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 MOMPPCR
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.
