Comparison of a DNA probe assay with culture for the detection of Chlamydia trachomatis.

A new DNA probe assay (PACE 2, Gen-probe) was compared with cell culture for the detection of Chlamydia trachomatis in 909 women attending the Royal Women's Hospital, Melbourne, Victoria. The DNA probe assay had a sensitivity of 86.2%, a specificity of 99.9% and a positive predictive value of 96.2% in a population with 3.2% prevalence, indicating that it may be a suitable alternative to culture for the detection of C. trachomatis in specimens from the genital tract.

Chlamydia trachomatis--role in tubal infertility.

The prevalence of humoural IgG and IgM antibodies to Chlamydia trachomatis was determined in 110 infertile women and compared to 87 healthy pregnant women without any known fertility problem. Overall antibodies to chlamydia were detected in 45% of infertile women. Antibodies were found in significantly more patients with tubal factor infertility (65%) than in women whose infertility was due to other causes (22%) (p less than 0.005). These findings are consistent with the hypothesis that C. trachomatis is a major cause of tubal factor infertility. In addition the prevalence of antibody in patients with other sexually transmitted diseases (STD), pelvic inflammatory disease and confirmed chlamydia cases were evaluated. Within this miscellaneous high risk group of patients, chlamydial antibodies were detected commonly, ranging from 19-72%.

Simplified culture procedure for large-scale screening for Chlamydia trachomatis infections.

A method that uses a 48-well tissue culture cluster tray system for the isolation of Chlamydia trachomatis is described. The cluster tray system was as sensitive (100%) as and more time efficient than the conventional cover slip method, thereby being considerably cost saving. With both culture methods, the prevalence rates of genital carriage of C. trachomatis in women attending clinics for legal abortion and for cervical dysplasia were 5% (31 of 641 patients) and 2% (3 of 148 patients), respectively.

Comparison of polymerase chain reaction and culture techniques for detection of Chlamydia trachomatis.

The aim of this study was to compare culture and polymerase chain reaction techniques in detection of Chlamydia trachomatis in clinical specimens. Two hundred clinical specimens previously examined for C. trachomatis by culture were analysed blindly by polymerase chain reaction. A 144 bp fragment of DNA from the MOMP of C. trachomatis was amplified. In addition, a 250 bp segment of beta-globin gene was amplified as an internal control. In 27 culture negative specimens, the beta-globin amplicon was not detected. Of the 173 specimens assessable by PCR, 24 (13.8%) were positive by both methods. Four specimens were positive by PCR and negative by culture. Three were collected post-antibiotic treatment; two were from previous culture-proven chlamydia infection suggestive of the presence of DNA of non-viable organisms, and one case was toxic by culture. No specimen was positive by culture and negative by PCR. Overall PCR when compared to culture had a sensitivity of 100% and specificity of 97.3% with positive and negative predictive values of 85.7% and 100%, respectively. PCR is especially useful when culture results can not be confirmed due to toxicity, inadequate transport or insufficient specimen collected.

Chlamydia trachomatis conjunctivitis. Prevalence and association with genital tract infection.

OBJECTIVES: To determine the prevalence of Chlamydia trachomatis in acute conjunctivitis (non-trachoma) in Australia and to examine the source of transmission. DESIGN: A prospective survey of 400 consecutive patients presenting with acute conjunctivitis to the Royal Victorian Eye and Ear Hospital Emergency Department, Melbourne, from May to November 1991. Patients identified with chlamydial conjunctivitis during the survey period and in the following two months were assessed for concomitant genital infection. RESULTS: Chlamydia was the causative organism in 2% of patients with acute conjunctivitis. Of 15 patients with chlamydial conjunctivitis, 11 presented with disease in one eye only, and the same number had had symptoms for longer than two weeks. Many had been seen previously by experienced ophthalmologists, yet there were long delays in making a definitive diagnosis. Ten of the 12 adult patients who were assessed had signs of concomitant genital tract infection, although none had past or current genital tract symptoms. Serotyping of chlamydial isolates from the genital tract and eye showed concordance in individual patients. CONCLUSION: Most cases of ocular chlamydia infection have a genital source. Therefore, it is essential that all patients with chlamydial conjunctivitis and their sexual partners are examined and treated for concomitant genital infection.

A comparison of cytobrush and cotton swab sampling for the detection of Chlamydia trachomatis by cell culture.

A cytobrush was compared with a cotton-tipped aluminium shafted swab for the collection of 2024 paired endocervical specimens for the culture of Chlamydia trachomatis. There was no significant advantage with the use of either device with respect to the number of positive specimens detected or the number of inclusions present in positive specimens. However, the use of cytobrushes resulted in an increased level of cervical bleeding and increased collection of cervical mucus resulting in difficulties in the handling of laboratory specimens.

Patient-administered tampon-collected genital cells in the assessment of Chlamydia trachomatis infection using polymerase chain reaction.

BACKGROUND: Diagnosis of genital Chlamydia trachomatis infection in women traditionally requires a speculum examination to collect endocervical cells, followed by cell culture. This method is time consuming, requires stringent transport conditions, and is technically demanding. GOALS: To compare tampons as a patient-administered collection method followed by detection with polymerase chain reaction (PCR) with the traditional endocervical swab culture followed by cell culture detection. STUDY DESIGN: At the emergency department of a hospital for obstetrics and gynecology, 1,000 consecutive women with symptoms suggestive of infection with C. trachomatis were tested for C. trachomatis infection by PCR on both tampon (PCR-T) and swab (PCR-S) specimen and by culture of the swab specimen. RESULTS: Seventeen PCR-T and 16 PCR-S specimens were positive; 16 endocervical specimens were positive by culture, and 14 of the endocervical samples were positive by the three methods. Sixty-one PCR-S samples were inadequate as shown by the lack of amplification of the beta-globin gene segment, indicating poor collection of specimens by endocervical swab for chlamydial testing. CONCLUSIONS: Tampon specimens collected for PCR detection provided an easy and sensitive method of detection of C. trachomatis and overcame the obstacle of endocervical sampling and subsequent stringent transport requirements of culture.