Use of a Direct Fluorescent Antibody Test for Detecting Chlamydia trachomatis Cervical Infection in Women Seeking Routine Gynecologic Care

• Published in: The Journal of infectious diseases Vol. 156; no. 4; pp. 575 - 581
• Main Authors: Phillips, Russell S., Hanff, Philip A., Kauffman, Robert S., Aronson, Mark D.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University Chicago Press 01.10.1987; University of Chicago Press
• Subjects: Adult; Bacterial diseases; Bacterial diseases of the genital system; Biological and medical sciences; Cervix Uteri - microbiology; Chlamydia; Chlamydia Infections - diagnosis; Chlamydia trachomatis; Epithelial cells; Female; Fluorescence; Fluorescent Antibody Technique; Human bacterial diseases; Humans; Infections; Infectious diseases; Medical sciences; Middle Aged; Monoclonal antibodies; Mucus; Original Articles; Predictive Value of Tests; Sexually transmitted diseases; Specimens; Uterine Cervical Diseases - diagnosis; Vaginal smears; Human; Infection; Screening; Bacteriosis; Chlamydiosis; Uterine cervix; Female genital diseases
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/156.4.575

We determined the sensitivity, specificity, and predictive value of a direct fluorescence test for Chlamydia trachomatis infectioncompared with culture of the endocervix in women seeking routine gynecologic care. Of 527 patients seen in a hospital-based practice, 23 (4.4%) had a positive culture for C. trachomatis. The overall sensitivity of the direct test was 70%, and the specificity was 98%. When five or more endocervical cells were present on the direct test slide, the sensitivity increased to 92%, and the specificity decreased to 96% (P < .05). When the presence of any columnar epithelial cells, five or more elementary bodies, or both was used as the criteria for accepting specimens, the sensitivity and specificity of the direct test were 80% and 96%, respectively. However, 44% of the specimens would be rejected if these criteria were used. The overall probability that an individual with a positive direct test would have a positive culture was 62%.