PCR testing of genital and urine specimens compared with culture for the diagnosis of chlamydial infection in men and women

The aim of this study was to assess if patient characteristics could influence the sensitivity of enzyme immunoassay (EIA) testing used for chlamydia screening. Our cohort consisted of 56 patients who were known polymerase chain reaction-positive for chlamydia, but with variable EIA results. Characteristics analysed included those already known to influence the EIA (menstruation, pregnancy, difficult examination) and those suspected from clinical observation (including presence of symptoms or signs, coexistent gonorrhoea, duration from last sexual exposure). An unexpected finding was that significantly more cases of bacterial vaginosis were found in those chlamydia EIA-negative compared to those with positive results. We postulate that an enzyme produced in bacterial vaginosis, proline aminopeptidase, may cause destruction of the chlamydial cell wall, therefore affecting the EIA adversely. Further research is needed to explore this hypothesis.

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“…As anticipated the PCR method almost doubled the chlamydia yield (see Table 1) in keeping with our studies 8,9 .…”

Section: Resultssupporting

confidence: 91%

Does bacterial vaginosis alter the sensitivity of screening tests for Chlamydia trachomatis? An analysis of patient characteristics

et al. 2003

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“…Van Der Pol et al (13) tested 2,236 endocervical swab specimens for C. trachomatis in this system and reported sensitivity after discrepancy resolution of 89.7% and inhibitors in 2.4%. Young et al (15), who also tested only for C. trachomatis in 286 endocervical samples, describe sensitivity, specificity, and positive and negative predictive values for CA of 96, 100, 100, and 99.1%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of COBAS AMPLICOR (Roche): Accuracy in Detection of Chlamydia trachomatis and Neisseria gonorrhoeae by Coamplification of Endocervical Specimens

Livengood

Wrenn

2001

J Clin Microbiol

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We evaluated further the accuracy of the COBAS AMPLICOR (Roche) (CA) PCR-based system in detection of Chlamydia trachomatis and Neisseria gonorrhoeae in endocervical specimens. Endocervical specimens collected for any indication for testing for C. trachomatis and N. gonorrhoeae among a university hospital health system population were included. Testing for C. trachomatis was done by two PCR methods, CA and manual microwell AMPLICOR (Roche) (MWA), and by culture; testing for N. gonorrhoeae was done by CA and culture. Discrepancy resolution was performed. Reproducibility testing and hands-on labor time measurements for CA were done. Among 654 C. trachomatis samples, the prevalence of true positivity was 9.2%, and among the 618 N. gonorrhoeae samples, the prevalence of true positivity was 4.4%. result was estimated to be at 7.5 min. The prevalence of inhibitory specimens was 3.5%, including two positive C. trachomatis samples which would have been missed otherwise. The direct cost of each clinical result with CA was estimated to be $9.09. Our methods include a diverse range of indications for testing among women, using endocervical swabbing samples, 2 M sucrose phosphate transport medium, and discrepancy resolution for comparison. Under our test conditions, the CA system is an accurate, rapid, and cost-and labor-efficient method for detection of C. trachomatis and N. gonorrhoeae.Diagnosis of infection through laboratory testing based on the identification of amplified nucleic acid specific to the causative agent has been rapidly integrated into clinical practice, particularly in female reproductive tract infections (2). These tests offer enhanced accuracy and a marked decrease in time to result compared to traditional methods. In general these tests are also labor saving. Broad-based screening for genital Chlamydia trachomatis and Neisseria gonorrhoeae infections in women has been recommended (3), as they are prevalent and often asymptomatic and are the major known causes of ectopic pregnancy and tubal factor infertility when not detected and treated. They are also the two known causes of the acute clinical syndromes of mucopurulent cervicitis and pelvic inflammatory disease. Thus, the availability of a largely automated amplified nucleic acid-based test to assay simultaneously for chlamydia and gonococcal infection from a single specimen is an important advance and deserves intensive study in different settings to assess its true value.In this study we evaluated the accuracy, reproducibility, labor requirements, and costs of the COBAS AMPLICOR CT/NG system (Roche Diagnostic Systems, Branchburg, N.J.) (CA) for the detection of C. trachomatis and N. gonorrhoeae infections in endocervical swab samples. MATERIALS AND METHODSFemale patients for whom testing for endocervical C. trachomatis and N. gonorrhoeae infection was indicated, as determined by their practitioners, provided specimens for this study. These patients were seen in our emergency department, private and staff obstetric and gynecologic clinics, and inpati...

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“…Polymerase chain reaction (PCR) and ligase chain reaction (LCR) have been offered for detection of C. trachomatis (10,11). Accuracy of nucleic acid amplification tests (NAATs) in detection of C. trachomatis infections have been shown in several studies (11,12). The specificity of the PCR was 100% and the sensitivity was 100% (13).…”

Section: Introductionmentioning

confidence: 99%

Chlamydia trachomatis Detection by Nested-PCR Method on Females Referred to Medical Centers of Tehran, Iran

Eslami

Goudarzi

Taheripanah

et al. 2012

Arch Clin Infect Dis

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Background:Chlamydia trachomatis (C. trachomatis) is the most common sexually transmitted bacterial infectious disease in the world. Moreover, it plays a role in spontaneous abortion. The accuracy of PCR in detection of C. trachomatis infections has been shown in several studies. Objectives: The frequency of spontaneous abortion and known side effects and statistics vary in Chlamydia trachomatis infection in women with spontaneous abortion and different ways to identify and determine the prevalence of Chlamydia trachomatis are used. Materials and Methods: Four sterile Dacron swabs were used to collect specimens from endocervix and vagina from women with miscarriage. DNA was extracted by AccuPrep Genomic DNA extraction kit. The nested PCR procedure was performed with two pair primers. This study was conducted on women referred to Medical Centers of Tehran, Iran in 1391. Results: The number of intercourses per week and history of miscarriage can be known as the risk factors of abortion. Frequency of C. trachomatis in endocervix was 13.25%; the amount of vaginal infection among this group was 19%. Conclusions: Nested PCR as a sensitive Chlamydia trachomatis detection test and endocervical specimens has been offered to detect this bacterium in spontaneous abortion. Besides, C. trachomatis screening among pregnant women can be suggested to prevent abortion.

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PCR testing of genital and urine specimens compared with culture for the diagnosis of chlamydial infection in men and women

Cited by 21 publications

References 0 publications

Does bacterial vaginosis alter the sensitivity of screening tests for Chlamydia trachomatis? An analysis of patient characteristics

Does bacterial vaginosis alter the sensitivity of screening tests for Chlamydia trachomatis? An analysis of patient characteristics

Evaluation of COBAS AMPLICOR (Roche): Accuracy in Detection of Chlamydia trachomatis and Neisseria gonorrhoeae by Coamplification of Endocervical Specimens

Chlamydia trachomatis Detection by Nested-PCR Method on Females Referred to Medical Centers of Tehran, Iran

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