Detection ofNeisseria gonorrhoeaeInfection by Ligase Chain Reaction Testing of Urine Among Adolescent Women With and WithoutChlamydia trachomatisInfection

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Abstract

Background and Objectives:

Culture, the conventional method for detection ofNeisseria gonorrhoeae,requires invasive sampling and stringent specimen transport conditions. The recently developed ligase chain reaction test (LCR; Abbott Laboratories; North Chicago, IL) allows noninvasive sampling and stable transport conditions, but has not been evaluated with specimens from adolescent populations.

Goal of this Study:

To perform a comparative evaluation of a commercial LCR test and culture for the diagnosis ofN. gonorrhoeaein adolescent women.

Study design:

Urine and endocervical swab specimens from 330 teenage women seen in two public health adolescent clinics were tested by LCR and culture. For resolution of discordant results, a polymerase chain reaction (PCR) test was developed that directly amplifiesN. gonorrhoeaeDNA from urine samples processed for LCR.

Results:

Thirty-one of 330 (9.4%) cervical specimens were culture-positive forN. gonorrhoeae,and 30 of 330 (9.1%) urine specimens were positive by LCR. After resolution of 13 discordant results, the sensitivity, specificity, and positive and negative predictive values of LCR for urine were 88.2%, 100%, 100%, 98.7%, respectively, and for culture of endocervical specimens were 82.3%, 98.9%, 90.3% and 98%, respectively.

Conclusions:

Although more expensive than culture, LCR offers a sensitive means for the detection ofN. gonorrhoeaein urine samples and may be useful for this purpose in settings where pelvic examinations are difficult to perform and simultaneous detection ofN. gonorrhoeaeandChlamydia trachomatisis advantageous.

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