Multicenter Evaluation of the BDProbeTec ET System for Detection of Chlamydia trachomatis and Neisseria gonorrhoeae in Urine Specimens, Female Endocervical Swabs, and Male Urethral Swabs

ABSTRACT The performance of the Becton Dickinson BDProbe Tec ET SystemChlamydia trachomatis and Neisseria gonorrhoeaeAmplified DNA Assays (BD Biosciences, Sparks, Md.) was evaluated in a multicenter study. Specimens were collected from 2,109 men and women, with or without symptoms, attending sexually transmitted disease, family planning, and obstetrics and gynecology clinics. Both swab and urine samples were collected, and the results obtained from 4,131 specimens were compared to those from culture and the LCx nucleic acid amplification test (Abbott Industries, Abbott Park, Ill.). PCR and cytospin of the culture transport medium with chlamydia direct fluorescent antibody staining were used to adjudicate chlamydia culture-negative results. Sensitivity and specificity were calculated both with and without use of the amplification control (AC), with little apparent difference in the results. Without the AC result, sensitivity for C. trachomatis and N. gonorrhoeae were 92.8 and 96.6%, respectively, for cervical swabs and 80.5 and 84.9% for urine from women. C. trachomatis and N. gonorrhoeae sensitivities were 92.5 and 98.5%, respectively, for male urethral swabs and 93.1 and 97.9% for urine from men. This amplified DNA system for simultaneous detection of chlamydial and gonococcal infections demonstrated superior sensitivity compared to chlamydia culture and has performance characteristics comparable to those of other commercially available nucleic acid-based assays for these organisms.

[1]  L. Bodin,et al.  Programmes to reduce pelvic inflammatory disease—the Swedish experience , 1998, The Lancet.

[2]  J. Schachter,et al.  Culture and isolation of Chlamydia trachomatis. , 1994, Methods in enzymology.

[3]  W. Miller Can we do better than discrepant analysis for new diagnostic test evaluation? , 1998, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[4]  Brian G. Scrivens,et al.  Strand displacement amplification and homogeneous real-time detection incorporated in a second-generation DNA probe system, BDProbeTecET. , 1999, Clinical chemistry.

[5]  M. R. Howell,et al.  Control of Chlamydia trachomatis infections in female army recruits: cost-effective screening and treatment in training cohorts to prevent pelvic inflammatory disease. , 1999, Sexually transmitted diseases.

[6]  J. Schachter DFA, EIA, PCR, LCR and other technologies: what tests should be used for diagnosis of chlamydia infections? , 1997, Immunological investigations.

[7]  B. Katz,et al.  Effect of differences in specimen processing and passage technique on recovery of Chlamydia trachomatis , 1989, Journal of clinical microbiology.

[8]  Maurice Rosenstraus,et al.  An Internal Control for Routine Diagnostic PCR: Design, Properties, and Effect on Clinical Performance , 1998, Journal of Clinical Microbiology.

[9]  P. Piot,et al.  Declining trends in some sexually transmitted diseases in Belgium between 1983 and 1989. , 1991, Genitourinary medicine.

[10]  W. Cates,et al.  Genital Chlamydia infections in sexually active female adolescents: do we really need to screen everyone? , 1997, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[11]  E. Albanese,et al.  Reproducibility of the Roche Amplicor polymerase chain reaction assay for detection of infection by Chlamydia trachomatis in endocervical specimens. , 1998, Clinical chemistry.

[12]  T. Quinn,et al.  Multicenter Evaluation of the AMPLICOR and Automated COBAS AMPLICOR CT/NG Tests for Detection ofChlamydia trachomatis , 2000, Journal of Clinical Microbiology.

[13]  R. Knaup,et al.  Urine Screening for Gonococcal and Chlamydial Infections at Community‐Based Organizations in a High‐Morbidity Area , 2000, Sexually transmitted diseases.

[14]  E. Hook,et al.  Laboratory to Laboratory Variation in Chlamydia trachomatis Culture Practices , 1995, Sexually transmitted diseases.

[15]  H. Handsfield,et al.  Fluorescent monoclonal antibody for confirmation of Neisseria gonorrhoeae cultures , 1987, Journal of clinical microbiology.

[16]  J. Schachter,et al.  Is the routine pelvic examination needed with the advent of urine-based screening for sexually transmitted diseases? , 1999, Archives of pediatrics & adolescent medicine.

[17]  J. P. Davis,et al.  Decreased Prevalence of Chlamydia trachomatis Infection Associated With a Selective Screening Program in Family Planning Clinics in Wisconsin , 1993, Sexually transmitted diseases.

[18]  W. Levine,et al.  Estimated incidence and prevalence of genital Chlamydia trachomatis infections in the United States, 1996. , 1999, Sexually transmitted diseases.

[19]  M. S. St. Louis,et al.  Laboratory testing for Neisseria gonorrhoeae by recently introduced nonculture tests: a performance review with clinical and public health considerations. , 1998, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[20]  K. Holmes,et al.  Prevention of pelvic inflammatory disease by screening for cervical chlamydial infection. , 1996, New England Journal of Medicine.

[21]  V. Goulet,et al.  Surveillance of sexually transmitted diseases in France: recent trends and incidence. , 1994, Genitourinary medicine.

[22]  S. Hewitt,et al.  HIV prevention through early detection and treatment of other sexually transmitted diseases--United States. Recommendations of the Advisory Committee for HIV and STD prevention. , 1998, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[23]  C. Black “But doctor, I'm celibate!” The potential for, sources, and implications of false-positive (and -negative) results of tests for s , 1998 .

[24]  J. Mahony,et al.  Effect of swab type and storage temperature on the isolation of Chlamydia trachomatis from clinical specimens , 1985, Journal of clinical microbiology.

[25]  R. Brugha,et al.  Epidemiology of genital Chlamydia trachomatis in England and Wales. , 1997, Genitourinary medicine.

[26]  H. Verbrugh,et al.  Comparison of three commercially available amplification assays, AMP CT, LCx, and COBAS AMPLICOR, for detection of Chlamydia trachomatis in first-void urine , 1997, Journal of clinical microbiology.

[27]  David Baorto,et al.  Reproducibility Problems with the Abbott Laboratories LCx Assay for Chlamydia trachomatis andNeisseria gonorrhoeae , 2000, Journal of Clinical Microbiology.

[28]  J. Sellors,et al.  Urine Specimens from Pregnant and Nonpregnant Women Inhibitory to Amplification of Chlamydia trachomatis Nucleic Acid by PCR, Ligase Chain Reaction, and Transcription-Mediated Amplification: Identification of Urinary Substances Associated with Inhibition and Removal of Inhibitory Activity , 1998, Journal of Clinical Microbiology.

[29]  J. Paavonen,et al.  Chlamydia trachomatis: impact on human reproduction. , 1999, Human reproduction update.

[30]  M. Blythe,et al.  Declining Prevalence of Chlamydial Infection Among Adolescent Girls , 1996, Sexually Transmitted Diseases.

[31]  D. E. Schultz,et al.  Performance of the Gen-Probe AMPLIFIED Chlamydia Trachomatis Assay in Detecting Chlamydia trachomatis in Endocervical and Urine Specimens from Women and Urethral and Urine Specimens from Men Attending Sexually Transmitted Disease and Family Planning Clinics , 1998, Journal of Clinical Microbiology.

[32]  S. Morré,et al.  Determination of Chlamydia trachomatisPrevalence in an Asymptomatic Screening Population: Performances of the LCx and COBAS Amplicor Tests with Urine Specimens , 1999, Journal of Clinical Microbiology.