Evaluation of Patient-Administered Tampon Specimens forChlamydia trachomatisandNeisseria gonorrhoeae

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Background:The patient-administered tampon specimen has proven to be an easy and sensitive method for the diagnosis of genitalChlamydia trachomatisandNeisseria gonorrhoeaeinfections in women by polymerase chain reaction (PCR). This method avoids the need for endocervical sampling and stringent criteria for transport.Goal:To evaluate two commercial amplification systems for the detection ofC trachomatisandN gonorrhoeaefrom tampon specimens.Study Design:A group of 400 positive and negative tampon specimens tested by an in-house PCR method were selected from a pool of more than 2000 previously collected tampons. Overall, 93C trachomatis-positive and 77N gonorrhoeae-positive specimens were evaluated. Each specimen was tested by Roche Cobas Amplicor and Abbott LCx (LCR), and results were compared to the in-house PCR method.Results:Detection ofC trachomatisby both assays was not significantly different from the in-house PCR assay. Fewer tampons were positive forN gonorrhoeaeby LCR than either the in-house assay (P= 0.0001) or by Roche Amplicor (P= 0.01). However, tampon specimens tested by Roche Amplicor required DNA extraction to achieve comparative sensitivity.Conclusion:Both commercial assays can be applied to tampon-collected specimens for automated detection of sexually transmitted diseases. The detection ofC trachomatiswas similar to the in-house PCR test for both assays (P= 0.73, 0.68). Detection ofN gonorrhoeaeresulted in fewer positive tampon specimens when tested by ligase chain reaction than both Roche Amplicor and in-house PCR.

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