Abstract
The role of confirmatory PCR assays for determining the performance of Chlamydia Amplicor PCR for endocervical specimens from women with a low prevalence of infection was evaluated. An endocervical swab was collected from 770 women and tested by culture or direct fluorescent antibody (DFA) staining. A second swab was tested by Chlamydia Amplicor PCR (Roche Molecular Systems, Branchburg, N.J.). Discordant results were resolved by three confirmatory PCRs: one targeting the plasmid by using different primers and two directed to the major outer membrane protein (MOMP) gene. Of the 30 swabs that were positive by culture or DFA (3.9%), 27 were positive by Amplicor PCR. An additional five swabs were positive by Amplicor PCR but negative by culture or DFA. Both plasmid and MOMP confirmatory PCRs identified the five culture-DFA negatives and the three Amplicor negatives as true positives. The three specimens originally classified as negative by Amplicor PCR were positive on repeat Amplicor testing. After resolution of the discordant results by confirmatory PCR testing, the sensitivity of the initial Amplicor PCR was 91.4% (32 of 35 specimens), changing to 100% after storage and repeat testing. The specificity of Amplicor PCR was 100% (735 of 735 specimens). Our results demonstrated that plasmid and MOMP confirmatory PCRs worked equally well in resolving false-positive and false-negative Amplicor PCR results. Some specimens may contain inhibitors of Amplicor PCR which may disappear with time.
Full text
PDF



Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bass C. A., Jungkind D. L., Silverman N. S., Bondi J. M. Clinical evaluation of a new polymerase chain reaction assay for detection of Chlamydia trachomatis in endocervical specimens. J Clin Microbiol. 1993 Oct;31(10):2648–2653. doi: 10.1128/jcm.31.10.2648-2653.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bauwens J. E., Clark A. M., Loeffelholz M. J., Herman S. A., Stamm W. E. Diagnosis of Chlamydia trachomatis urethritis in men by polymerase chain reaction assay of first-catch urine. J Clin Microbiol. 1993 Nov;31(11):3013–3016. doi: 10.1128/jcm.31.11.3013-3016.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bauwens J. E., Clark A. M., Stamm W. E. Diagnosis of Chlamydia trachomatis endocervical infections by a commercial polymerase chain reaction assay. J Clin Microbiol. 1993 Nov;31(11):3023–3027. doi: 10.1128/jcm.31.11.3023-3027.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bobo L., Coutlee F., Yolken R. H., Quinn T., Viscidi R. P. Diagnosis of Chlamydia trachomatis cervical infection by detection of amplified DNA with an enzyme immunoassay. J Clin Microbiol. 1990 Sep;28(9):1968–1973. doi: 10.1128/jcm.28.9.1968-1973.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Claas H. C., Melchers W. J., de Bruijn I. H., de Graaf M., van Dijk W. C., Lindeman J., Quint W. G. Detection of Chlamydia trachomatis in clinical specimens by the polymerase chain reaction. Eur J Clin Microbiol Infect Dis. 1990 Dec;9(12):864–868. doi: 10.1007/BF01967500. [DOI] [PubMed] [Google Scholar]
- Claas H. C., Wagenvoort J. H., Niesters H. G., Tio T. T., Van Rijsoort-Vos J. H., Quint W. G. Diagnostic value of the polymerase chain reaction for Chlamydia detection as determined in a follow-up study. J Clin Microbiol. 1991 Jan;29(1):42–45. doi: 10.1128/jcm.29.1.42-45.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dutilh B., Bébéar C., Rodriguez P., Vekris A., Bonnet J., Garret M. Specific amplification of a DNA sequence common to all Chlamydia trachomatis serovars using the polymerase chain reaction. Res Microbiol. 1989 Jan;140(1):7–16. doi: 10.1016/0923-2508(89)90053-3. [DOI] [PubMed] [Google Scholar]
- Griffais R., Thibon M. Detection of Chlamydia trachomatis by the polymerase chain reaction. Res Microbiol. 1989 Feb;140(2):139–141. doi: 10.1016/0923-2508(89)90047-8. [DOI] [PubMed] [Google Scholar]
- Jang D., Sellors J. W., Mahony J. B., Pickard L., Chernesky M. A. Effects of broadening the gold standard on the performance of a chemiluminometric immunoassay to detect Chlamydia trachomatis antigens in centrifuged first void urine and urethral swab samples from men. Sex Transm Dis. 1992 Nov-Dec;19(6):315–319. [PubMed] [Google Scholar]
