common of the most frequently repor...

common of the most frequently reported infectious diseases is Chlamydia, which can cause significant reproductive morbidity in women The prevalence of chlamydial infections in adolescent and young adult women in the United States ranges from 5 to 27 percent placing this age collection at the highest risk for this infection. Various organizations have praiseed screening asymptomatic young women for chlamydial infections. The goal of this screening should be to find the example that is least invasive and mostly acceptable for patients and health care professionals. The nucleic acid amplification criterions can detect Chlamydia on genital secretions, urine specimens, and endocervical or urethral samples. These trials have been assessed in high-risk populations forward symptomatic and asymptomatic patients. Shrier and associates evaluated the different touchstone types, specimen sources, and collection systems for Chlamydia screening in asymptomatic female adolescents and young adults. In addition, they assessed the way sexual history and clinical findings affect the prediction of chlamydial infections.

Participants in the research included female patients from 16 to 25 years of age who were examined at sum of two units outpatient centers for routine gynecologic care. They were exclud from the thought if they reported any symptoms consistent with a sexually transmitted disease (STD) were pregnant, had taken antibiotics within the past 21 days, had a chlamydial infection within the past six weeks, or were sexual partners with some-one known to have an STD

Participants were interviewed about their sexual history using a standardized format. Specimen collection started with brace swabs inserted into the vagina on the participants and collection of the first 30 mL of voided urine. During the pelvic examination, specimens were assembleed from the distal urethra, vaginal area, and endocervical canal. Testing included agricultures for Chlamydia and gonorrhea, and polymerase chain reaction, ligase chain reaction, and nucleic acid amplification tests

not at home of 139 participants, all nine proof results were available for 126 participants. The prevalence of Chlamydia infection in the research population was 22 percent. The sensitivities for the polymerase chain reaction and ligase chain reaction were similar, if it were not that the urine polymerase chain reaction proof had a lower sensitivity. The specificities for each of the trials were 99 to 100 percent unless the urine polymerase chain reaction test's specificity was 91 percent The positive predictive values for the proofs were higher than 93 percent save for the urine polymerase chain reaction exhibition which was 65 percent. The negative predictive values for all of the criterions were 83 to 91 percent Combining sum of two units tests from two different specimens improved sensitivities without having a negative impact forward the specificities.

The authors judge that the sensitivity of common test from one specimen is les than was previously reported. They add that when screening for Chlamydia infection in asymptomatic adolescents and young adults, the limitations of common test type at one site must be considered.

Shrier LA, et al. Limitations of screening experiments for the detection of Chlamydia trachomatis in asymptomatic adolescent and young adult women Am J Obstet Gynecol March 2004;190:654-62

COPYRIGHT 2005 American Academy of Family Physicians

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