Endocervical Samples Research Articles

Conventional Agar-Based Culture Method, and Nucleic Acid Amplification Test (NAAT) of the cppB Gene for Detection of Neisseria gonorrhea in Pregnant Women Endocervical Swab Specimens

BackgroundNeisseria gonorrhea is the etiological agent of the sexually transmitted disease (STD) gonorrhea, and primarily infects the mucous membranes of the urethra, endocervix, pharynx or rectum of females which may result in substantial morbidity. N. gonorrhea also causes disseminated infection, with complications that may result in ectopic pregnancy, tubal infertility, chronic pelvic pain or maternal transmission of gonorrhea, and also increases susceptibility to HIV.ObjectivesIn the present investigation, we used conventional agar-based culture method, and nucleic acid amplification of CCPB gene for detection of Neisseria gonorrhea in endocervical swabs samples collected from pregnant women studiedPatients and MethodsEndocervical swabs specimens for this study were obtained from 1100 pregnant women who presented to Shiraz (Iran) Hospitals from 2009 to 2011. In the present investigation we used conventional agar-based culture method, and nucleic acid amplification test (NAAT) of CCPB gene for detection of Neisseria gonorrhea in endocervical swabs samples collected from pregnant women studied. From each pregnant woman two endocervical swabs were taken: one swab placed in tubes containing phosphate buffered saline for Polymerase Chain Reaction, and the other to inoculate on culture media.ResultsAmong 1100 endocervical swabs examined, 13 (1.18%) samples had positive results by polymerase chain reaction (PCR) on Neisseria gonorrhea CCPB gene. All endocervical swabs culture had negative results for Neisseria gonorrhea. 84 (7%) of the women had vaginal discharge, in whom PCR on endocervical swabs of these individuals had negative findings.ConclusionsNucleic acid amplification tests (NAATs) are very appropriate in detection of infected individuals. Detection techniques such as NAATs are independent of bacterial viability, and have a potential to limit false negative samples, therefore, in our country, the application of different laboratory diagnosis methods including NAATs with culture as gold standard for determination antimicrobial susceptibility is essential.

Primary Cervical Cancer Screening and Triage Using an mRNA Human Papillomavirus Assay and Visual Inspection

Mexican Cervical Cancer Screening Study II (MECCS II) seeks to develop a highly sensitive and highly specific screening program able to be adapted to all socioeconomic levels in Mexico. The objectives of MECCS II are (1) to compare the sensitivity and specificity for cervical intraepithelial neoplasia (CIN) 3 or cancer of self-collected vaginal specimens tested for high-risk types of the human papillomavirus (HR-HPV) by APTIMA with those tested for HR-HPV by Hybrid Capture 2 (HC2); and (2) determine the efficacy of cryotherapy in the treatment of HR-HPV-positive and acetic acid-aided visual inspection (VIA)-positive and -negative women after VIA triage. The study was conducted in rural Mexico. Women aged 30 to 50 years, nonpregnant, with no history of hysterectomy or pelvic irradiation and varied histories of screening, participated. A direct endocervical sample was tested for cytology, HC2, and APTIMA assay (AHPV). Subjects positive on any test were recalled for triage VIA, biopsies, and immediate cryotherapy. Tests were compared using McNemar test. Two thousand forty-nine patients have complete results. Mean age of the patients was 39.2 years; 7.7% presented with ≥atypical squamous cells of uncertain significance (ASCUS), 1.8% ≥low-grade squamous intraepithelial neoplasia, and 0.5% ≥high-grade squamous intraepithelial neoplasia. Two percent of patients had ≥CIN2, and 0.78% had ≥CIN3 (including 2 with invasive disease). The sensitivity of ThinPrep (>ASCUS), HC2, and AHPV for >CIN3 for direct endocervical collection was 87.5%, 100%, and 100%, respectively. The specificity of ThinPrep (>ASCUS), HC2, and AHPV for >CIN3 was 94.1%, 92.2%, and 93.5%, respectively. Specificities of HC2 and AHPV differed significantly. The overall percentage of agreement among HPV assays (HC2 vs APTIMA) is 97%. Four hundred sixty-nine women returned for VIA. Two hundred ninety-one women were treated with cryotherapy. The specificity of the APTIMA assay along with high sensitivity is an advantage for primary screening. Follow-up evaluation will be important to determine the true impact of potential undertreatment in the screening algorithm. Self-sampling applications are explored.

