Endocervical Gram stain smears and their usefulness in the diagnosis of Chlamydia trachomatis

Abstract

Objective: To evaluate the usefulness of endocervical Gram stain smears in the diagnosis of Chlamydia trachomatis and Neisseria gonorrhoeae in a female population attending a STD clinic. Methods: 494 females attending a STD clinic and undergoing a speculum examination had endocervical specimens submitted for C trachomatis culture, direct fluorescent antibody testing (DFA), and N gonorrhoeae culture. Endocervical smears were also collected for Gram stain. The number of polymorphonuclear leucocytes (PMN) per high power field (HPF), presence of bacteria, yeast, red blood cells, and clue cells were recorded. Clinical signs of cervicitis were also documented. Results: N gonorrhoeae was isolated from one subject who was co-infected with C trachomatis and no further analysis was done regarding N gonorrhoeae. Analysis was performed on 220 participants. The prevalence of C trachomatis infection was 13%. Of the Gram smears collected, 55% were inadequate owing to the presence of vaginal contamination. There were an equal number of C trachomatis isolates in patients with <10 PMN/HPF (48%) and >10 PMN/HPF (52%). Endocervical mucopus and erythema were statistically significant for the presence of C trachomatis (p<0.001 and 0.02 respectively). The presence of any signs of cervicitis-that is, mucopus, friability, erythema, and ectropion together with >10 PMN/HPF was statistically significant for the presence of C trachomatis. Conclusion: The use of endocervical Gram smear results together with clinical information can be used to identify high risk women for C trachomatis infection. (Sex Transm Inf 2001;77:103-106)

Interactions Among Urogenital, Intestinal, Skin, and Oral Infections in Pregnant and Lactating Panamanian Ngäbe Women: A Neglected Public Health Challenge

“…79 Urine culture would have allowed us to establish the etiology of AB/UTI. Nucleic acid amplification tests would have allowed us to confirm if intracellular diplococci were Neisseria gonorrhoeae and to determine if Chlamydia was prevalent in this population (suspected based on our clinical findings, morphology of epithelial cells, and the presence of abundant leukocytes in the gram-stained vaginal smears 80 ). Our findings have several implications for clinical care of this vulnerable population.…”

Effect of Unani Formulation in Cervicitis (Warme-unqur-rahm): A Single-blind Randomized Placebo-controlled Trial

“…Other subtle signs includes cervical ectopy with identification of ≥10 PMNLs per high power field in gram stained smear of cervical secretions [5,6]. The presence of above finding suggest either Neisseria gonorrhoea or Chalamydial infection but studies revealed that above organism are identified in only half or less than half of cases of cervicitis and causes of rest cases remain unknown [7,8].…”

Comparison of cervico-vaginal colonization among sexually active women by intrauterine device use

“…In this study, chlamydial antigen positivity was higher among women over 30 years of age compared to women under 30 years of age. In previous studies, C. trachomatis prevalence was found to be 2.5%-30.3% in vaginal discharge by various diagnostic techniques [3,16,19,21]. In Turkey, frequency of chlamydial infections in women is low, between 5.1% and 24% [20,22,23] for symptomatic patients and 1.11% [22] for asymptomatic patients.…”

“…Additionally, Chlamydia trachomatis infections have been associated with increased rates of transmission of HIV [9]. Occasionally, the infection spreads to the upper genital tract in women, causing pelvic inflammatory disease, ectopic pregnancy, infertility, or to the epididymis in men, causing epididymitis [5,7,[9][10][11][12][13][14][15][16]. Bacterial vaginosis is believed to be the most common vaginal disorder affecting women and is characterized by the overgrowth of several anaerobic and microaerophilic bacteria and the decreased prevalence of Lactobacillus species due to alteration of the vaginal bacterial morphotypes [5].…”