Comparison of Cervical, Urethral, and Urine Specimens for the Detection of Chlamydia trachomatis in Women

Cervical, urethral, and first void urine (FVU) specimens from 937 women were tested for Chlamydia trachomatis by culture or EIA to determine the most sensitive combination of tests and specimens. For cervical and urethral specimens the prevalence of infection by culture or confirmed EIA was 7.2% (67/937) at either site, 6.8% (64/937) at the cervix, and 4.3% (40/937) at the urethra. Of 67 specimens, 37 (55.2%) yielded a positive test from both the cervical and urethral swabs. Three (4.5%) of the 67 infections were only at the urethra and none were only in FVU. Only 37.3% (25/67) of all positive women had a positive FVU. The most sensitive combination was cervical swab culture and EIA, which detected 95.5% (64/67) of the infections, a substantial increase over culture only (76.1%) or EIA of the cervical swab (79.1%). The testing of urethral and FVU specimens apparently offers only minimal advantage over testing of cervical specimens only for chlamydia.