Vulvovaginal-swab or first-catch urine specimen to detect Chlamydia trachomatis in women in a community setting?

Skidmore, S; Horner, P; Herring, A; Sell, J; Paul, I; Thomas, J; Caul, EO; Egger, M; McCarthy, A; Sanford, E; Salisbury, C; Macleod, J; Sterne, JA; Low, N; Chlamydia, Screening Studies (ClaSS) Project Group (2006). Vulvovaginal-swab or first-catch urine specimen to detect Chlamydia trachomatis in women in a community setting? Journal of clinical microbiology, 44(12), 4389-94. Epub 2006 Oct 25.. Washington, D.C.: American Society for Microbiology 10.1128/JCM.01060-06

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Screening for chlamydia in women is widely recommended. We evaluated the performance of two nucleic acid amplification tests for detecting Chlamydia trachomatis in self-collected vulvovaginal-swab and first-catch urine specimens from women in a community setting and a strategy for optimizing the sensitivity of an amplified enzyme immunoassay on vulvovaginal-swab specimens. We tested 2,745 paired vulvovaginal-swab and urine specimens by PCR (Roche Cobas) or strand displacement amplification (SDA; Becton Dickinson). There were 146 women infected with chlamydia. The assays detected 97.3% (95% confidence interval [CI], 93.1 to 99.2%) of infected patients with vulvovaginal-swab specimens and 91.8% (86.1 to 95.7%) with urine specimens. We tested 2,749 vulvovaginal-swab specimens with both a nucleic acid amplification test and a polymer conjugate-enhanced enzyme immunoassay with negative-gray-zone testing. The relative sensitivities obtained after retesting specimens in the negative gray zone were 74.3% (95% CI, 62.8 to 83.8%) with PCR and 58.3% (95% CI, 46.1 to 69.8%) with SDA. In community settings, both vulvovaginal-swab and first-catch urine specimens from women are suitable substrates for nucleic acid amplification tests, but enzyme immunoassays, even after negative-gray-zone testing, should not be used in screening programs.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
UniBE Contributor:	Egger, Matthias, Sterne, Jonathan, Low, Nicola
ISSN:	0095-1137
ISBN:	17065268
Publisher:	American Society for Microbiology
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 14:48
Last Modified:	05 Dec 2022 14:15
Publisher DOI:	10.1128/JCM.01060-06
PubMed ID:	17065268
Web of Science ID:	000242876300015
URI:	https://boris.unibe.ch/id/eprint/20080 (FactScience: 3198)