Diagnosing genitourinary chlamydial infection

doi:10.1136/bmj.323.7311.515

BMJ 2001;323:515 ( 1 September )

Letters

Diagnosing genitourinary chlamydial infection

Vaginal swabs alone may not be sufficient

Authors' reply

Vaginal swabs alone may not be sufficient

The first 150 words of the full text of this article appear below.

EDITOR $---$ Gilson and Mindel in their article on recent advances in the management of sexually transmitted infections emphasisedsome important diagnostic issues.¹ As Gilson and Mindel say,many studies have shown that DNA amplification tests are now thegold standard for the diagnosis of genital Chlamydia trachomatis.But we are concerned with the unreferenced statement that a vaginalswab is a better alternative for the detection of genital chlamydialinfection.

We found two studies that have examined the utility of vaginal swabs, collected either by healthcare personnel or patientsthemselves. ² ³ Both found high sensitivity for vaginal swabs,but this was matched by the sensitivity of sampling both urine(as a surrogate for the urethra) and the cervix. In some casesof genital chlamydial infections (cervical swab positive) vaginalswabs were negative.² In women the sensitivity of testing forC trachomatis by the polymerase chain reaction is increased by. . . [Full text of this article]