First-Void Urine Testing forChlamydia trachomatisby Polymerase Chain Reaction in Asymptomatic Women

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Background:BecauseChlamydia trachomatisinfections are usually asymptomatic or minimally symptomatic, diagnosis is often delayed.Goal:To perform a comparative study of first-void urine (FVU) polymerase chain reaction (PCR) testing and endocervical swab antigen testing in the diagnosis ofC. trachomatisinfection among asymptomatic women.Study Design:The study population consisted of 1,090 unselected women attending a family planning clinic or a university student health clinic. Calculations of test performances were based on an expanded reference standard including enzyme immunoassay (EIA) or PCR tests confirmed by direct fluorescence antibody (DFA) test or major outer membrane protein PCR test, respectively.Results:The overall prevalence ofC. trachomatisinfection was 5,6%. After resolution of discrepant specimens, FVU PCR detected 85% (52/61) and endocervical swab EIA/DFA 90% (55/61) of confirmed positive cases.Conclusions:These results indicate that the FVU PCR test is an accurate, noninvasive screening method and can replace endocervical swab EIA in the detection ofC. trachomatisinfection in low-prevalence populations.

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