Rapid Polymerase Chain Reaction–Based Test for the Detection of Female Urogenital Chlamydial Infections

OBJECTIVE The purpose of this study was to evaluate the Amplicor Chlamydia trachomatis Test (Roche Molecular Systems, Branchburg, NJ), a polymerase chain reaction (PCR)-based technique, as a screening test for the detection of female urogenital C. trachomatis infections, comparing it to an enzyme immunoassay method. METHODS Endocervical specimens for PCR and Chlamydiazyme (Abbott Laboratories, North Chicago, IL) analysis were obtained from 328 unselected patients at the outpatient Sexually Transmitted Diseases Clinic at the Allegheny County Health Department, Pittsburgh, PA. In addition, urethral swabs for PCR analysis were obtained from 256 of these patients. RESULTS By PCR analysis, the prevalence of urogenital chlamydial infections was 15.6% and that of cervical chlamydial infections was 10.7%. The sensitivity of PCR in the detection of endocervical chlamydial infections was 89.7% and the specificity was 100%. The positive and negative predictive values of PCR were 100% and 99%, respectively. The sensitivity of Chlamydiazyme in the detection of cervical infections was 61.5% and the specificity was 99.7%, with a positive predictive value of 96.0%. Among all patients with urogenital chlamydial infections, concomitant infections in the urethra and cervix occurred in 52.5%, whereas the urthra or cervix was solely infected in 35.0% and 12.5%, respectively. CONCLUSIONS This PCR-based technique is a rapid screening tool for the diagnosis of urogenital chlamydial infections and is more sensitive than Chlamydiazyme for endocervical infections in a sexually transmitted disease clinic population.