title: Pelvic examination findings and Chlamydia trachomatis infection in asymptomatic young women screened with a nucleic acid amplification test.
abstract: 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.
authors.affiliation: STD Program, University of Alabama at Birmingham, Birmingham, Alabama 35294-0007, USA. wgeisler@uab.edu
authors.forename: William M
authors.initials: WM
authors.lastname: Geisler
authors.forename: Joan M
authors.initials: JM
authors.lastname: Chow
authors.forename: Julius
authors.initials: J
authors.lastname: Schachter
authors.forename: William M
authors.initials: WM
authors.lastname: McCormack
mesh_terms: 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
chemical_list: D004269:DNA, Bacterial