A Simple HPV 18 Detection Method Based on Ultra Specific Primer Immobilized on Glass Slides

This study was carried out to develop a simple and inexpensive method for detection of Human papillomavirus (HPV 18) based on irreversible immobilization of ultra specific primer on silanized glass slides. This method is revealed by Blue Green Loading Dye I (LGC) and compared with conventional polymerase chain reaction (PCR) for endocervical samples. The new method was tested in 40 DNA samples with precancer uterine lesions of women treated in Hospital of Recife PE, Brazil. DNA samples were extracted using Wizard Genomic DNA Purification Kit according to manufacturer's instructions. The samples were tested for HPV 18 by conventional PCR (PCRc) and the products visualized on 1.2% agarose gel, with LGC under UV 260 nm. After that the positive and negative samples to HPV 18 were tested by immobilization method and the results visualized with LGC under UV 260 nm. Both PCRc and immobilization method showed high degree of correlation (95%), whereas comparison between PCRc and immobilization method showed good correlation (100%). PCRc is widely known for detection of HPV because of its high sensitivity and efficiency, but due to high cost it is not yet standardized for use in public health laboratories. In our study, the single-stranded DNA immobilized method on a glass slide was effective in screening for HPV revealed by Blue Green and may be an alternative method for diagnosis of HPV once it offers a fast, and easy handling.

Low Prevalence of Cervical Cancer Screening Among HIV-Positive Women in Catalonia (Spain)

There is evidence that HIV-positive women in Catalonia are at high risk for cervical cancer and have a high prevalence of oncogenic genotypes. Catalonia’s screening protocol recommends that HIV-positive women undergo Pap smear at least annually, and more frequently depending on CD4 count. The objective of the present study is to describe the cervical cancer screening among HIV-positive women in Catalonia, with an emphasis on screening coverage. This study included 479 HIV-positive women from the PISCIS cohort. Participants completed a clinicalepidemiological survey that included sociodemographic, behavioral, clinical, and screening history variables. All patients also underwent a gynecological exam, including endocervical sampling for conventional or liquid cytology (Papanicolau). 50.6% of the women reported annual PAP screenings; 11% had never had a Pap smear; and screening coverage for the last two-year was only 60.0%. The finding of low screening coverage is consistent with the high prevalence of cervical cancer in HIV-positive women in Catalonia. It is important to educate both medical professionals and HIV-positive women on the consequences of failure to screen for cervical cancer, diagnostic techniques to detect asymptomatic HPV, and methods of primary prevention.

Assessment of self taken swabs versus clinician taken swab cultures for diagnosing gonorrhoea in women: single centre, diagnostic accuracy study

Objective To compare gonorrhoea detection by self taken vulvovaginal swabs (tested with nucleic acid amplification tests) with the culture of urethral and endocervical samples taken by clinicians.Design Prospective study of...

Assessment of best single sample for finding chlamydia in women with and without symptoms: a diagnostic test study

Objective To compare vulvovaginal swabs with endocervical swabs as optimal diagnostic sample for detection of Chlamydia trachomatis infection.Design A diagnostic test study.Setting An urban sexual health centre.Participants 3973 women aged...

Intraoperative post‐conisation human papillomavirus testing for early detection of treatment failure in patients with cervical intraepithelial neoplasia: a pilot study

To evaluate the feasibility and utility of intraoperative post-conisation human papillomavirus (IOP-HPV) testing and cytology to detect treatment failure in patients with cervical intraepithelial neoplasia grades2-3 (CIN2-3). Prospective observational pilot study. Barcelona, Spain. A cohort of 132 women treated for CIN2-3 by loop electrosurgical conisation. An endocervical sample was obtained intraoperatively with a cytobrush from the cervix remaining after the conisation. The material was kept in PreservCyt medium and processed for Hybrid Capture2 and cytology. Patients were followed-up for 24months. The performance of IOP-HPV testing and IOP cytology was compared with conventional indicators of recurrence (cone margin, endocervical curettage, and HPV testing and cytology at 6months). Treatment failure (i.e. recurrent CIN2-3 during follow-up). Treatment failure was identified in 12 women (9.1%). IOP-HPV testing for sensitivity, specificity, and positive and negative predictive values for treatment failure were 91.7, 78.3, 62.2, and 96.0%, respectively, which are similar to the figures for conventional HPV testing at 6months (91.7, 76.0, 64.0, and 95.1%, respectively), and are better than the values of other conventional predictive factors (cone margin, endocervical curettage, and cytology intraoperative at 6months). IOP-HPV was strongly associated with treatment failure in the multivariate analysis (OR 15.40, 95%CI 1.58-150.42). IOP-HPV testing is feasible, and accurately predicts treatment failure in patients with CIN2-3. This new approach may allow an early identification of patients with treatment failure, thereby facilitating the scheduling of an attenuated follow-up for negative patients who are at very low risk of persistent disease.

