Chlamydia trachomatis infection is considered the most prevalent bacterial sexually transmitted disease worldwide. C.trachomatis causes eye infections such as trachoma and newborn inclusion conjunctivitis, newborn pneumonia, genitourinary system infections and suppurative inguinal lymphadenitis namely lymphogranuloma venerum. The aim of this study was to investigate C.trachomatis by direct fluorescent antibody (DFA), polymerase chain reaction (PCR) and cell culture methods in the clinical samples sent to the microbiology laboratory with the prediagnosis of genital infections. A total of 50 swab samples obtained from adult patients (49 female, 1 male) who were admitted to Erciyes University Hospital, Kayseri, Turkey between February-March 2010, were included in the study. C.trachomatis antigens were investigated by a commercial DFA (PathoDx, Remel, USA) method. McCoy cell cultures prepared in microplate wells were used for the isolation of C.trachomatis. The growth of C.trachomatis in cell cultures was confirmed by DFA and iodine staining methods. C.trachomatis DNA was investigated by commercially available PCR (Chlamydia trachomatis 330/740 IC; Sacace, Italy) method. In our study, 4 (8%) of the 50 swab samples were found positive with DFA, 1 (2%) was positive with cell culture, and 1 (2%) was positive with PCR. The only sample that gave positive results with all of the three methods was an urethral swab. Three cervical swab samples that were found positive only with DFA method was evaluated as false positivity. When cell culture was considered as the reference method, the sensitivity and specificity of DFA method were estimated as 100% and 94%, respectively, while those rates for PCR were 100% and 100%, respectively. In conclusion, although cell culture is still the gold standard in the diagnosis of C.trachomatis. infections, since it is time consuming and difficult to apply, more rapid and reliable PCR methods may be applied in diagnosis. DFA method which is practical and cheap, is preferred largely in routine laboratory practice. However, false negative and false positive DFA results should be prevented by the maintainence of good quality clinical specimens, evaluation of the test by experienced personnel and use of quality control samples in each run.
Adenoviruses are the most common causative agents of epidemics of community acquired and nosocomial conjunctivitis. Adenoviruses are resistant to physical and chemical factors and they can spread easily. Due to these factors, rapid and accurate diagnosis is very important in adenoviral eye infections. In this study, it was aimed to investigate adenoviruses from conjunctival swab samples of 50 patients suspected of adenoviral conjunctivitis by two different cell culture and PCR methods. Conjunctival swab samples from patients suspected of adenoviral conjunctivitis were taken between March 2012-December -11, 15, 16, 17, 19, 20, 22 cause conjunctivitis, serotypes 2, 3, 4, 5, 7, 8, 10, 11, 19, 21, 22, 29, 34, 37, 53, 54, 56 cause epidemic keratoconjunctivitis and serotypes 3, 4 and 7 cause pharyngoconjunctival fever (5,7,8). Outbreaks of adenoviral infections are common (9). Due to remaining infectious at room temperature for weeks and high level of resistance to environmental factors, transmission of adenovirus may occur easily (9,10). As can be transmitted from person to person, transmission may occur through water, objects and medical devices. Therefore nosocomial adenovirus infections can be seen (10).Adenoviral infections are mainly diagnosed by direct methods such as cell culture, nucleic acid detection and antigen detection (10,11). Indirect diagnosis based on the serological methods are mainly preferred in epidemiological researches instead of diagnosing adenoviral infections because of their low sensitivity rates (11). Rapid diagnose in adenoviral eye infections, especially in outbreaks of nosocomial conjunctivitis is very important and essential for confirmation of clinical diagnosis, limiting the spread of infection, implementation of appropriate protective measures and prevention of inappropriate treatment (12). Promptly isolation of infected individuals is critically important for control of outbreaks in both community acquired and nosocomial outbreaks (13). In this study, it was aimed to investigate adenovirus from conjunctival swab samples of patients suspected of adenoviral conjunctivitis by cell culture and PCR methods. MATERIALS AND METHODSThis study was performed in Virology Laboratory, with approval of Local Ethics Committee approval (06/05/2010) and supported by Scientific Research Projects Department (TSU-11-3645 code number). Total of 50 patients admitted to Ophthalmology Clinic whom suspected of adenoviral conjunctivitis between March 2012-December 2012 were included in this study. Two sets of conjunctival swab samples using plastic handle with a Dacron swab were taken from each patient. All samples were hold in viral transport medium (Vircell, Spain) in -70 °C until the day of study. One of the viral transport medium was used in
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