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Detection of Chlamydia trachomatis in general practice urine samples
M S Dryden1, M Wilkinson, M Redman
1Department of Microbiology, Royal Hampshire County Hospital, Winchester.
Summary
Chlamydia trachomatis is often missed in general practice, causing urinary symptoms. Screening sterile pyuria samples for chlamydial antigen in young adults is cost-effective and medically beneficial.
Area of Science:
- Medical Microbiology
- Public Health
- Diagnostic Immunology
Background:
- Chlamydia trachomatis is a common cause of dysuria and urinary frequency, frequently overlooked in general practice.
- Genitourinary infections require timely diagnosis and treatment to prevent complications and onward transmission.
Purpose of the Study:
- To assess the impact of chlamydial antigen detection on sterile pyuria samples from patients aged 16-65.
- To evaluate the cost-effectiveness of screening for Chlamydia trachomatis in a hospital microbiology laboratory setting.
Main Methods:
- Enzyme immunoassay and direct immunofluorescence were used for chlamydial antigen detection.
- Questionnaires were distributed to general practitioners to gather data on patient management and treatment outcomes.
- Cost analysis was performed to estimate the screening program's cost per cure.
Main Results:
- Chlamydial antigen was detected in 5% (54/1025) of sterile pyuria samples, with higher rates in the 16-20 age group.
- 59% of positive cases were referred for specialist treatment and contact tracing; the remainder were treated by general practitioners.
- The estimated cost per cure for the screening program was 246 pounds.
Conclusions:
- Chlamydia trachomatis is a significant pathogen that can remain undiagnosed and untreated.
- Screening for chlamydial antigen in sterile pyuria samples, particularly in young adults (16-30 years), is medically and financially beneficial compared to ignoring the infection.
- General practitioners should consider chlamydial infection in young adults with sterile pyuria, and laboratories should implement antigen screening for Chlamydia trachomatis.