USE OF POLYMERASE CHAIN-REACTION FOR THE DETECTION OF CHLAMYDIA-TRACHOMATIS IN OCULAR AND NASOPHARYNGEAL SPECIMENS FROM INFANTS WITH CONJUNCTIVITIS

Background. Chlamydia trachomatis is the most common identifiable infe ctious cause of neonatal conjunctivitis. Nonculture tests including en zyme immunoassays and direct fluorescent antibody tests have been show n to perform well for the diagnosis of chlamydial conjunctivitis with sensitivities and specificities greater than or equal to 90%. However, the performance with respiratory specimens has been less than satisfa ctory. Methods. We compared a new, commercially available polymerase c hain reaction (PCR) assay, Roche AMPLICOR(R) (Roche Diagnostic Systems , Branchburg, NJ) with culture for the detection of C. trachomatis in conjunctival and nasopharyngeal specimens from infants with conjunctiv itis. We also evaluated AMPLICOR(R) for the detection of C. trachomati s in the urine of mothers of positive infants. Results. Ocular and nas opharyngeal specimens from 75 infants with conjunctivitis were obtaine d for culture and PCR. AMPLICOR(R) was equivalent to culture for eye s pecimens and more sensitive than culture for nasopharyngeal specimens, The sensitivity, specificity and positive and negative predictive val ues of PCR compared with culture for conjunctival specimens were 92.3, 100, 100 and 98.4%, respectively. The sensitivity, specificity and po sitive and negative predictive values for nasopharyngeal specimens wer e 100, 97.2, 60 and 100%, respectively. We also detected C. trachomati s by PCR in the urine of 12 mothers of culture positive infants, Concl usions, PCR performed comparably to culture for detection of C. tracho matis in conjunctival and nasopharyngeal specimens from infants with c onjunctivitis.