First-void urine testing for Chlamydia trachomatis by polymerase chain reaction in asymptomatic women

Background: Because Chlamydia trachomatis infections are usually asymptomatic or minimally symptomatic, diagnosis is often delayed. Goal: To perform a comparative study of first-void urine (FVU) polymerase chain reaction (PCR) testing and endocerv ical swab antigen testing in the diagnosis of C. trachomatis infection among asymptomatic women. Study Design: The study population consisted of 1,090 unselected women attending a family planning clinic or: a university student health clinic. Calculations of test performances were based on an expanded reference standard including enzyme immunoassay (EIA) or PCR tests confirmed by direct fluorescence antibody (DFA) test or major outer membrane protein PCR test, respectively. Results: The overall prevalence of C. trachomatis infection was 5,6%. After resolution of discrepant specimens, FVU PCR detected 85% (52/61) and endocervical swab EIA/DFA 90% (55/61) of confirmed positive cases. Conclusions: These results indicate that the PW PCR test is an accurate, noninvasive screening method and can replace endocervical swab EIA in the detection of C. trachomatis infection in low-prevalence populations.