Faculty Collaboration Database

Can a Clean Catch Urine Sample Be Used to Diagnose Chlamydia and Gonorrhea in Adolescent Females? J Adolesc Health 2021 Oct;69(4):574-578

Date

04/14/2021

Pubmed ID

33846057

DOI

10.1016/j.jadohealth.2021.02.022

Scopus ID

2-s2.0-85104082927 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

PURPOSE: Clean catch urine samples may be an alternative specimen to test for chlamydia and gonorrhea infections. The aim of this study was to determine the sensitivity and specificity of clean urine for chlamydia and gonorrhea in women.

METHODS: This was a noninferiority prospective cohort study of women aged 14-22 years requiring chlamydia and gonorrhea testing. Patients provided a vaginal swab (gold standard), clean urine (test sample), and dirty urine (usual care). All samples were analyzed using Hologic's Aptima Combo2 Assay, a second-generation nucleic acid amplification test. The sensitivity and specificity of the clean and dirty urine were calculated and compared.

RESULTS: Three hundred and twenty-three females were included, mean age 17.0 ± 1.6 years. For chlamydia, 59 participants were positive by vaginal swab. The sensitivity of clean urine to diagnose chlamydia was 86.2% (95% CI: 74.8%-93.1%) and specificity was 98.8% (95% CI: 96.5%-99.8%). The sensitivity of dirty urine to diagnose chlamydia was 89.8% (95% CI: 79.2%-95.6%), and the specificity was 99.6% (95% CI 97.6%-100%). For gonorrhea, 18 participants were positive by vaginal swab. The sensitivity of clean urine to diagnose gonorrhea was 94.4% (95% CI: 72.4%-100%) and specificity was 99.7% (95% CI: 98.0%-100.0%). The sensitivity of dirty urine to diagnose gonorrhea was 100% (95% CI: 79.3%-100%) and specificity was 99.7% (95% CI: 98.0%-100%). Specificity of clean urine was noninferior compared with dirty urine for diagnosing chlamydia (p = .0004) and gonorrhea (p < .0001).

CONCLUSIONS: Clean urine samples may be an alternative option to diagnose chlamydia and gonorrhea in women.

Author List

Pickett ML, Visotcky A, Brazauskas R, Ledeboer NA, Drendel AL

Authors

Ruta Brazauskas PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Amy L. Drendel DO Interim Chief, Professor in the Pediatrics department at Medical College of Wisconsin
Nathan A. Ledeboer PhD Vice Chair, Professor in the Pathology department at Medical College of Wisconsin
Michelle L. Pickett MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Alexis M. Visotcky Biostatistician III in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Chlamydia Infections
Chlamydia trachomatis
Female
Gonorrhea
Humans
Neisseria gonorrhoeae
Prospective Studies
Sensitivity and Specificity