Detection of Chlamydia trachomatis in pregnant women by the Papanicolaou technique, enzyme immunoassay and polymerase chain reaction.
OBJECTIVE
To compare Papanicolaou staining, enzyme immunoassay (EIA) and the polymerase chain reaction (PCR) techniques for detecting Chlamydia trachomatis in pregnant women.


METHODS
Endocervical specimens were taken randomly from 125 pregnant women with or without symptoms. These women attended their first medical consultation at the Regional General Ignacio Zaragoza Hospital. Samples were analyzed for detection of C trachomatis. When results differed between tests, specimens were evaluated by direct immunofluorescence staining.


RESULTS
The prevalence of chlamydial infection was 2.4%. The characteristics of patients positive for Chlamydia were: average age, 24 years; first sexual encounter at age 21 years, one partner and six to nine months of gestation. The sensitivity, specificity, accuracy, positive predictive values and negative predictive values were 100%, 99.18%, 99.20%, 75% and 100%, respectively, for Papanicolaou staining; 100%, 92.62%, 92%, 25% and 100% for EIA; and 100%, 100%, 100% and 100% for PCR.


CONCLUSIONS
Both Papanicolaou staining and PCR were adequate for diagnosis of C trachomatis infection. EIA was not reliable and therefore is not recommended for use as a diagnostic technique in a pregnant population with low risk and low prevalence.
Bañuelos Pánuco
C A
CA
Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, México, Distrito Federal. ady@lambda.gene.cinvestav.mx
Deleón Rodríguez
I
I
Hernández Méndez
J T
JT
Martínez Guzmán
L A
LA
Akle Fierro
D
D
Miranda Murillo
J
J
Reyes Maldonado
E
E
D000328:Adult; D000942:Antigens, Bacterial / Q000032:analysis; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000235:genetics / Q000302:isolation & purification*; D004269:DNA, Bacterial / Q000032:analysis; D005069:Evaluation Studies as Topic; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D007124:Immunoenzyme Techniques / Q000379:methods; D065006:Papanicolaou Test; D016133:Polymerase Chain Reaction / Q000379:methods; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000382:microbiology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014626:Vaginal Smears / Q000379:methods
D000942:Antigens, Bacterial; D004269:DNA, Bacterial