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Noninvasive detection of Chlamydia trachomatis urethritis in men by a rapid enzyme immunoassay test
D G Ferris1, W H Martin, D M Mathis
1Department of Family Medicine, Medical College of Georgia, Augusta 30912.
Background:
The purpose of this investigation was to evaluate the ability of a rapid enzyme immunoassay test to noninvasively detect Chlamydia trachomatis urethritis in men from a urine specimen.
Methods:
Urethral samples and urine from 207 patients were evaluated. Urethral and urine sediment Gram stains, leukocyte esterase dipstick tests, and enzyme immunoassay analyses of centrifuged and uncentrifuged urine were compared with urethral C trachomatis culture.
Results:
The prevalence of infection in this population was 10.3%. Sensitivity and specificity of the enzyme immunoassay on the centrifuged urine specimen were 70% and 96%, respectively. The positive and negative predictive values were 67% and 97%, respectively. The uncentrifuged urine enzyme immunoassay sensitivity was 35.7% and specificity was 98.9%. Leukocyte esterase test sensitivity compared with that of the Neisseria gonorrhoeae and/or C trachomatis cultures was 83.3%, and specificity was 52%.
Conclusions:
The rapid enzyme immunoassay clinically complemented the screening urine sediment Gram stain and the leukocyte esterase test. The judicious use of a noninvasive C trachomatis rapid enzyme immunoassay test to identify organism-specific urethritis may improve patient management of sexually transmitted disease.