Influence of endocervical specimen adequacy on PCR and direct fluorescent-antibody staining for detection of Chlamydia trachomatis infections

Welsh, Laura; Quinn, Thomas C.; Gaydos, Charlotte A.

doi:10.1128/jcm.35.12.3078-3081.1997

Cited by 30 publications

(17 citation statements)

References 23 publications

(17 reference statements)

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“…Cervical samples tested negative by PCR might have also been missed due to the inhibitors (16,27), poor sampling quality (28) or incorrect sample preparation (29).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of vaginal introital sampling as an alternative approach for the detection of genital Chlamydia trachomatis infection in women

Domeika¹,

Bassiri²,

Butrimienė³

et al. 1999

Acta Obstet Gynecol Scand

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“…Cervical samples tested negative by PCR might have also been missed due to the inhibitors (16,27), poor sampling quality (28) or incorrect sample preparation (29).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of vaginal introital sampling as an alternative approach for the detection of genital Chlamydia trachomatis infection in women

Domeika¹,

Bassiri²,

Butrimienė³

et al. 1999

Acta Obstet Gynecol Scand

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“…Additionally, the quality of the endocervical specimen, as measured by the presence of columnar epithelial cells, has been shown to play a significant role in the numbers of positive specimens (19,37). In another study of family-planning clinics in Baltimore, Md., clinicians obtained adequate specimens only 72.3% of the time (37).…”

Section: Discussionmentioning

confidence: 99%

Use of Ligase Chain Reaction with Urine versus Cervical Culture for Detection of Chlamydia trachomatis in an Asymptomatic Military Population of Pregnant and Nonpregnant Females Attending Papanicolaou Smear Clinics

et al. 1998

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Ligase chain reaction (LCR) (Abbott Laboratories, Abbott Park, Ill.) with first-catch urine specimens was used to detect Chlamydia trachomatis infections in 465 asymptomatic military women attending clinics for routine Papanicolaou smear tests. Results were compared to results of cervical culture to determine the sensitivity of the urine LCR and the possible presence of inhibitors of amplification in pregnant and nonpregnant women. Discrepant results for LCR and culture were resolved by direct fluorescent antibody staining of culture sediments, two different PCR assays, and LCR for the outer membrane protein 1 gene. The prevalence of Chlamydia in specimens by urine LCR was 7.3% compared to 5% by culture. For 434 women with matching specimens, there were 11 more specimens positive by LCR than were positive by culture, of which all but one were determined to be true positives. There were four culture-positive, LCR-negative specimens, all from nonpregnant women. The sensitivity, specificity, and positive and negative predictive values of urine LCR after discrepant results were resolved were 88. 6, 99.7, 96.9, and 99.0%, respectively. The sensitivity of culture was 71.4%. From the 148 pregnant women (prevalence by LCR, 6.8%), there were no patients who were cervical culture positive and urine LCR negative to indicate the presence in pregnant women of inhibitors of LCR. Additionally, a subset of 55 of the LCR-negative frozen urine specimens from pregnant women that had been previously processed in LCR buffer were inoculated with 5 cell culture inclusion forming units of C. trachomatis each and retested by LCR; all tested positive, indicating the absence of inhibitors of LCR in urine from these pregnant women. The use of LCR testing of urine specimens from asymptomatic women, whether pregnant or not, offers a sensitive and easy method to detect C. trachomatis infection in women.

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“…Specimen adequacy has been shown to be an important determinant of the sensitivity of this test. 30 We were unable to assess this factor because of cytolytic agents included in the transport medium.…”

Section: Discussionmentioning

confidence: 99%

Performance of a commercial polymerase chain reaction test for endocervical Chlamydia trachomatis infection in a university hospital population

Livengood

Boggess

Wrenn

et al. 1998

Infect. Dis. Obstet. Gynecol.

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Objectives: To examine the accuracy of a commercial polymerase chain reaction (PCR) test (Amplicor CT R , Roche Diagnostic Systems, Branchburg NJ) for identification of endocervical chlamydial infections through both laboratory evaluation and among a diverse teaching hospital patient population.Methods: Testing of reliable threshold inocula and reproducibility were carried out using laboratory stock organisms. Paired endocervical samples from patients with a wide range of indications were tested by PCR and an established culture procedure, and discrepant pairs were further analyzed to determine true results.Results: Laboratory evaluation suggested that one copy of target DNA from a viable organism consistently yielded a positive result, and test reproducibility was very good, with an overall coefficient of variation of 15%. Compared to true results in 1,588 paired clinical samples from 1,489 women with a 10% prevalence of infection, the PCR test and culture yielded respective sensitivities of 87.4% and 78.0%, and negative predictive values of 98.6% and 97.6%. Specificity and positive predictive value for both tests were 100%. Cost per specimen was nearly identical at $18.84 and $18.88 respectively. Polymerase inhibitors and organisms lacking target DNA were not found in false-negative PCR samples.Conclusion: This commercial PCR test is accurate, cost-competitive, and much faster than culture for diagnosis of endocervical chlamydia infections in our population of intermediate prevalence of chlamydial infection. Infect. Dis. Obstet. Gynecol. 6:224-229, 1998.

show abstract

Influence of endocervical specimen adequacy on PCR and direct fluorescent-antibody staining for detection of Chlamydia trachomatis infections

Cited by 30 publications

References 23 publications

Evaluation of vaginal introital sampling as an alternative approach for the detection of genital Chlamydia trachomatis infection in women

Evaluation of vaginal introital sampling as an alternative approach for the detection of genital Chlamydia trachomatis infection in women

Use of Ligase Chain Reaction with Urine versus Cervical Culture for Detection of Chlamydia trachomatis in an Asymptomatic Military Population of Pregnant and Nonpregnant Females Attending Papanicolaou Smear Clinics

Performance of a commercial polymerase chain reaction test for endocervical Chlamydia trachomatis infection in a university hospital population

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