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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