Urine-Based Screening for Chlamydia trachomatis in Men Attending Sexually Transmitted Disease Clinics
Background: Nucleic acid-amplified tests for Chlamydia trachomatis are accurate but costly. Screening strategies for asymptomatic men are needed. Goal: To assess C trachomatis screening strategies for asymptomatic males. Study Design: Men attending a sexually transmitted disease clinic were tested f...
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| Veröffentlicht in: | Sexually transmitted diseases 2001-04, Vol.28 (4), p.219-225 |
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| creator | MARRAZZO, JEANNE M. WHITTINGTON, WILLIAM L. H. CELUM, CONNIE L. HANDSFIELD, H. HUNTER CLARK, AGNES CLES, LINDA KREKELER, BARBARA STAMM, WALTER E. |
| description | Background: Nucleic acid-amplified tests for Chlamydia trachomatis are accurate but costly. Screening strategies for asymptomatic men are needed. Goal: To assess C trachomatis screening strategies for asymptomatic males. Study Design: Men attending a sexually transmitted disease clinic were tested for C trachomatis with ligase chain reaction and culture, and for urethral inflammation with urine leukocyte esterase and urethral Gram stain. Results: C trachomatis prevalence was 5.5% among 1,625 asymptomatic men. Ligase chain reaction increased detection by 49% among men without urethral inflammation. An age of younger than 25 years and urethral inflammation were associated with positive ligase chain reaction results. The negative predictive value of urine leukocyte esterase was highest among older men, but urethral Gram stain was equally sensitive in predicting infection regardless of age. An age of younger than 30 years or urethral inflammation identified the highest proportion of infections (92%) and reduced the percentage of men screened by 43%. Conclusions: Urine ligase chain reaction increased C trachomatis detection, particularly among men without urethral inflammation. Testing all asymptomatic men younger than 30 years is optimal, whereas negative urine leukocyte esterase or urethral Gram stain results in men 30 years or older support no testing. |
| doi_str_mv | 10.1097/00007435-200104000-00006 |
| format | Article |
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H. ; CELUM, CONNIE L. ; HANDSFIELD, H. HUNTER ; CLARK, AGNES ; CLES, LINDA ; KREKELER, BARBARA ; STAMM, WALTER E.</creator><creatorcontrib>MARRAZZO, JEANNE M. ; WHITTINGTON, WILLIAM L. H. ; CELUM, CONNIE L. ; HANDSFIELD, H. HUNTER ; CLARK, AGNES ; CLES, LINDA ; KREKELER, BARBARA ; STAMM, WALTER E.</creatorcontrib><description>Background: Nucleic acid-amplified tests for Chlamydia trachomatis are accurate but costly. Screening strategies for asymptomatic men are needed. Goal: To assess C trachomatis screening strategies for asymptomatic males. Study Design: Men attending a sexually transmitted disease clinic were tested for C trachomatis with ligase chain reaction and culture, and for urethral inflammation with urine leukocyte esterase and urethral Gram stain. Results: C trachomatis prevalence was 5.5% among 1,625 asymptomatic men. Ligase chain reaction increased detection by 49% among men without urethral inflammation. An age of younger than 25 years and urethral inflammation were associated with positive ligase chain reaction results. The negative predictive value of urine leukocyte esterase was highest among older men, but urethral Gram stain was equally sensitive in predicting infection regardless of age. An age of younger than 30 years or urethral inflammation identified the highest proportion of infections (92%) and reduced the percentage of men screened by 43%. Conclusions: Urine ligase chain reaction increased C trachomatis detection, particularly among men without urethral inflammation. Testing all asymptomatic men younger than 30 years is optimal, whereas negative urine leukocyte esterase or urethral Gram stain results in men 30 years or older support no testing.</description><identifier>ISSN: 0148-5717</identifier><identifier>EISSN: 1537-4521</identifier><identifier>DOI: 10.1097/00007435-200104000-00006</identifier><identifier>PMID: 11318253</identifier><identifier>CODEN: STRDDM</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Age Factors ; Bacterial diseases ; Bacterial diseases of the genital system ; Biological and medical sciences ; Carboxylic Ester Hydrolases - urine ; Chlamydia Infections - diagnosis ; Chlamydia Infections - epidemiology ; Chlamydia Infections - urine ; Chlamydia trachomatis - isolation & purification ; Clinics ; Gentian Violet ; Human bacterial diseases ; Humans ; Infectious diseases ; Ligase Chain Reaction - methods ; Male ; Mass Screening - methods ; Mass Screening - standards ; Medical sciences ; Medical screening ; Men ; Phenazines ; Predictive Value of Tests ; Prevalence ; Sensitivity and Specificity ; Sexually transmitted diseases ; STD ; Urethra - microbiology ; Urethritis - microbiology ; Urine</subject><ispartof>Sexually transmitted diseases, 2001-04, Vol.28 (4), p.219-225</ispartof><rights>Copyright © 2001 American Sexually Transmitted Diseases Association</rights><rights>2002 INIST-CNRS</rights><rights>Copyright Lippincott Williams & Wilkins Apr 2001</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c440t-d6d86ed0f6256a67225a896554941b372347f758b9651ef0b0275059c8fc32593</citedby><cites>FETCH-LOGICAL-c440t-d6d86ed0f6256a67225a896554941b372347f758b9651ef0b0275059c8fc32593</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/44965465$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/44965465$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,780,784,803,27924,27925,30999,58017,58250</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=13406962$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11318253$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MARRAZZO, JEANNE M.</creatorcontrib><creatorcontrib>WHITTINGTON, WILLIAM L. H.</creatorcontrib><creatorcontrib>CELUM, CONNIE L.</creatorcontrib><creatorcontrib>HANDSFIELD, H. HUNTER</creatorcontrib><creatorcontrib>CLARK, AGNES</creatorcontrib><creatorcontrib>CLES, LINDA</creatorcontrib><creatorcontrib>KREKELER, BARBARA</creatorcontrib><creatorcontrib>STAMM, WALTER E.</creatorcontrib><title>Urine-Based Screening for Chlamydia trachomatis in Men Attending Sexually Transmitted Disease Clinics</title><title>Sexually transmitted diseases</title><addtitle>Sex Transm Dis</addtitle><description>Background: Nucleic acid-amplified tests for Chlamydia trachomatis are accurate but costly. Screening strategies for asymptomatic men are needed. Goal: To assess C trachomatis screening strategies for asymptomatic males. Study Design: Men attending a sexually transmitted disease clinic were tested for C trachomatis with ligase chain reaction and culture, and for urethral inflammation with urine leukocyte esterase and urethral Gram stain. Results: C trachomatis prevalence was 5.5% among 1,625 asymptomatic men. Ligase chain reaction increased detection by 49% among men without urethral inflammation. An age of younger than 25 years and urethral inflammation were associated with positive ligase chain reaction results. The negative predictive value of urine leukocyte esterase was highest among older men, but urethral Gram stain was equally sensitive in predicting infection regardless of age. An age of younger than 30 years or urethral inflammation identified the highest proportion of infections (92%) and reduced the percentage of men screened by 43%. Conclusions: Urine ligase chain reaction increased C trachomatis detection, particularly among men without urethral inflammation. Testing all asymptomatic men younger than 30 years is optimal, whereas negative urine leukocyte esterase or urethral Gram stain results in men 30 years or older support no testing.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Bacterial diseases</subject><subject>Bacterial diseases of the genital system</subject><subject>Biological and medical sciences</subject><subject>Carboxylic Ester Hydrolases - urine</subject><subject>Chlamydia Infections - diagnosis</subject><subject>Chlamydia Infections - epidemiology</subject><subject>Chlamydia Infections - urine</subject><subject>Chlamydia trachomatis - isolation & purification</subject><subject>Clinics</subject><subject>Gentian Violet</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Ligase Chain Reaction - methods</subject><subject>Male</subject><subject>Mass Screening - methods</subject><subject>Mass Screening - standards</subject><subject>Medical sciences</subject><subject>Medical screening</subject><subject>Men</subject><subject>Phenazines</subject><subject>Predictive Value of Tests</subject><subject>Prevalence</subject><subject>Sensitivity and Specificity</subject><subject>Sexually transmitted diseases</subject><subject>STD</subject><subject>Urethra - microbiology</subject><subject>Urethritis - microbiology</subject><subject>Urine</subject><issn>0148-5717</issn><issn>1537-4521</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNpdkU9P3DAQxa2Kqiy0H6HIQiq3tOP_yRG20CIt6mGXc-R1JsWrxAE7kdhvXy-7BQlfrHnzm9HoPUIog-8MKvMD8jNSqIIDMJC5KnaS_kBmTAlTSMXZEZkBk2WhDDPH5CSlDexqYJ_IMWOClVyJGcH76AMWVzZhQ5cuIgYf_tJ2iHT-0Nl-23hLx2jdw9Db0SfqA73DQC_HEUOzQ5f4PNmu29JVtCH1Pjca-tMnzCvpvPPBu_SZfGxtl_DL4T8l9zfXq_nvYvHn1-38clE4KWEsGt2UGhtoNVfaasO5smWllZKVZGthuJCmNapcZ41hC2vgRoGqXNk6wVUlTsnFfu9jHJ4mTGPd--Sw62zAYUq1AVNyIyGD5-_AzTDFkG-rOefCCC5Zhso95OKQUsS2foy-t3FbM6h3OdT_c6hfc3iRdB49O-yf1j02b4MH4zPw7QDY5GzXZu-cT2-ckKArzTP3dc9t0jjE176U2QKplfgHuM2Xjw</recordid><startdate>20010401</startdate><enddate>20010401</enddate><creator>MARRAZZO, JEANNE M.</creator><creator>WHITTINGTON, WILLIAM L. H.</creator><creator>CELUM, CONNIE L.</creator><creator>HANDSFIELD, H. HUNTER</creator><creator>CLARK, AGNES</creator><creator>CLES, LINDA</creator><creator>KREKELER, BARBARA</creator><creator>STAMM, WALTER E.