Use of a Direct Fluorescent Antibody Test for Detecting Chlamydia trachomatis Cervical Infection in Women Seeking Routine Gynecologic Care

Abstract

We determined the sensitivity, specificity, and predictive value of a direct fluorescence test for Chlamydia trachomatis infection compared with culture of the endocervix in women seeking routine gynecologic care. Of 527 patients seen in a hospital-based practice, 23 (4.4%) had a positive culture for C. trachomatis. The overall sensitivity of the direct test was 70%, and the specificity was 98%. When five or more endocervical cells were present on the direct test slide, the sensitivity increased to 92%, and the specificity decreased to 96% (P less than .05). When the presence of any columnar epithelial cells, five or more elementary bodies, or both was used as the criteria for accepting specimens, the sensitivity and specificity of the direct test were 80% and 96%, respectively. However, 44% of the specimens would be rejected if these criteria were used. The overall probability that an individual with a positive direct test would have a positive culture was 62%.

Oral Chlamydia trachomatis in patients with established periodontitis

“…For endocervical specimens "adequate" is the presence of whole columnar cells, and for the oral specimens cuboidal cells were used [39,54]. The majority of periodontal specimens, and in particular specimens from the diseased periodontal sites (93%, 81/87) were adequate.…”

“…For DFA testing of cervical specimens an adequate specimen contains columnar epithelial cells for these are the host cells preferred by C. trachomatis [39,54]. In 82% of the specimens from the diseased periodontal sites with deep pocket depths, the cuboidal epithelial cells were present.…”

Avaliação de parâmetros para o diagnóstico laboratorial de infecção genital feminina pela Chlamydia trachomatis

“…Avaliou-se nos esfregaços a presença de c o r p ú s c u l o s e l e m e n t a r e s ( C E s ) v e r d e s fluorescentes e o número de células epiteliais presentes. De acordo com esta última variável, os esfregaços foram assim classificados: a) sem células epiteliais; b) com 1 a 4 células; c) com 5 a 9 células e d) com 10 ou mais células epiteliais, sendo considerados adequados os materiais com mais de 5 células nos esfregaços 19 . Pesquisa de anticorpos nas secreções cervicais.…”

“…O método mais aplicado para isolamento da C. trachomatis na atualidade é o tratamento da célula McCoy com a cycloheximida, droga citostática que permite a utilização de células em plena atividade metabólica, com apenas 24h de incubação, tornando-as mais sensíveis ao desenvolvimento da clamídia 21 . Na coleta da amostra, quer para fins citológicos, quer para fins de isolamento, devese sempre considerar a quantidade de células epiteliais contidas nesse material 19 , levando-se em conta que a clamídia é um microrganismo intracelular obrigatório, com preferência por células do epitélio colunar. Assim, a presença dessas células reflete a qualidade da amostra para diagnóstico laboratorial.…”

Current Methods of Laboratory Diagnosis of Chlamydia Trachomatis Infections

“…Both the sensitivity and the specificity of diagnostic tests for C. trachomatis have been shown to be directly related to the adequacy of the specimen (82,95,137,159,187). The lack of specimen adequacy remains a serious shortcoming in many screening programs and research studies.…”