Pelvic examination findings and Chlamydia trachomatis infection in asymptomatic young women screened with a nucleic acid amplification test.
BACKGROUND
Nucleic acid amplification tests (NAATs) allow chlamydia screening in asymptomatic women who otherwise may not have pelvic examinations. How often these women have examination findings that may prompt empiric therapy is unclear.


OBJECTIVE
The objective of this study was to assess the relationship of chlamydia with pelvic examination findings in asymptomatic women screened by NAAT.


METHODS
The authors conducted a retrospective analysis of clinical data from 577 young asymptomatic women screened by chlamydial transcription-mediated amplification (TMA).


RESULTS
TMA was positive in 68 (11.8%). The most common examination finding was vaginal discharge (5.9%) followed by cervical ectopy (3.6%), endocervical mucopus (2.3%) or easily induced bleeding (2.3%), and cervical motion (1.4%) or adnexal (0.7%) tenderness. On multivariate analysis, only easily induced bleeding or mucopus predicted chlamydia (adjusted odds ratio [AOR] = 4.7; P = 0.010 and AOR = 4.4; P = 0.015, respectively).


CONCLUSIONS
Abnormal pelvic examination findings were infrequent in asymptomatic young women screened by a chlamydial NAAT. However, endocervical bleeding or mucopus, when present, predicted chlamydia.
Geisler
William M
WM
STD Program, University of Alabama at Birmingham, Birmingham, Alabama 35294-0007, USA. wgeisler@uab.edu
Chow
Joan M
JM
Schachter
Julius
J
McCormack
William M
WM
D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D002692:Chlamydia trachomatis / Q000235:genetics / Q000302:isolation & purification*; D003430:Cross-Sectional Studies; D004269:DNA, Bacterial / Q000032:analysis; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods; D009519:New York City / Q000453:epidemiology; D021141:Nucleic Acid Amplification Techniques / Q000379:methods; D010808:Physical Examination / Q000379:methods; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012495:San Francisco / Q000453:epidemiology; D014626:Vaginal Smears
D004269:DNA, Bacterial