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Ligase chain
reaction performed on urine samples is a convenient and accurate way
to test for cure of C. trachomatis infection.
Correlation between
culture testing of swabs and ligase chain reaction of first void urine
from patients recently treated for Chlamydia trachomatis.
Jang D, Sellors J, Howard M, Mahony J, Frost
E, Patrick D, Bouchard C, Dubois J, Scholar L, Chernesky M.
Sexually
Transmitted Infections 2003;79:237-239
Summary:
Question
How does the ligase chain reaction compare to culture as a test of cure
for genital chlamydia infection?
Design
This study describes a comparison of the results of ligase chain reaction
(LCR) performed on first void urine samples with those of culture of
urethral and cervical swabs for the detection of chlamydia in three
post-treatment follow-up specimens from men and women previously diagnosed
with C. trachomatis infections.
Participants
Ten men and 19 women, who were confirmed C. trachomatis positive by
EIA or culture and by LCR on urine samples, were tested. The participants
were part of a multicenter randomized controlled trial in Vancouver,
British Columbia, Sherbrooke, Quebec, Laval, Quebec, and Regina,
Saskatchewan. The mean age was 25.2 years.
Description of Tests and Diagnostic
Standard
Four men and eight women were treated with doxycycline and 6 men and 11
women were treated with azithromycin. The patients returned for at least
two of three follow-up visits at 8, 28, and 42 days after treatment began.
To determine chlamydia status at each visit post-treatment, urethral and
cervical swabs were obtained from men and women, respectively, for
chlamydia culture, and the first 25 ml of voided urine was obtained from
all patients for LCR testing. For culture, specimens were inoculated onto
McCoy cells and stained for inclusions using fluorescent-labeled
species-specific monoclonal antibody for C. trachomatis. Urine
samples were frozen, shipped to the regional virology laboratory, and
analyzed by LCR (Abbott Laboratories, Chicago, IL). Genotyping by
restriction fragment length polymorphism (RFLP) analysis of the outer
membrane protein gene was performed on specimens from the initial and all
subsequent C. trachomatis positive samples.
Main Outcome Measures
The results of C. trachomatis culture and LCR performed on
specimens collected at 3 post-treatment visits were compared.
Main Results
All 4 men and 8 women who received doxycycline, and all 11 women and 3 of
6 men who received azithromycin were negative for C. trachomatis by
culture and LCR at all follow-up visits. The LCR, culture, and RFLP
genotyping results for 3 men taking azithromycin who had at least one C.
trachomatis positive post-treatment sample are shown in the table.
Authors' Conclusions
When test of cure is considered, LCR
performed on first void urine may be a convenient and accurate way to
monitor antibiotic success or failure in eradicating C. trachomatis
from the lower genital tract.
Source of funding: None given.
For correspondence: Dan Jang, Regional
Virology and Chlamydiology Laboratory, St. Joseph's Healthcare, 50
Charlton Avenue East, Hamilton, Ontario, L8N 4A6, Canada. E-mail address:
jangd@mcmaster.ca.
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