Abstract: 【Abstract】 Objective To compare the detection rate of genital Chlamydia trachomatis （CT） DNA between urine and urethral/cervical swab samples. Methods From December 2018 to December 2019, a total of 1 475 outpatients were collected from sexually transmitted disease clinics in 7 medical institutions, such as Department of Venereology, Guangzhou Institute of Dermatology, including 1 118 males and 357 females. One urethral/cervical swab sample and one urine sample were collected successively from each patient. Real-time fluorescence-based PCR was performed to detect CT DNA in urine and urethral/cervical swab samples, and paired chi-square test was used to compare the positive rate of CT DNA between the 2 kinds of samples. Random- or fixed-effect meta-analysis was conducted for the test of heterogeneity and merging of positive rates of CT DNA in the urine and urethral/cervical swabs among 7 medical institutions. Results The positive rate of CT DNA in the urine samples was significantly higher than that in the swab samples from 4 medical institutions （all P < 0.05）, while there was no significant difference in the positive rate of CT DNA between the 2 kinds of samples from 3 medical institutions （all P > 0.05）. The heterogeneity （I 2） estimates of the CT-DNA positive rate in urine and swab samples among different medical institutions were 78.6% （95% CI: 55.9% - 89.6%） and 73.7% （95% CI: 43.7% - 87.7%）, respectively; meta-analysis showed that the total merged positive rate of CT DNA in the urine samples was 10.8% （95% CI: 7.2% - 15.9%）, which was significantly higher than that in the swab samples （7.8%, 95% CI: 4.9% - 12.1%; χ2 = 39.2, P < 0.05）. Compared with the swab sample-based CT-DNA detection method, the sensitivity, specificity, positive predictive value, negative predictive value and consistency rate of the urine sample-based CT-DNA detection method were 97.0% （128/132）, 96.3% （1 293/1 343）, 71.9% （128/178）, 99.7% （1 293/1 297）, and 96.3% （1 421/1 475）, respectively. The positive rate of CT DNA in the urine samples from 1 118 male patients was 11.0% （95% CI: 7.2% - 16.5%）, which was significantly higher than that in the swab samples （7.6%, 95% CI: 4.9% - 11.8%; χ2 = 34.3, P < 0.05）. There was no significant difference in the positive rate of CT DNA between the urine （11.9%, 95% CI: 7.7% - 17.9%） and cervical swab samples from 357 female patients （10.4%, 95% CI: 7.6% - 14.0%; χ2 = 3.2, P > 0.05）. Conclusions The positive rate of CT DNA in urine samples is higher than or similar to that in urethral/cervical swab samples. The urine sample-based CT-DNA detection method has characteristics of convenience, non-invasiveness, painlessness and low cost, and is worthy of clinical promotion.

Key words: Chlamydia trachomatis, Nucleic acid amplification techniques, Urine, Swab