Investigating a cluster of vulvar cancer in young women: a cross-sectional study of genital human papillomavirus prevalence

BackgroundVulvar cancer is a relatively rare malignancy, which occurs most often in postmenopausal women. We have previously identified a geographic cluster of vulvar cancer in young Indigenous women living in remote communities in the Arnhem Land region of Australia. In this population, we investigated the prevalence of oncogenic human papillomavirus (HPV) infection in anogenital samples (vulvar/vaginal/perianal area and cervix) and compared the overall, type-specific and multiple infection prevalence between sites.MethodsA cross-sectional survey of 551 Indigenous women aged 18–60 years was undertaken in 9 Arnhem Land communities. Women were consented for HPV detection and genotyping collected by a combined vulvar/vaginal/perianal (VVP) sweep swab and a separate PreservCyt endocervical sample collected during Pap cytology screening. HPV DNA testing was undertaken using PCR with broad spectrum L1 consensus PGMY09/11 primers with genotyping of positive samples by Roche Linear Array. The primary outcomes were the prevalence of cervical and VVP high-risk (HR) HPV.ResultsThe prevalence of VVP HR-HPV was 39%, which was significantly higher than the cervical HR-HPV prevalence (26%, p<0.0001). HPV-16 was the most common genotype detected in both sites (VVP 11%, cervical 6%). HPV-16 infection peaked in women aged <20 years; however, there was a marked decline in cervical HPV-16 prevalence with age (p=0.007), whereas following an initial decline, the prevalence of VVP HPV-16 remained constant in subsequent age-groups (p=0.835).ConclusionsIn this population experiencing a cluster of vulvar cancer, the prevalence of cervical oncogenic HPV infection was similar to that reported by studies of other Australian women; however there was a significantly higher prevalence of vulvar/vaginal/perianal infection to cervical. The large discrepancy in HPV prevalence between anogenital sites in this population may represent more persistent infection at the vulva. This needs further investigation, including the presence of possible environmental and/or genetic factors that may impair host immunity.

FemCerv – Single Pass Device for Targeted Endo-Cervical – In-Office Sampling

Demonstrate use of the FemCerv Endocervical Sampler (FemCerv) prototype as a single-pass 360 degree alternative to the multi- pass Kevorkian device. Evaluate adequacy of sample size for pathological evaluation and tissue type specificity. Design Feasitility Study. Extirpated Uterus in Operating Room under institutional IRB approval. Undergoing hysterectomy for benign disease. The FemCerv single use device (Femasys Inc.) is placed transvaginally into the cervical canal utilizing its self-dilating tapered tip is advanced to the placement marker for targeted sampling of the endocervix. The device collection chamber which measures 2.0 cm is opened only within the endo-cervical canal. With the chamber open, it is rotated clockwise 360 degrees and then counter-clockwise to its original position. During the rotation process the laser cut edges gather tissue into the chamber. It is then closed while in the endo-cervix avoiding ecto-cervical sample contamination during device removal. Sample submitted was 1cm in aggregate dimension and upon histopathological evaluation found to contain only endo-cervical tissue. A single pass endo-cervical sampling device that provides an adequate site specific specimen for pathologic evaluation should reduce false positive findings and in turn decrease the number of unnecessary LEEP and Cone-Biospy procedures. With its ease of use and anticipated decreased patient discomfort, health care providers might be less reluctant to sample the endo-cervix and thus with increased use may improve the early detection of high grade lesions. The device's encouraging initial results warrants a more robust extirpated study leading to an in-office evaluation used to assess its applicability in clinical practice.

