Affiliation:
1. St. Joseph's Healthcare/McMaster University
2. Hamilton Community Health Centre, Hamilton
3. Evergreen Health Centre
4. MDS Laboratories, Toronto, Ontario, Canada
Abstract
ABSTRACT
Infections with
Chlamydia trachomatis
and
Neisseria gonorrhoeae
are often asymptomatic. Liquid-based Pap (L-Pap) screening may provide samples for testing by commercial assays. Women attending a health clinic or a street youth clinic had a PreservCyt ThinPrep sample and a cervical swab (CS) collected. The L-Pap sample was tested for cytopathology; then 1 ml was transferred to an L-Pap specimen transfer tube for testing by the Gen-Probe APTIMA assays (APTIMA Combo 2 [AC2], APTIMA
C. trachomatis
[ACT], and APTIMA
N. gonorrhoeae
[AGC]). The residual L-Pap sample was tested for
C. trachomatis
and
N. gonorrhoeae
using Roche AMPLICOR (AMP) and Becton Dickinson ProbeTec (PT). The CS was tested by AC2. A patient was considered infected if two specimens were positive or if a single specimen was positive in two tests. The prevalence of infection was 10% (29/290) for
C. trachomatis
and 2.4% (7/290) for
N. gonorrhoeae
. Most of the positive patients had specimens that were reactive in all assays (20/29 for
C. trachomatis
; 6/7 for
N. gonorrhoeae
). Four patients had double infections. The sensitivities and specificities of the various tests for the specimens tested were as follows. For
C. trachomatis
on L-Pap, sensitivity and specificity were 100 and 98.1%, respectively, for ACT, 93.1 and 98.8% for AC2, 86.2 and 91.2% for AMP, and 72.4 and 92.7% for PT. For
N. gonorrhoeae
on L-Pap, sensitivity and specificity were 100% for both AGC and AC2, 85.7 and 100% for AMP, and 85.7 and 100% for PT. For AC2 with CSs, sensitivity and specificity were 93.1 and 98.5%, respectively, for
C. trachomatis
, and both were 100% for
N. gonorrhoeae
. There were significant differences in sensitivity and specificity (
P
< 0.001). The APTIMA assays were more sensitive and specific than AMP or PT for detecting women's
C. trachomatis
and/or
N. gonorrhoeae
infections by testing ThinPrep samples.
Publisher
American Society for Microbiology
Reference11 articles.
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Chlamydia trachomatis
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2. High Analytical Sensitivity and Low Rates of Inhibition May Contribute to Detection of
Chlamydia trachomatis
in Significantly More Women by the APTIMA Combo 2 Assay
3. Use of Flocked Swabs and a Universal Transport Medium To Enhance Molecular Detection of
Chlamydia trachomatis
and
Neisseria gonorrhoeae
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