OPPORTUNISTIC SCREENING FOR CHLAMYDIA-TRACHOMATIS CERVICITIS - THE VALUE OF CYTOBUSH SPECIMENS FOR DETECTION BY PCR COMPARED WITH CELL-CULTURE

Endocervical sampling for microbiological and pathological screening i s laborious and expensive due to different sampling devices and techni ques. The purpose of this study was to examine if the routine procedur e could be simplified by using a cytobrush for concurrent cytology and sampling for Chlamydia trachomatis detection using the PCR method or cell culture. As a sampling device control we used a conventional rayo n swab. Results. Culture: Out of 873 paired endocervical specimens, C. trachomatis was isolated in 68 swab specimens and in 65 cytobrush spe cimens (overall detection rate 8.4%). The cytobrush proved less suitab le than the swab for the isolation of C, trachomatis as 31.5% of the c ytobrush samples showed cytotoxicity to the cultured cells vs 0.9% of the swab samples. PCR: In a random sample of 427 paired endocervical s pecimens, C. trachomatis was detected in 45 pairs without any differen ce between the two sampling devices. The sensitivity of PCR was 93.8% vs 89.6% and 87.5% in cultured swab and cultured cytobrush specimens, respectively. The cytobrush can therefore be recommended as a cervical sampling device if a PCR assay is used for the detection of C. tracho matis, but not if the cell culture method is used, due to high cytotox icity. Furthermore, the same cytobrush may be used for cervical cytolo gical sampling and thereafter placed in transport medium for subsequen t C. trachomatis detection if the PCR technique is used.