Prevalência de Chlamydia trachomathis em amostras endocervicais de mulheres em São Paulo e Santa Catarina pela PCR

INTRODUÇÃO: Nenhuma outra doença sexualmente transmissível (DST) tem mostrado frequência tão elevada quanto a infecção por Chlamydia trachomatis (CT). É frequente a detecção de mulheres portadoras de danos tubários causados por esse agente, determinando infertilidade permanente e as intervenções cirúrgicas não têm demonstrado sucesso em reparar esses danos. A reação em cadeia da polimerase (PCR) se mostrou mais sensível do que a cultura para a identificação de CT, principalmente em cervicite clamidiana nas mulheres. A PCR promove a detecção de sequências específicas de nucleotídeos para a CT. OBJETIVO: Analisar a prevalência de infecções causadas pela CT em mulheres nos estados de São Paulo e Santa Catarina utilizando amostras endocervicais. MATERIAIS E MÉTODOS Utilizaram-se para o presente trabalho amostras enviadas pelos laboratórios conveniados ao Genolab, pertencentes aos estados de São Paulo e de Santa Catarina. Foram consultados os resultados dos laudos de exames para CT oriundos do banco de dados do Genolab no ano de 2010. Para a obtenção e o isolamento do ácido desoxirribonucleico (DNA), utilizou-se a técnica de fenol-clorofórmio e para a amplificação do material genético, a técnica de PCR. RESULTADOS: Obteve-se uma amostra de 287 indivíduos, e desse total 56,45% das mulheres eram positivas. A amostra que obteve o maior número de positivos foi o swab endocervical, com 75%. CONCLUSÃO: As amostras biológicas provenientes do endocérvix apresentaram detecção eficiente da CT na população feminina. A alta prevalência salienta a importância no emprego do diagnóstico molecular, principalmente por este trabalho apontar esse aspecto.

Secondary Screening After Primary Self-Sampling for Human Papillomavirus From SHENCCAST II

We recently demonstrated that a self-collected sample tested with a high-throughput polymerase chain reaction-based high-risk human papillomavirus (HR-HPV) assay is equal in sensitivity to a physician-obtained direct endocervical sample. We now explore some secondary screening options to improve specificity. The Shenzhen Cervical Cancer Screening Trial II is a multisite, population-based cross-sectional cervical cancer screening study conducted in Guangdong Province, China. Two HR-HPV assays were used for self-collected specimens, and 3 assays were used for directly collected specimens along with cytology. The polymerase chain reaction-based matrix-assisted laser desorption/ionization time-of-flight mass spectrometry assay reported 14 HR-HPV types. Any patient with a positive lesion on any assay or cytology underwent colposcopy and biopsy. A total of 8,556 women with a mean age of 38.9 years (range = 25-54 years) were included in the analysis. Primary self-collection had a sensitivity of 94.3% and a specificity of 87.5% (for cervical intraepithelial neoplasia grade 3 or cancer). Secondary cervical cytology had a sensitivity and specificity of 83.0% and 95.2%, respectively, which would require a pelvic examination and sacrifice some sensitivity. Secondary genotyping for HPV types 16 or 18 had a sensitivity and specificity of 53.9% and 97.7%, respectively; and HPV types 16, 18, 31, 33, 45, 52, and 58 had a sensitivity and specificity of 92.2% and 90.4%, respectively. Genotyping is efficient if it is part of the primary test result. It potentially identifies a high percentage of the cancers (types 16/18 = 84.5% in China).

Diagnostic accuracy of two endocervical sampling method: randomized controlled trial

To compare the diagnostic accuracy of endocervical curettage (ECC) and endocervical brushing (EB) in patients referred for colposcopic evaluation for low grade squamous intraepithelial lesion. A prospective, randomized, comparative trial was conducted in an Education and Research Hospital, Gynecologic Oncology Clinic. After exclusion of 40 subjects, 208 patients were randomly allocated into ECC (n = 104) and EB (n = 104) groups. A pathologist blinded to the specimen obtaining method evaluated all samples for the primary outcome of sampling adequacy. Secondary outcome measure was pain scores during the sampling was investigated by using visual analogue scale (VAS). Ten samples from the ECC group (9.6 %) and 12 samples from the brushing group (12 %) contained scanty endocervical specimen (p = 0.09). Evaluating samples for stroma; it was reported that brushing group had a statistically significantly higher percentage of specimens with no stroma (44 %) than ECC group (24 %) (p = 0.003). Mean and standard deviation of VAS scores during the ECC and EB procedures were 2.55 ± 1.12 and 1.99 ± 0.87, respectively (p < 0.001). Endocervical brushing was proved to be as accurate with respect to diagnostic yield as ECC but less painful, evaluating the endocervical canal. It can be an alternative for evaluation of the cervical canal pathology in patients with low grade cytologic abnormalities but devoid of the misinterpretation of stromal invasion; ECC should be preferred in patients with a suspicion of invasive disease.

