ABSTRACT
Background: Chlamydia trachomatis is the most common sexually transmitted bacterial pathogen worldwide. Early detection and treatment of C.trachomatis genital infection prevent serious reproductive complications
Objective: Performances of enzyme immunoassay [EIA] and major outer membrane protein [MOMP]-polymerase chain reaction [PCR] for diagnosis of genital C.trachomatis infection in women were compared
Materials and Methods: In this cross sectional study a total of 518 women volunteers were included [33.67 +/- 8.3 yrs] who had been referred to Gynecology clinics of Qom province, Iran, were included. Endocervical swab specimens were collected to detect lipopolysaccharide [LPS] antigen in EIA and to amplify MOMP gene of C.trachomatis in PCR. Results were confirmed using ompI nested-PCR. Sensitivity, specificity, positive [PPV] and negative predictive values [NPV] were calculated for performance of the tests. Odds ratios were determined using binary logistic regression analysis
Results: In total, 37 [7.14%] cases were positive by EIA and/or MOMP-PCR. All discrepant results were confirmed by nested-PCR. Sensitivity, specificity, PPV and NPV values of EIA were 59.46%, 100%, 100% and 96.98%, and those of MOMP-PCR were 97.30%, 100%, 100%, 99.79%, respectively. Reproductive complications including 2.7% ectopic pregnancy, 5.4% stillbirth, 5.4% infertility, and 10.8% PROM were recorded. The risk of developing chlamydiosis was increased 4.8-fold in volunteers with cervicitis [p<0.05; OR 4.80; 95% CI 1.25-18.48]
Conclusion: C.trachomatis infection should be regarded in women of reproductive ages especially those with cervicitis. Primary screening of women by using the low cost antigen-EIA is recommended; however, due to the low sensitivity of Ag-EIA, verification of the negative results by a DNA amplification method is needed