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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,dagger 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.

dagger 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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