</creator><general>Lippincott Williams & Wilkins</general><general>Lippincott</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7QL</scope><scope>7T2</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20010401</creationdate><title>Urine-Based Screening for Chlamydia trachomatis in Men Attending Sexually Transmitted Disease Clinics</title><author>MARRAZZO, JEANNE M. ; WHITTINGTON, WILLIAM L. H. ; CELUM, CONNIE L. ; HANDSFIELD, H. HUNTER ; CLARK, AGNES ; CLES, LINDA ; KREKELER, BARBARA ; STAMM, WALTER E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c440t-d6d86ed0f6256a67225a896554941b372347f758b9651ef0b0275059c8fc32593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Bacterial diseases</topic><topic>Bacterial diseases of the genital system</topic><topic>Biological and medical sciences</topic><topic>Carboxylic Ester Hydrolases - urine</topic><topic>Chlamydia Infections - diagnosis</topic><topic>Chlamydia Infections - epidemiology</topic><topic>Chlamydia Infections - urine</topic><topic>Chlamydia trachomatis - isolation & purification</topic><topic>Clinics</topic><topic>Gentian Violet</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Ligase Chain Reaction - methods</topic><topic>Male</topic><topic>Mass Screening - methods</topic><topic>Mass Screening - standards</topic><topic>Medical sciences</topic><topic>Medical screening</topic><topic>Men</topic><topic>Phenazines</topic><topic>Predictive Value of Tests</topic><topic>Prevalence</topic><topic>Sensitivity and Specificity</topic><topic>Sexually transmitted diseases</topic><topic>STD</topic><topic>Urethra - microbiology</topic><topic>Urethritis - microbiology</topic><topic>Urine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>MARRAZZO, JEANNE M.</creatorcontrib><creatorcontrib>WHITTINGTON, WILLIAM L. H.</creatorcontrib><creatorcontrib>CELUM, CONNIE L.</creatorcontrib><creatorcontrib>HANDSFIELD, H. HUNTER</creatorcontrib><creatorcontrib>CLARK, AGNES</creatorcontrib><creatorcontrib>CLES, LINDA</creatorcontrib><creatorcontrib>KREKELER, BARBARA</creatorcontrib><creatorcontrib>STAMM, WALTER E.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Sexually transmitted diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MARRAZZO, JEANNE M.</au><au>WHITTINGTON, WILLIAM L. H.</au><au>CELUM, CONNIE L.</au><au>HANDSFIELD, H. HUNTER</au><au>CLARK, AGNES</au><au>CLES, LINDA</au><au>KREKELER, BARBARA</au><au>STAMM, WALTER E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Urine-Based Screening for Chlamydia trachomatis in Men Attending Sexually Transmitted Disease Clinics</atitle><jtitle>Sexually transmitted diseases</jtitle><addtitle>Sex Transm Dis</addtitle><date>2001-04-01</date><risdate>2001</risdate><volume>28</volume><issue>4</issue><spage>219</spage><epage>225</epage><pages>219-225</pages><issn>0148-5717</issn><eissn>1537-4521</eissn><coden>STRDDM</coden><abstract>Background: Nucleic acid-amplified tests for Chlamydia trachomatis are accurate but costly. Screening strategies for asymptomatic men are needed. Goal: To assess C trachomatis screening strategies for asymptomatic males. Study Design: Men attending a sexually transmitted disease clinic were tested for C trachomatis with ligase chain reaction and culture, and for urethral inflammation with urine leukocyte esterase and urethral Gram stain. Results: C trachomatis prevalence was 5.5% among 1,625 asymptomatic men. Ligase chain reaction increased detection by 49% among men without urethral inflammation. An age of younger than 25 years and urethral inflammation were associated with positive ligase chain reaction results. The negative predictive value of urine leukocyte esterase was highest among older men, but urethral Gram stain was equally sensitive in predicting infection regardless of age. An age of younger than 30 years or urethral inflammation identified the highest proportion of infections (92%) and reduced the percentage of men screened by 43%. Conclusions: Urine ligase chain reaction increased C trachomatis detection, particularly among men without urethral inflammation. Testing all asymptomatic men younger than 30 years is optimal, whereas negative urine leukocyte esterase or urethral Gram stain results in men 30 years or older support no testing.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>11318253</pmid><doi>10.1097/00007435-200104000-00006</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Age Factors Bacterial diseases Bacterial diseases of the genital system Biological and medical sciences Carboxylic Ester Hydrolases - urine Chlamydia Infections - diagnosis Chlamydia Infections - epidemiology Chlamydia Infections - urine Chlamydia trachomatis - isolation & purification Clinics Gentian Violet Human bacterial diseases Humans Infectious diseases Ligase Chain Reaction - methods Male Mass Screening - methods Mass Screening - standards Medical sciences Medical screening Men Phenazines Predictive Value of Tests Prevalence Sensitivity and Specificity Sexually transmitted diseases STD Urethra - microbiology Urethritis - microbiology Urine |
| title | Urine-Based Screening for Chlamydia trachomatis in Men Attending Sexually Transmitted Disease Clinics |
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