Evaluation of Different Techniques in Diagnosing Chlamydial Endocervical Infection Among Egyptian Females

Abstract

Objective: To detect the prevalence of Chlamydia. Trachomatis infection symptomatic and asymptomatic in Egyptian females and to evaluate the diagnostic utility of polymerase chain reaction (PCR), direct immunofluorescence technique (DIF), and enzyme-linked immunosorbent assay (ELISA) for detection of C Trachomatis DNA, antigen and antibody respectively. Study design: The study included 70 females who have been classified into :20 patients with tubal infertility, 15 patients with ectopic pregnancy, 20 patients with premature rupture of membrane (PROM) and 15 apparently healthy women (asymptomatic group). Endocervical specimens, vaginal swab and 3 ml blood samples have been collected from all subjects and stored at –20C till being processed. PCR,DIF and ELISA techniques have been done to detect C. Trachomatis DNA, antigen and antibody respectively. Results: C. Trachomatis DNA was detected by PCR in the endocervix of 17 out of 55 infected cases (30.9 % ). however DIF technique was positive for 21.6% of patient groups and 13.3% of asymptomatic group. The tubal infertility group showed the highest percentage of active C. Trachomatis infection (45%) (P<0.05) PCR showed better sensitivity than DIF for detection of C. Trachomatis infection (96.2% versus 70% respectively), however both techniques had 100% specificity. Tubal infertility group showed highest sero prevalence (45%), followed by ectopic pregnancy group (35%) (P= 0.001 and P<0.05 respectively). Conclusions: PCR procedure is suitable for confirmation of ELISA results in high-volume laboratories. Cost, experience of the laboratory personnel and the patient well-being must be taken into account to select the test for the detection of C.Trachomatis infections.