prevalence in urine, optimum specimen and compare sensitivity/feasibility of routine use of different testing methods.

Design Group A, 'sterile' pyuria samples June 1998-January 1999, tested by enzyme immunoassay (EIA) and, if reactive, by immunofluorescence (IF). Subsequently batch-tested by polymerase chain reaction (PCR). Group B, consecutive urine samples October 1998-January 1999; batch-tested by PCR.

Setting Microbiology laboratory.

Samples From males aged 18-30 years; group A = 71, group B = 83.

Main outcome measures Chlamydia trachomatis positive if EIA- and IF- or PCR-positive.

Results Group A: 12 EIA/IF-positive; 9/12 and 15 EIA-negative samples PCR-positive. Group B: 11 PCR-positive; 8/11 showed 'sterile' pyuria.

Conclusions Opportunistic testing of urine from young men shows a significant number of C. trachomatis infections. 'Sterile' pyuria samples are optimal. EIA/IF are less sensitive than PCR but can be routinely performed and detect a significant proportion of cases.

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