Evaluation of the Tissue Culture Standard and Correlation with DNA Probes and ELISA for the Detection of 'Chlamydia trachomatis'

摘要

Endocervical swabs collected in triplicate from 209 symptomatic and asymptomatic women in a high prevalence adolescent clinic (99) and in an intermediate prevalence University Health Service (110) were cultured simultaneously for isolation of Chlamydia trachomatis. Chlamydia was isolated from 33 patients, with 24 positive for all three specimens and nine with various patterns of positive and negative specimens. Discrepancy analysis consisting of multiple passes and reculture of discrepant negative specimens resolved swab-to-swab variation in 3/9 patients. This left 6/33 (18%) positive patients with discrepant negatives due to swab-to-swab variation. In the same populations, triplicate endocervical specimens were collected from 884 patients. Two DNA probes (non-isotopic (NIP) and isotopic (IP)) specific for chlamydial ribosomal RNA and an established ELISA were compared to the culture standard. There were no significant differences in the total sensitivities of the three non-culture tests compared to culture. Discrepancy analysis of patient specimens in which non-culture test(s) did not agree with culture explained over 78% of the false negative and false positive non-culture results. The IP and ELISA methods appear to be suitable diagnostic tests in these populations. The NIP which was in the final stage of development must reduce its false positive rate, but has reached a convenience and performance level near that of an established ELISA. Theses. (KT/AW)