title: Cytologic manifestations of cervical and vaginal infections. II. Confirmation of Chlamydia trachomatis infection by direct immunofluorescence using monoclonal antibodies.
abstract: We found inflammatory patterns of transparent lymphocytes on increased numbers of histiocytes suggestive of chlamydial infection in 68 (56%) of 121 cervical cytologic smears. Chlamydia trachomatis was isolated from 36 (53%) of those with and only two (4%) of those without such inflammatory patterns. Direct stain with fluorescein-conjugated monoclonal antibodies demonstrated elementary bodies of C trachomatis in 30 (79%) of the 38 culture-positive patients, including 29 of the culture-positive patients who had an inflammatory cytologic pattern suggestive of C trachomatis infection. Thus, Papanicolaou smears can be screened for inflammatory pattern, and separate endocervical smears from patients with a pattern suggestive of chlamydial infection can then be stained by immunofluorescence to confirm the presence of C trachomatis infection. This two-step approach detected 29 of 38 infections confirmed by culture in the present study, giving a sensitivity of 76%, a specificity of 100%, and a positive predictive value of 100% in a population having a 31% prevalence of C trachomatis infection.
authors.forename: N B
authors.initials: NB
authors.lastname: Kiviat
authors.forename: M
authors.initials: M
authors.lastname: Peterson
authors.forename: E
authors.initials: E
authors.lastname: Kinney-Thomas
authors.forename: M
authors.initials: M
authors.lastname: Tam
authors.forename: W E
authors.initials: WE
authors.lastname: Stamm
authors.forename: K K
authors.initials: KK
authors.lastname: Holmes
mesh_terms: D000911:Antibodies, Monoclonal; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000473:pathology; D002692:Chlamydia trachomatis; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D065006:Papanicolaou Test; D013194:Staining and Labeling; D002575:Uterine Cervicitis / Q000382:microbiology* / Q000473:pathology; D014626:Vaginal Smears; D014627:Vaginitis / Q000382:microbiology* / Q000473:pathology
chemical_list: D000911:Antibodies, Monoclonal