NAATs to diagnose Chlamydia trachomatis genital infection: a promise still unfulfilled

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Abstract
Nucleic acid amplification tests (NAATs) have created a revolution in our ability to diagnose chlamydial infections. They are markedly more sensitive (while maintaining exquisite specificity) than previously used tests. They can be used with noninvasively collected specimens (first-catch urine for men or women and vaginal swabs from women). This allows their use in screening asymptomatic individuals who represent the bulk of prevalent infections. Mishandling of urine specimens can lead to false-negative results and few are aware of that potential for getting incorrect results. The leading deterrent to the acceptance of NAATs has been their perceived cost. This is based on the purchase price of tests and fails to consider the total cost of testing, which also includes costs of specimen collection, where NAATs have a major advantage.