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Journal of Clinical Microbiology, June 1998, p. 1489-1493, Vol. 36, No. 6
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Comparison of Performances of Two Commercially Available Tests, a PCR Assay and a Ligase Chain Reaction Test, in Detection of Urogenital Chlamydia trachomatis Infection

Mirja Puolakkainen,1,* Eija Hiltunen-Back,2 Timo Reunala,2 Satu Suhonen,3 Pekka Lähteenmäki,3 Matti Lehtinen,4 and Jorma Paavonen5

Haartman Institute, Department of Virology,1 and Departments of Dermatology and Venereology2 and Obstetrics and Gynecology,5 University of Helsinki, Family Federation of Finland,3 and Department of Infectious Disease Epidemiology, National Public Health Institute,4 Helsinki, Finland

Received 23 September 1997/Returned for modification 16 January 1998/Accepted 19 February 1998

The diagnostic performance of a PCR test (Roche Cobas Amplicor CT/NG Test) and that of a ligase chain reaction (LCR) test (Abbott LCx Chlamydia trachomatis assay) were compared by using endocervical and urethral swab specimen culture as a reference test. First-void urine (FVU) and endocervical and urethral swab specimens were collected from 1,015 unselected patients attending a sexually transmitted disease clinic and a clinic for adolescents in Helsinki, Finland. Chlamydia trachomatis was cultured from samples from the endocervix or urethra. PCR was performed with fresh and frozen urine and the culture transport medium. LCR was performed with fresh and frozen urine and LCx swab transport medium. Diagnostic consistency and diagnostic accuracy were statistically tested. The test results were identical for 984 patients (97%). Discrepant results were observed for 31 patients. Overall, LCR and PCR showed excellent kappa coefficients of consistency for both swab and FVU specimens (0.93 and 0.95, respectively). Sixty-one patients (6%) were culture positive. Testing of FVU by LCR or PCR increased the overall positivity rates to 7.0 and 7.7%, respectively. While PCR of FVU detected the greatest number of C. trachomatis infections (sensitivity, 96.1%), for some PCR-positive FVU specimens the results could not be confirmed (specificity, 99.6%). PCR and LCR were more sensitive than culture (sensitivities, 92 and 93% versus 79% for culture) in the diagnosis of genital C. trachomatis infection. In conclusion, both tests can be recommended for use in the clinical laboratory and for the screening of asymptomatic C. trachomatis infections.

* Corresponding author. Mailing address: Haartman Institute, Department of Virology, P.O. Box 21, FIN-00014 University of Helsinki, Helsinki, Finland. Phone: 358-9-43461. Fax: 358-9-4346491. E-mail: Mirja.Puolakkainen{at}Helsinki.fi.

Journal of Clinical Microbiology, June 1998, p. 1489-1493, Vol. 36, No. 6
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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