COMPARISON OF SYNOVIAL TISSUE AND SYNOVIAL-FLUID AS THE SOURCE OF NUCLEIC-ACIDS FOR DETECTION OF CHLAMYDIA-TRACHOMATIS BY POLYMERASE CHAIN-REACTION

Objective. Difficulties in detecting Chlamydia trachomatis in human jo ints by polymerase chain reaction (PCR) may be related to whether syno vial tissue or synovial fluid (SF) is used as the source of DNA in PCR amplification. In this study, a new PCR assay was developed and used to compare chlamydial DNA in paired samples of SF and synovial tissue front patients with arthritis. Methods. The PCR assay targeted the rib osomal RNA operons, which are present in 2 copies on the C trachomatis chromosome. DNA from several relevant bacteria and chlamydial serovar s was used for testing this screening system. The detection of chlamyd ial DNA in nucleic acid preparations from matched samples of SF and sy novial tissue was compared by PCR assay. Samples were obtained from 55 patients, including patients with reactive arthritis, Reiter's syndro me, and other arthropathies. Results. Testing of the PCR screening sys tem confirmed it to be highly specific and sensitive. Use of this assa y to screen DNA from SF and synovial tissue samples showed that 29 (53 %) of 55 synovial tissue preparations were positive for chlamydial DNA , but only 16 (29%) of the matched SF samples from these 29 patients w ere similarly positive. Five (9%) of 55 SF samples, but not their tiss ue counterparts, were positive for chlamydial DNA by PCR. Conclusion. Detection of chlamydial DNA in the joints of patients by PCR give posi tive results more often when synovial tissue rather than SF is the sou rce of target nucleic acids. Although synovial tissue is the source of choice for the most reliable determination of chlamydia in the joint, both synovial tissue and SF should be assayed if possible.