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Journal of Clinical Microbiology, April 1999, p. 976-980, Vol. 37, No. 4
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Mailed, Home-Obtained Urine Specimens: a Reliable Screening Approach for Detecting Asymptomatic Chlamydia trachomatis Infections

Servaas A. Morré,1 Irene G. M. van Valkengoed,2 Afke de Jong,1 A. Joan P. Boeke,2 Jacques T. M. van Eijk,2 Chris J. L. M. Meijer,1 and Adriaan J. C. van den Brule1,*

Department of Pathology, Section of Molecular Pathology, University Hospital Vrije Universiteit, 1081 HV Amsterdam,1 and Institute for Research in Extramural Medicine, Vrije Universiteit, 1081 BT, Amsterdam,2 The Netherlands

Received 11 September 1998/Returned for modification 15 October 1998/Accepted 15 December 1998

The use of mailed, home-obtained urine specimens could facilitate screening programs for the detection of asymptomatic Chlamydia trachomatis infections. Since transport time could have an adverse effect on the sensitivity of C. trachomatis detection by PCR, the influence of DNA degradation on amplification was monitored over the course of 1 week. Therefore, urine specimens were aliquoted on the day of collection or arrival. Two groups of urine specimens were investigated. Group I contains first-void C. trachomatis-positive and -negative urine samples. DNA degradation was monitored in group I samples for 7 days at room temperature (RT) and at 4°C by amplifying different lengths of the human beta -globin gene and the C. trachomatis plasmid target. DNA degradation was observed only for the larger human beta -globin fragments at days 5 to 7 at RT. In contrast, at 4°C all targets could be amplified. Urine specimens were also frozen and thawed before aliquoting to mimic freezing during transport. This resulted in a lower sensitivity for the detection of C. trachomatis after thawing and 3 to 4 days at RT. In addition, mailed, home-obtained C. trachomatis-positive urine specimens (group II) were analyzed for 7 days after arrival by two commercially available C. trachomatis detection systems (PCR and ligase chain reaction [LCR]). The C. trachomatis plasmid target in mailed, home-obtained urine specimens could be amplified by both PCR and LCR after 1 week of storage and/or transport at RT. In conclusion, our findings indicate that mailed, home-obtained urine specimens are suitable for the sensitive detection of asymptomatic C. trachomatis infections by amplification methods, even if the transport time is up to 1 week at RT. These findings support the feasibility and validity of screening programs based on mailed, home-obtained urine specimens. Larger studies should be initiated to confirm our results.

* Corresponding author. Mailing address: Department of Pathology, Section of Molecular Pathology, University Hospital Vrije Universiteit, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. Phone: 31-20-4440503 or 31-20-4444023. Fax: 31-20-4442964. E-mail: vandenbrule{at}azvu.nl.

Journal of Clinical Microbiology, April 1999, p. 976-980, Vol. 37, No. 4
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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