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Journal of Clinical Microbiology, May 1998, p. 1300-1304, Vol. 36, No. 5
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Use of Ligase Chain Reaction with Urine versus Cervical Culture
for Detection of Chlamydia trachomatis in an Asymptomatic
Military Population of Pregnant and Nonpregnant Females Attending
Papanicolaou Smear Clinics
Charlotte A.
Gaydos,1,*
M. Rene
Howell,1
Thomas C.
Quinn,1,2
Joel C.
Gaydos,3,
and
Kelly T.
McKee Jr.4
Infectious Disease Division, The Johns
Hopkins University, Baltimore,1
National
Institute of Allergy and Infectious Diseases, National Institutes
of Health, Bethesda,2 and
U.S. Army
Center for Health Promotion and Preventive Medicine, Aberdeen
Proving Ground,3 Maryland, and
Preventive Medicine Service, Womack Army Medical Center,
Fort Bragg, North Carolina4
Received 13 November 1997/Returned for modification 27 January
1998/Accepted 16 February 1998
Ligase chain reaction (LCR) (Abbott Laboratories, Abbott Park,
Ill.) with first-catch urine specimens was used to detect
Chlamydia trachomatis infections in 465 asymptomatic
military women attending clinics for routine Papanicolaou smear tests.
Results were compared to results of cervical culture to determine the
sensitivity of the urine LCR and the possible presence of inhibitors of
amplification in pregnant and nonpregnant women. Discrepant results for
LCR and culture were resolved by direct fluorescent antibody staining of culture sediments, two different PCR assays, and LCR for the outer
membrane protein 1 gene. The prevalence of Chlamydia in specimens by urine LCR was 7.3% compared to 5% by culture. For 434 women with matching specimens, there were 11 more specimens positive by
LCR than were positive by culture, of which all but one were determined
to be true positives. There were four culture-positive, LCR-negative
specimens, all from nonpregnant women. The sensitivity, specificity,
and positive and negative predictive values of urine LCR after
discrepant results were resolved were 88.6, 99.7, 96.9, and 99.0%,
respectively. The sensitivity of culture was 71.4%. From the 148 pregnant women (prevalence by LCR, 6.8%), there were no patients who
were cervical culture positive and urine LCR negative to indicate the
presence in pregnant women of inhibitors of LCR. Additionally, a subset
of 55 of the LCR-negative frozen urine specimens from pregnant women
that had been previously processed in LCR buffer were inoculated with 5 cell culture inclusion forming units of C. trachomatis each
and retested by LCR; all tested positive, indicating the absence of
inhibitors of LCR in urine from these pregnant women. The use of LCR
testing of urine specimens from asymptomatic women, whether pregnant or
not, offers a sensitive and easy method to detect C. trachomatis infection in women.
*
Corresponding author. Mailing address: The Johns
Hopkins University, Infectious Disease Division, 1159 Ross Research
Building, 720 Rutland Ave., Baltimore, MD 21205. Phone: (410) 614-0932. Fax: (410) 955-7889. E-mail:
cgaydos{at}welchlink.welch.jhu.edu.
Present address: Jackson Foundation, Rockville, Md.
Journal of Clinical Microbiology, May 1998, p. 1300-1304, Vol. 36, No. 5
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
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