Chlamydia trachomatis in non-gonococcal urethritis patients and their heterosexual partners: routine testing by polymerase chain reaction.

OBJECTIVES To identify the proportion of cases of non-gonococcal urethritis (NGU) in which Chlamydia trachomatis was detected in patients and their partners, using DNA amplification testing; and to relate the importance of age and symptoms to the presence of chlamydial infection and so clarify the aetiology and epidemiology of NGU, with a view to reducing the prevalence of chlamydial infection in general. METHODS A 6 month cohort of all newly registered heterosexual men diagnosed with NGU, shortly after the introduction of polymerase chain reaction (PCR) chlamydial testing in 1997, was reviewed, with particular reference to their age and presence of symptoms; where possible, their women partners' data were traced. RESULTS Of 283 NGU patients, 35% were chlamydia positive and significantly younger than the chlamydia negative cases (mean ages 25 and 29 years respectively). 51% NGU patients were symptomatic, of whom 40% were chlamydia positive. 43% of all chlamydia positive NGU patients were asymptomatic. 36 men had had chlamydia positive index partners. 26% of the 97 secondary female contacts were chlamydia positive; three had had a negative male partner. From 155 men (28% chlamydia positive) no contacts were traceable. CONCLUSIONS In comparison with a previous similar study in 1987-90, using less sensitive diagnostic methods, a higher rate of chlamydial infection in NGU was detected. Young age and the presence of symptoms were confirmed as important factors for chlamydial positivity.