- Loeffelholz M. J., Lewinski C. A., Silver S. R., Purohit A. P., Herman S. A., Buonagurio D. A., Dragon E. A. Detection of Chlamydia trachomatis in endocervical specimens by polymerase chain reaction. J Clin Microbiol. 1992 Nov;30(11):2847–2851. doi: 10.1128/jcm.30.11.2847-2851.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mahony J. B., Luinstra K. E., Jang D., Sellors J., Chernesky M. A. Chlamydia trachomatis confirmatory testing of PCR-positive genitourinary specimens using a second set of plasmid primers. Mol Cell Probes. 1992 Oct;6(5):381–388. doi: 10.1016/0890-8508(92)90031-r. [DOI] [PubMed] [Google Scholar]
- Mahony J. B., Luinstra K. E., Sellors J. W., Chernesky M. A. Comparison of plasmid- and chromosome-based polymerase chain reaction assays for detecting Chlamydia trachomatis nucleic acids. J Clin Microbiol. 1993 Jul;31(7):1753–1758. doi: 10.1128/jcm.31.7.1753-1758.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mahony J. B., Luinstra K. E., Sellors J. W., Jang D., Chernesky M. A. Confirmatory polymerase chain reaction testing for Chlamydia trachomatis in first-void urine from asymptomatic and symptomatic men. J Clin Microbiol. 1992 Sep;30(9):2241–2245. doi: 10.1128/jcm.30.9.2241-2245.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mahony J. B., Luinstra K. E., Waner J., McNab G., Hobranzska H., Gregson D., Sellors J. W., Chernesky M. A. Interlaboratory agreement study of a double set of PCR plasmid primers for detection of Chlamydia trachomatis in a variety of genitourinary specimens. J Clin Microbiol. 1994 Jan;32(1):87–91. doi: 10.1128/jcm.32.1.87-91.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Näher H., Drzonek H., Wolf J., von Knebel Doeberitz M., Petzoldt D. Detection of C trachomatis in urogenital specimens by polymerase chain reaction. Genitourin Med. 1991 Jun;67(3):211–214. doi: 10.1136/sti.67.3.211. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ossewaarde J. M., Rieffe M., Rozenberg-Arska M., Ossenkoppele P. M., Nawrocki R. P., van Loon A. M. Development and clinical evaluation of a polymerase chain reaction test for detection of Chlamydia trachomatis. J Clin Microbiol. 1992 Aug;30(8):2122–2128. doi: 10.1128/jcm.30.8.2122-2128.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ostergaard L., Traulsen J., Birkelund S., Christiansen G. Evaluation of urogenital Chlamydia trachomatis infections by cell culture and the polymerase chain reaction using a closed system. Eur J Clin Microbiol Infect Dis. 1991 Dec;10(12):1057–1061. doi: 10.1007/BF01984929. [DOI] [PubMed] [Google Scholar]
- Palmer H. M., Gilroy C. B., Thomas B. J., Hay P. E., Gilchrist C., Taylor-Robinson D. Detection of Chlamydia trachomatis by the polymerase chain reaction in swabs and urine from men with non-gonococcal urethritis. J Clin Pathol. 1991 Apr;44(4):321–325. doi: 10.1136/jcp.44.4.321. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ratti G., Moroni A., Cevenini R. Detection of Chlamydia trachomatis DNA in patients with non-gonococcal urethritis using the polymerase chain reaction. J Clin Pathol. 1991 Jul;44(7):564–568. doi: 10.1136/jcp.44.7.564. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smith I. W., Morrison C. L., Patrizio C., McMillan A. Use of a commercial PCR kit for detecting Chlamydia trachomatis. J Clin Pathol. 1993 Sep;46(9):822–825. doi: 10.1136/jcp.46.9.822. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Watson M. W., Lambden P. R., Clarke I. N. Genetic diversity and identification of human infection by amplification of the chlamydial 60-kilodalton cysteine-rich outer membrane protein gene. J Clin Microbiol. 1991 Jun;29(6):1188–1193. doi: 10.1128/jcm.29.6.1188-1193.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Williams T. W., Tyler S. D., Giercke S., Pollard D. R., McNicol P., Rozee K. R. Comparison of polymerase chain reaction and chlamydiazyme for the detection of Chlamydia trachomatis in clinical specimens. Eur J Clin Microbiol Infect Dis. 1992 Mar;11(3):233–236. doi: 10.1007/BF02098085. [DOI] [PubMed] [Google Scholar]
- Wu C. H., Lee M. F., Yin S. C., Yang D. M., Cheng S. F. Comparison of polymerase chain reaction, monoclonal antibody based enzyme immunoassay, and cell culture for detection of Chlamydia trachomatis in genital specimens. Sex Transm Dis. 1992 Jul-Aug;19(4):193–197. doi: 10.1097/00007435-199207000-00002. [DOI] [PubMed] [Google Scholar]