Objective: To compare the sensitivity and specificity of the cervical/urethral swabs with voided urine specimens for the detection of genitourinary tract infection with Chlamydia trachomatis and determine whether urine specimens can replace the cervical/urethral swabs in detection of C. trachomatis. Methods: The matched cervical/urethral swabs and voided urine specimens were collected from 569 patients of STD clinics.Polymerase chain reaction (PCR) assay specific for C. trachomatis plasmid DNA and rapid antigen testing (Clear view assay) was used to detect C. trachomatis. Standard criteria that defined """"true"""" positive included: 1) positive PCR results both in cervical/urethral swab and voided urine specimen or 2) positive voided urine results both by PCR assay and clear view test or 3)positive results in both PCR assay of cervical/urethral swab and clear view test of voided urine. For statistical analysis, the chi-square test was used. Results: The prevalence of C. trachomatis in patients with symptoms was 12.1% (28/231) in women and 10.4%(10/96) in men, with no significant difference between them (x^2=0.21,P>0.05). The prevalence of C. trachomatis in patients with no symptoms was 11.0% (11/100) in women and 15.5% (22/142) in men, with a significant difference existing between them. (x^2=4.0, P0.05) existed between PCR testing of swabs (sensitivity 87.3 %; specificity 99.2 %) and PCR testing of urine (sensitivity 88.7%; specificity 98.8%). As for clear view assay, sensitivity was 60.6% and specificity was 100%. Conclusions: PCR assay is superior to clear view in detecting C. trachomatis. Although both PCR testing of swabs and PCR testing of urine specimens both have high sensitivity and specificity, urine specimen testing is more cost-effective, practical and noninvasive. Thus urine specimens can take the place of the swabs in PCR testing for chlamydia.
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