Comparison of three techniques for detection of Chlamydia trachomatis in endocervical specimens from asymptomatic women

Abstract

Culture in DEAE-dextran-treated HeLa 229 cells, a solid-phase enzyme immunoassay (EIA) (Chlamydiazyme; Abbott Laboratories, North Chicago, 111.), and a direct immunofluorescence test (DFA) (MicroTrak; Syva Co., Palo Alto, Calif.) were compared for the detection of Chlamydia trachomatis in endocervical specimens from 715 asymptomatic women. Response to antibiotic therapy was also monitored at least 4 weeks after completion of therapy. An additional sample was collected at a control visit, and a second culture was performed if discrepancies were observed between the three tests. A total of 48 infections were diagnosed, for a prevalence of 6.7%. At the first visit, 37 specimens were positive by culture. The respective sensitivities of EIA and DFA were 78.4 and 81.1% and the respective specificities were 96.8 and 97.9% when compared with the cell culture technique. The positive predictive values were 56.9 and 68.2%, respectively. When the additional 11 infections detected by the second culture were included to establish a new standard of positivity, the sensitivity of the first culture was estimated at 77.1%. The positive predictive values of EIA and DFA increased to 77.6 and 83.7%, respectively. EIA and DFA performed as well as culture for control of therapy; a 100% agreement among the three techniques was observed.

Comparison of the Clearview Chlamydia test, Chlamydiazyme, and cell culture for detection of Chlamydia trachomatis in women with a low prevalence of infection

“…These findings reflect the low prevalence of sexually transmitted disease present in the women attending gynecological clinics at our hospital. The results of this study are also consistent with the experience of other investigators (8,11) who have evaluated nonculture methods for the diagnosis of C. trachomatis in similar populations with a low prevalence of infection.…”

“…The introduction of commercial kits with species-specific monoclonal antibodies that detect chlamydial antigens in the outer membrane protein and genus-specific antibodies to cell wall lipopolysaccharide has permitted the development of techniques for more rapid testing of specimens. Both enzymelinked immunoassay and direct fluorescent-antibody (DFA) methods are available (7,8,11,14,15). Several new rapid tests that are easier to perform and that do not require the purchase of expensive supplementary equipment have also been introduced (4).…”

Evaluation of a direct fluorescent antibody test for detection of Chlamydia trachomatis in endocervical specimens

“…The DFA test for C. iruchornutis appears to be equally effective in both symptomatic and high-risk, high prevalence ( > 10"h) asymptomatic female subjects (8,11). However it is not recommended for low-risk populations as a screening test (2,3,6). In our research we found the prevalence rate in the asymptomatic group to be 23%.…”

Prevalence of Chlamydial Infection in Females Attending Antenatal and Family Planning Clinics in Karachi Pakistan

“…The specimens that were found positive were retested and reconfirmed by the direct immunofluorescent test (Biomerix). The sensitivity for this test is 81.1% and specificity is 97.9% (6). This protocol was used to eliminate the false positive tests in the study.…”