Polymerase chain reaction for detection of endocervical Chlamydia trachomatis infection in women attending a gynecology outpatient department in India.
OBJECTIVE
To detect Chlamydia trachomatis infection by polymerase chain reaction (PCR) in symptomatic women attending a gynecology clinic in a city hospital and in randomly selected slum dwellers.


METHODS
Endocervical specimens were collected from 350 women with genitourinary complaints (group I) and 53 slum dwellers (group II). Samples were analyzed by PCR, direct fluorescence assay (DFA) and Giemsa stain cytology for detection of C trachomatis and compared for their sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).


RESULTS
The prevalence of endocervical C trachomatis infection was 43.1% and 24.5% in groups I and II, respectively. The sensitivity, specificity, PPV and NPV of PCR were 80.0%, 75.0%, 66.6% and 85.7%, respectively, when DFA was considered true positive. The percent increment in detection of C trachomatis by PCR was 15.3%.


CONCLUSIONS
Giemsa stain cytology has low sensitivity and specificity; hence, it cannot be recommended for use as a diagnostic technique. It appears that PCR can be used routinely in Chlamydia diagnosis and in screening selected populations. The high positivity of C trachomatis infection in urban slum dwellers is cause for concern.
Singh
Vineeta
V
Institute of Pathology, Indian Council of Medical Research, Safdarjang Hospital Campus, P.B. No. 4909, New Delhi-110 029, India.
Rastogi
Sangita
S
Garg
Suneela
S
Kapur
Sujala
S
Kumar
Amit
A
Salhan
Sudha
S
Mittal
Aruna
A
D000328:Adult; D002584:Cervix Uteri / Q000382:microbiology; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology; D002692:Chlamydia trachomatis / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D007194:India / Q000453:epidemiology; D008403:Mass Screening; D010045:Outpatients; D016133:Polymerase Chain Reaction / Q000379:methods*; D011237:Predictive Value of Tests; D015995:Prevalence; D012680:Sensitivity and Specificity; D012923:Social Class; D014504:Urban Health; D002577:Uterine Cervical Diseases / Q000175:diagnosis* / Q000453:epidemiology; D002575:Uterine Cervicitis / Q000382:microbiology; D014626:Vaginal Smears