The vaginal introitus: A novel site for Chlamydia trachomatis testing in women

Wiesenfeld, Harold C.; Heine, R. Phillips; Rideout, Anne; Macio, Ingrid; DiBiasi, Faith; Sweet, Richard L.

doi:10.1016/s0002-9378(96)70603-8

Cited by 92 publications

(68 citation statements)

References 14 publications

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“…As in previous studies on C. trachomatis/N. gonorrhoeae NAAT assays, our data show that a urine specimen alone is not sufficiently sensitive (86.7%) to screen for N. gonorrhoeae in females (19,20). We have previously shown that interference from mucopurulent discharge in N. gonorrhoeae-positive patients causes failed cobas 4800 results (12), and this has also been reported by Hopkins et al (10).…”

Section: Discussionsupporting

confidence: 83%

Comparison of the cobas 4800 CT/NG Test with Culture for Detecting Neisseria gonorrhoeae in Genital and Nongenital Specimens in a Low-Prevalence Population in New Zealand

Bromhead¹,

Miller²,

Jones³

et al. 2013

J Clin Microbiol

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bTo assess the clinical utility of replacing microbial culture for Neisseria gonorrhoeae with a nucleic acid amplification test (NAAT), we compared N. gonorrhoeae culture with the cobas 4800 CT/NG test for 18,247 urogenital and 666 nongenital samples. For urogenital specimens, the sensitivity, specificity, and positive and negative predictive values of the cobas N. gonorrhoeae PCR were 98.7%, 100%, 95.6%, and 100%, respectively, and for nongenital specimens, the values were 100%, 99.8%, 92.9%, and 100%, respectively. In our test population, 37% (10,185) of patients tested over the study period were screened for C. trachomatis by PCR but were not screened for gonorrhea by culture. Of these, 43 were N. gonorrhoeae positive by PCR and therefore went undiagnosed. The cobas 4800 CT/NG test diagnosed 33% (n ‫؍‬ 30) more urogenital and 25% (n ‫؍‬ 3) more rectal gonorrhea infections than culture and, based on the above performance indicators, does not require supplementary testing for urogenital or rectal specimens. The ability to test noninvasive specimens (such as urine and self-taken vulvovaginal swabs) for N. gonorrhoeae will enable more patients to be screened for infection, thus offering significant positive public health benefits.

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Section: Discussionsupporting

confidence: 83%

Comparison of the cobas 4800 CT/NG Test with Culture for Detecting Neisseria gonorrhoeae in Genital and Nongenital Specimens in a Low-Prevalence Population in New Zealand

Bromhead¹,

Miller²,

Jones³

et al. 2013

J Clin Microbiol

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“…The slightly higher sensitivities found with vulvovaginal swabs support the findings of other studies. [165][166][167][168][169][170][171] In addition, the cost per positive test was about 30% lower for vulvovaginal swab than for first catch urine specimens, largely owing to the lower number of inhibitory swab specimens tested by BD SDA. The time take to process the two specimen types was very similar, but urine specimens are thought to be more difficult for inexperienced staff to process, 172 and betweencentre variation in estimated sensitivity might be greater for first catch urine specimens (range 50-100%) than for vulval swabs (range 70-100%, with only one centre less than 90%).…”

Section: Vulvovaginal Swabs As a Non-invasive Specimen In Womenmentioning

confidence: 99%

Epidemiological, social, diagnostic and economic evaluation of population screening for genital chlamydial infection

Low

McCarthy²,

Macleod³

et al. 2007

Health Technol Assess

134

179

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“…The vaginal introitus (17) and vulva (12) have been shown to be acceptable sites for noninvasive sampling with swabs for the detection of C. trachomatis. It has been shown that patient-obtained vaginal swab specimens can be used to accurately detect N. gonorrhoeae infections (4).…”

mentioning

confidence: 99%

Detection of Chlamydia trachomatis and Neisseria gonorrhoeae by Strand Displacement Amplification and Relevance of the Amplification Control for Use with Vaginal Swab Specimens

2003

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Vaginal swab specimens may be preferable to cervical swab or urine specimens for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae because of the ease of specimen collection and transport. The purpose of this study was to evaluate whether vaginal swab specimens are equivalent to cervical swab specimens for the detection of N. gonorrhoeae and C. trachomatis by the Becton Dickinson strand displacement amplification assay (SDA) with the BDProbeTec ET instrument and then to evaluate the use of the amplification control in a clinical research setting. In the first phase, vaginal and cervical swab specimens were obtained from 455 symptomatic women aged 18 to 40 attending primary health care and sexually transmitted disease clinics. Thirty-nine specimens (8.6%) had true-positive results for N. gonorrhoeae and 37 specimens (8.1%) had true-positive results for C. trachomatis. The sensitivity of SDA was superior to that of culture for the detection of N. gonorrhoeae with vaginal swab specimens and equivalent to that of the Roche PCR for the detection of C. trachomatis with cervical swab specimens. In the second phase of the study, 1,411 consecutively collected vaginal swab specimens were evaluated, with 357 (25.3%) specimens giving indeterminate readings on the basis of the result for the amplification control. The prevalences of sexually transmitted pathogens in vaginal swab specimens with and without use of the amplification control were 6.0 and 5.8%, respectively, for C. trachomatis and 3.1 and 3.0%, respectively, for N. gonorrhoeae. Although, vaginal swab specimens were equivalent to cervical swab specimens for the detection of N. gonorrhoeae and C. trachomatis by SDA with respect to sensitivity, one in four vaginal swab specimens yielded an indeterminate result when the amplification control was used. The amplification control has limited value for use with vaginal swab specimens.Nucleic acid amplification techniques are available for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae. These methods have better sensitivities than culture and allow the detection of infection in individuals with a low number of infectious units (1). Recent studies have shown PCR (Roche Diagnostic Systems, Branchburg, N.J.) and ligase chain reaction (LCR; Abbott Laboratories, Chicago, Ill.) to be acceptable methods for the detection of C. trachomatis and N. gonorrhoeae with urine and urethral and endocervical swab specimens (2, 3, 9, 10, 11, 15). The amplified DNA assay with the BDProbeTec ET instrument (the strand displacement amplification assay [SDA]; Becton Dickinson, Sparks, Md.) for the detection of C. trachomatis and N. gonorrhoeae is based on simultaneous strand displacement amplification and real-time fluorescence detection (7,16). Like other amplification methods, this system can detect the bacterial agents of both urethritis and cervicitis in one specimen. Some amplification systems, including SDA and PCR, also have an amplification control, which is designed to detect inhibitors of amplification ...

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The vaginal introitus: A novel site for Chlamydia trachomatis testing in women

Cited by 92 publications

References 14 publications

Comparison of the cobas 4800 CT/NG Test with Culture for Detecting Neisseria gonorrhoeae in Genital and Nongenital Specimens in a Low-Prevalence Population in New Zealand

Comparison of the cobas 4800 CT/NG Test with Culture for Detecting Neisseria gonorrhoeae in Genital and Nongenital Specimens in a Low-Prevalence Population in New Zealand

Epidemiological, social, diagnostic and economic evaluation of population screening for genital chlamydial infection

Detection of Chlamydia trachomatis and Neisseria gonorrhoeae by Strand Displacement Amplification and Relevance of the Amplification Control for Use with Vaginal Swab Specimens

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