Cytobrush sampling technique

Chlamydiae are now commonly detected in genital tract specimens in routine diagnosis by direct immunofluorescence. Direct immunofluorescence is as sensitive and specific as conventional culture.' Studies in our laboratory also suggest that direct immunofluorescence may be a valuable test for cure.2 One of the problems encountered with direct immunofluorescence, as with culture, is the need for proper specimen collection and the ability to obtain endocervical cells for analysis.3 Phillips and colleagues found that the number of cells present on the slide affected the direct immunofluorescence test results, and improved sensitivity was found when more endocervical cells were present.4 A swab is generally used to collect cervical material for analysis with direct immunofluorescence. Another device, the cervical Cytobrush (International Cytobrush, Hollywood, Florida, USA), has been used successfully at this school of medicine for performing Papanicolau smears and has also been found by Ros et al to be superior to swab collection of hndocervical cells for cytopathological analysis.5 Because of its abrasive surface, the Cytobrush might also be better at disrupting the infected cells present in cervical secretions and thus improve chlamydial detection. As part of studies ofchlamydial infections in our family planning clinic,2 we studied the use of the Cytobrush as a collection device for diagnosing chlamydial infection, and we compared it with swab collection.