How do I request a Chlamydia (Chlamydia trachomatis) test on a urine sample?

How to Request a Chlamydia Test on a Urine Sample

To request a Chlamydia trachomatis test on a urine sample, ask your healthcare provider for a nucleic acid amplification test (NAAT) using a first-void urine specimen, as this is the recommended non-invasive testing method with high sensitivity and specificity.

Understanding Urine-Based Chlamydia Testing

Nucleic acid amplification tests (NAATs) are the preferred method for detecting Chlamydia trachomatis in urine samples due to their:

• High sensitivity (80-93% depending on the specific test) 1
• Excellent specificity (>97%) 1
• Non-invasive collection method 2

Specific Test Request Process

1. Ask specifically for: "Chlamydia trachomatis NAAT on urine specimen"

2. Collection instructions:

   • Provide a first-void urine sample (first part of urination)
   • Collect 20-30 mL of urine
   • Ideally, don't urinate for at least 2 hours before collection 3

3. Available NAAT technologies (your provider will select the appropriate one):

   • Polymerase chain reaction (PCR)
   • Transcription-mediated amplification (TMA)
   • Strand displacement amplification (SDA) 3

Important Considerations

Population-Specific Recommendations

• For women: While vaginal swabs are considered the optimal specimen, urine remains an acceptable alternative with slightly reduced performance compared to cervical/vaginal specimens 3
• For men: First-void urine is considered the optimal specimen type 3

Test Limitations

• In low-prevalence populations (<5%), positive results may require verification with a second test due to the possibility of false positives 4
• Urine tests for women may have slightly lower sensitivity than vaginal swab specimens 3

When to Get Tested

• Annual screening is recommended for all sexually active women under 25 years 3
• Men who have sex with men should be tested at least annually 3
• Testing is recommended after potential exposure or when symptoms are present
• Retest approximately 3 months after treatment for Chlamydia due to high reinfection rates 3

Advantages of Urine Testing

• Non-invasive collection (no need for urethral swabs in men or pelvic exam in women)
• Can be performed in non-clinical settings, expanding screening opportunities 2
• Particularly useful for asymptomatic screening, as 70-90% of women and many men with chlamydia are asymptomatic 3

Remember that proper specimen collection is crucial for accurate results. The first portion of the urine stream contains the highest concentration of organisms, making first-void samples essential for optimal test sensitivity.