Correlation Between &lt;i&gt;Koilocytes&lt;/i&gt;, HPV DNA and CD4 Cells Count in Male and Female HIV Cohorts

The study x-rays the relationship between <i>K</i><i>oilocytes</i> and [Cluster of Differentiation]CD4 Count from HIV positive unisex cohorts aged 15 -40 years and above. The cohorts, were randomly tested for the presence of koilocytes, using their semen and endocervical swab samples respectively at some top Hospitals in Abuja, F.C.T. Nigeria. Their blood samples were tested for CD4 count. Papanicolaou staining technique was adopted-for demonstrating koilocytes. Results showed that, high koilocytes count of 39.0% and low CD4 Count of 350 lymphocyte counts /µl were observed; and low monthly mean koilocytes count of 7.60% and high CD4 Count of 687 lymphocytes counts/ µl were observed in the female and male cohorts respectively. High monthly prevalence count of koilocytes and low CD4 Count in the female cohorts and verse versa in the male cohorts were significantly correlated (P<0.05). Depression of immunity, is worsen in HPV and HIV co- infectivity.

P44 An evaluation of gonococcal testing using a roche cobas PCR platform in a low prevalence area

BackgroundThe countywide sexual health service have recently adopted the roche cobas dual PCR for gonorrhoea testing. The locality has a low prevalence of gonorrhoea compared to national rates.AimsTo assess the...

O2 Who should have gonorrhoea cultures in addition to gonorrhoea and chlamydia nucleic acid amplification tests? Cost effectiveness study

BackgroundNucleic acid amplification tests (NAATs) can now detect chlamydia (CT) and gonorrhoea (GC) but cultures are needed in GC NAAT positive people prior to treatment. This necessitates re-evaluation, examination and...

Low Prevalence of Chlamydia trachomatis Infection in Non-Urban Pregnant Women in Vellore, S. India

ObjectiveTo determine the prevalence and risk factors for Chlamydia trachomatis (CT) infection in pregnant women and the rate of transmission of CT to infants.MethodsPregnant women (≥28 weeks gestation) in Vellore, South India were approached for enrollment from April 2009 to January 2010. After informed consent was obtained, women completed a socio-demographic, prenatal, and sexual history questionnaire. Endocervical samples collected at delivery were examined for CT by a rapid enzyme test and nucleic acid amplification test (NAAT). Neonatal nasopharyngeal and conjunctival swabs were collected for NAAT testing.ResultsOverall, 1198 women were enrolled and 799 (67%) endocervical samples were collected at birth. Analyses were completed on 784 participants with available rapid and NAAT results. The mean age of women was 25.8 years (range 18–39 yrs) and 22% (95% CI: 19.7–24.4%) were primigravida. All women enrolled were married; one reported >one sexual partner; and six reported prior STI. We found 71 positive rapid CT tests and 1/784 (0.1%; 95% CI: 0–0.38%) true positive CT infection using NAAT.ConclusionsTo our knowledge, this is the largest study on CT prevalence amongst healthy pregnant mothers in southern India, and it documents a very low prevalence with NAAT. Many false positive results were noted using the rapid test. These data suggest that universal CT screening is not indicated in this population.

Potential Mechanisms for Increased HIV-1 Transmission Across the Endocervical Epithelium During C. trachomatis Infection

Among the now pandemic sexually transmitted infections (STIs), Chlamydia trachomatis (C. trachomatis) is the predominant bacterial pathogen and human immunodeficiency virus type 1 (HIV-1) is the most lethal of the viral pathogens. The female genital tract is the primary site for heterosexual transmission of both C. trachomatis and HIV-1. Infection with C. trachomatis, and with a variety of other STIs, increases the risk for transmission of HIV-1, although the mechanisms for this finding remain unclear. We have used in vitro modeling to assess the mechanisms by which infection with genital C. trachomatis serovars might increase the transmission of HIV-1 across the female genital tract. C. trachomatis infection of an immortalized endocervical epithelial cell line (A2EN) increases the cell surface expression of the HIV-1 alternative primary receptor, galactosyl ceramide (GalCer), and of the HIV-1 co-receptors, CXCR4 and CCR5. C. trachomatis infection also increases the binding of HIV-1 to A2EN cells, and, subsequently, increases levels of virus in co-cultures of HIV-exposed A2EN and susceptible MT4-R5 T cells. Finally, in vivo endocervical cell sampling reveals a dramatic increase in the number of CD4+, CXCR4 and/or CCR5 positive T cell targets in the endocervix of C. trachomatis positive women when compared to those who are C. trachomatis negative. This combination of in vitro and in vivo results suggests several mechanisms for increased transmission of HIV-1 across the endocervices of C. trachomatis-infected women.

