How Reliable Is Urine Testing for Gonorrhea and Chlamydia?

Until recently, testing patients for chlamydia and gonorrhea involved collecting samples from the cervix or urethra and sending them for cultures. The discomfort and embarrassment associated with sampling these sites may deter some high-risk patients from seeking testing for these treatable infections. An alternative to cervical or urethral cultures is nucleic acid amplification tests (NAATs) that can be performed on urine samples. Three types of NAAT are commercially available: polymerase chain reaction (PCR), transcription-mediated amplification, and strand displacement amplification. However, concerns remain about the sensitivity and specificity of the NAAT compared with culture techniques. Cook and colleagues conducted a systematic review of the literature to compare the sensitivity and specificity of the NAAT for detecting chlamydia and gonorrhea in urine samples with that of cervical and urethral samples.