Laboratory aspects of screening men for Chlamydia trachomatis in the new millennium.

OBJECTIVE: To describe and review the methods for laboratory diagnosis of Chlamydia trachomatis in men. BACKGROUND: Men provide a reservoir for continued transmission of C. trachomatis to women, thus representing a population for potential targeted screening. Although there are no formal recommendations by professional organizations for screening men for chlamydia, guidance has been provided by the Centers for Disease Control and Prevention for sites wishing to screen men, who are primarily asymptomatic. METHODS: Review of the published literature for diagnostic laboratory tests for C. trachomatis in men. RESULTS: The laboratory test of choice for screening men is a nucleic acid amplification test (NAAT), and the specimen of choice is first-catch urine. The NAAT has sufficient sensitivity and specificity, and urine provides a noninvasive specimen; together, this combination provides the achievement of sensitivities of >90% to 97% and high specificity (99%). Populations of men, such as those in detention, Job Corps training, emergency departments, the military, and high schools can offer accessible target populations for easily implemented chlamydia screening. CONCLUSION: Screening more men with NAAT assays may provide the possibility of reducing the overall burden of chlamydia in both men and women.