Use of Cell Culture and a Rapid Diagnostic Assay for Chlamydia trachomatis Screening

Hook, Edward W.; Spitters, Christopher; Reichart, Cindy A.; Neumann, Theresa; Quinn, Thomas C.

doi:10.1001/jama.1994.03520110047027

Cited by 60 publications

(24 citation statements)

References 16 publications

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“…The selected literature was examined for content, and 24 articles deemed to be most relevant to the key questions were selected for critical review. Six articles examined the prospective risk of PID after untreated chlamydial infection [34][35][36][37][38][39], and 12 examined risk of long-term reproductive sequelae after PID, including either PID of any cause [7,15,[27][28][29]40] or C. trachomatis-associated PID [2,4,20,26,41,42]. Two articles prospectively explored the risk of PID after detected and treated chlamydial infection [43,44], and 6 provided information on the risk of sequelae associated with repeated infection [4,7,19,[45][46][47].…”

Section: Methodsmentioning

confidence: 99%

“…PID can serve as a surrogate or intermediary outcome, because its temporal relationship to both chlamydial infection and long-term outcomes is more conducive to study and because it has substantial morbidity and costs [8,11]. Several studies have attempted to assess the proportion of untreated C. trachomatis infections leading to PID [34][35][36][37][38][39], and another set of studies evaluated the proportion of PID cases leading to infertility and ectopic pregnancy [2,4,7,15,20,[26][27][28][29][40][41][42]. Synthesizing these data can offer some insight into the risk of long-term sequelae after untreated chlamydial infection.…”

Section: What Is the Risk Of Sequelae Over Time After An Untreated Cmentioning

confidence: 99%

“…Heinonen and Leinonen [40] [34][35][36]. In a study in 2 Baltimore sexually transmitted diseases (STD) clinics, 3 (3%) of 93 women who tested positive for C. trachomatis by culture developed PID within a median of 2 weeks between testing and treatment [36].…”

Section: S140mentioning

confidence: 99%

See 2 more Smart Citations

Risk of Sequelae afterChlamydia trachomatisGenital Infection in Women

Haggerty¹,

Gottlieb²,

Taylor³

et al. 2010

J INFECT DIS

556

471

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Chlamydia trachomatis infection, the most common reportable disease in the United States, can lead to pelvic inflammatory disease (PID), infertility, ectopic pregnancy, and chronic pelvic pain. Although C. trachomatis is identified among many women who receive a diagnosis of PID, the incidence and timing of PID and long-term sequelae from an untreated chlamydial infection have not been fully determined. This article examines evidence reviewed as part of the Centers for Disease Control and Prevention Chlamydia Immunology and Control Expert Advisory Meeting; 24 reports were included. We found no prospective studies directly assessing risk of long-term reproductive sequelae, such as infertility, after untreated C. trachomatis infection. Several studies assessed PID diagnosis after untreated chlamydial infection, but rates varied widely, making it difficult to determine an overall estimate. In high-risk settings, 2%-5% of untreated women developed PID within the approximately 2-week period between testing positive for C. trachomatis and returning for treatment. However, the rate of PID progression in the general, asymptomatic population followed up for longer periods appeared to be low. According to the largest studies, after symptomatic PID of any cause has occurred, up to 18% of women may develop infertility. In several studies, repeated chlamydial infection was associated with PID and other reproductive sequelae, although it was difficult to determine whether the risk per infection increased with each recurrent episode. The present review critically evaluates this body of literature and suggests future research directions. Specifically, prospective studies assessing rates of symptomatic PID, subclinical tubal damage, and long-term reproductive sequelae after C. trachomatis infection; better tools to measure PID and tubal damage; and studies on the natural history of repeated chlamydial infections are needed.

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Section: Methodsmentioning

confidence: 99%

Section: What Is the Risk Of Sequelae Over Time After An Untreated Cmentioning

confidence: 99%

See 1 more Smart Citation

Risk of Sequelae afterChlamydia trachomatisGenital Infection in Women

Haggerty¹,

Gottlieb²,

Taylor³

et al. 2010

J INFECT DIS

556

471

View full text Add to dashboard Cite

show abstract

“…2,8,10,64,[75][76][77][78][79][80][81][82][83][84][85]90,92 For example, CT is rarely isolated from more than half of males with leukocyte esterase positive urine samples and females with leukocyte laden vaginal wet mounts and endocervical gram stains. 2,64,[75][76][77][78][79][80][81][82][83][84][85] Thus, these non-specific clinical and laboratory findings should be regarded as a trigger for testing, not treatment.…”

Section: And M 6: Lower Genital Tract Chlamydial Infection Is a Clinimentioning

confidence: 99%

“…8,64,92,[98][99][100] Indeed, with sensitivities ranging from 65% to 85%, none of these techniques is sensitive enough to be recommended for routine clinical use. 8,64,[98][99][100] In settings where CT is prevalent and follow-up uncertain, on-site treatment of individuals with positive rapid test results and back-up NAAT testing for those with negative results should decrease transmission and the risk of incurring costly sequelae.…”

Section: And M 6: Lower Genital Tract Chlamydial Infection Is a Clinimentioning

confidence: 99%

Chlamydia Trachomatis: Common Misperceptions and Misunderstandings

Stevens‐Simon

Sheeder

2005

Journal of Pediatric and Adolescent Gynecology

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Urine-Based Screening of Adolescents in Detention to Guide Treatment for Gonococcal and Chlamydial Infections

Smith²,

O'Cain³

et al. 1998

Arch Pediatr Adolesc Med

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Objectives: To determine the utility of urine-based ligase chain reaction assays for Neisseria gonorrhoeae and Chlamydia trachomatis in (1) the acceptability of such testing to adolescent detainees, (2) the potential use of these tests for identifying asymptomatic infections, and (3) the effectiveness of this approach for ensuring treatment of infected adolescents.Design: Cross-sectional screening and verification of treatment for infected cases.Subjects: Adolescents admitted to a short-term juvenile detention center.Main Outcome Measures: Neisseria gonorrhoeae and C trachomatis infection rates, and timing and location of treatment for infected patients.Results: Refusal rate was 1.5%. Of 263 participants, 46 (17.5%) were female subjects. Chlamydia trachomatis infections were identified in 28.3% of the female and 8.8% of the male subjects. Neisseria gonorrhoeae infections were present in 13.1% of the female and 2.8% of the male subjects. Overall, 37 participants (14%) were positive for N gonorrhoeae, C trachomatis, or both, only one of whom had symptoms. Almost 70% (25/36) of asymptomatic infected subjects were treated within 28 days of screening. A treatment was documented in 36 of the 37 infected youth, including 20 who were followed up and treated after release from the detention center, by 6 months after testing. Conclusion:Urine ligase chain reaction tests were effective for identifying and guiding treatment of unsuspected N gonorrhoeae and C trachomatis infections in teenagers admitted to a short-term detention center where traditional swab specimens may be difficult to obtain.

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Use of Cell Culture and a Rapid Diagnostic Assay for Chlamydia trachomatis Screening

Cited by 60 publications

References 16 publications

Risk of Sequelae afterChlamydia trachomatisGenital Infection in Women

Risk of Sequelae afterChlamydia trachomatisGenital Infection in Women

Chlamydia Trachomatis: Common Misperceptions and Misunderstandings

Urine-Based Screening of Adolescents in Detention to Guide Treatment for Gonococcal and Chlamydial Infections

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