Performance of the cobas CT/NG Test Compared to the Aptima AC2 and Viper CTQ/GCQ Assays for Detection of Chlamydia trachomatis and Neisseria gonorrhoeae

The next-generation amplification test for Chlamydia trachomatis and Neisseria gonorrhoeae (Roche cobas 4800), a fully automated system, was compared head to head, using female samples, to Gen-Probe Aptima Combo 2 and BD ProbeTec using Viper. Endocervical swabs, female urine, and endocervical samples in liquid-based cytology medium were run on at least two of three platforms. A total of 4,316 samples were evaluated, and 281 chlamydial and 69 gonococcal infections were identified. Estimates of sensitivity and specificity were obtained relative to the patient infection standard (PIS) and using latent class analysis (LCA). Chlamydia sensitivity estimates ranged from 86.9 to 95.6% using PIS and 97.6 to 98% using LCA. Specificity was ≥ 99.6% for all sample types. Sensitivity ranged from 95.6 to 100% using PIS and 96.9 to 100% using LCA for the detection of gonococcal infections. Specificity for gonococcal infections was ≥ 99.8%. cobas 4800 performance was equivalent to the comparator assays (all P values, >0.05), and the fully automated system provides high laboratory efficiency.

Detection ofChlamydia trachomatisandNeisseria gonorrhoeaein urogenital and oral specimens using the cobas® 4800, APTIMA Combo 2® TMA, and ProbeTec™ ET SDA assays

This prospective, multicenter clinical trial was conducted to compare the performance of the cobas(®) 4800 CT/NG, APTIMA Combo 2(®), and ProbeTec(™) ET CT/GC assays for the detection of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in Japan. From 1274 male and female patients, more than 1900 urine, endocervical and throat specimens were collected. Positive and negative concordance rates for CT and NG results obtained for urine and endocervical samples collected from the same patient were high in all three assays (range 96.0-99.6%). The accuracy of the cobas(®) 4800 CT/NG test did not differ significantly from that of the APTIMA Combo 2(®) and ProbeTec(™) ET CT/GC assays. The accuracy of the assays did not change depending on the order of collection of endocervical specimens. Concordance rates for results obtained for throat swabs and mouthwashes in the ProbeTec(™) ET CT/GC and cobas(®) 4800 CT/NG assays, respectively, were 98.8% for CT and 95.1% for NG. These data suggest that the cobas(®) 4800 CT/NG test is a reliable and highly accurate diagnostic tool for the detection of CT and NG in urine, genital, and oral specimens. Owing to the high correlation of urine and endocervical swab results and the ease of acquisition, urine samples are suggested as the specimen of choice for screening of CT and NG.

Frequency of Chlamydia trachomatis in Ureaplasma-positive healthy women attending their first prenatal visit in a community hospital in Sapporo, Japan

BackgroundAlthough Chlamydia trachomatis is the most commonly reported pathogen that causes urogenital infection such as urethritis or cervicitis, Ureaplasma parvum and Ureaplasma urealyticum, which are commensals in the genital tract, have also now been recognized as contributors to urogenital infection. However, whether the presence of either U. parvum or U. urealyticum is related to that of C. trachomatis in the urogenital tract remains unknown. We therefore attempted to estimate by PCR the prevalence of C. trachomatis, U. parvum and U. urealyticum in endocervical samples obtained from healthy women attending their first prenatal visit in Sapporo, Japan.MethodsThe samples were taken from 303 apparently healthy women, and the extracted DNAs (n = 280) were used for PCR detection targeting C. trachomatis, U. parvum and U. urealyticum. Statistical analysis of the data was performed by Fisher's exact test.ResultsPCR detection revealed that the prevalence of C. trachomatis, U. parvum and U. urealyticum was 14.3% (40/280), 41.7% (117/280) and 8.9% (25/280), respectively. C. trachomatis ompA genotype D was most frequently identified. Surprisingly, either C. trachomatis or Ureaplasma spp. was detected in almost half of the healthy women. Mixed infection of C. trachomatis with either U. parvum or U. urealyticum was also observed in 9.2% (26/280) of the women. There was a significant association between C. trachomatis and either U. parvum (p = 0.023) or Ureaplasma total (p = 0.013), but not U. urealyticum (p = 0.275).ConclusionThis study demonstrated that the presence of Ureaplasma had a significant effect on the presence of C. trachomatis in the genital tract of healthy women, suggesting that mixed infection is an important factor in bacterial pathogenesis in the genital tract.