Genital Chlamydia Detection In Inner-City Adolescents - A Comparison Of Direct Specimen And Tissue-Culture Methods

We compared tissue cell culture isolation with the Microtrak fluorescent antibody direct specimen test for detection of genital Chlamydia trachomatis in an inner-city population of sexually active Black and Hispanic adolescents. Cervical specimens for Chlamydia trachomatis and Neisseria gonorrhaeae were obtained from 95 consecutive females (average age 17.9 years) undergoing a pelvic examination, and urethral specimens from 10 males (average age 18.7 years) with genitourinary complaints. Both tissue cell and direct specimen methods for Chlamydia were positive in 24 patients (22 female, 2 male). In 2 patients (1 female, 1 male), only the direct specimen method was positive; and, in 3 subjects (2 female, 1 male), only the tissue culture was positive. In total, 26.3% of females (N=25), and 40.0% of males (N=4) had Chlamydia. Contrary to previous reports, Blacks (28.6%) did not have a higher prevalence of endocervical Chlamydia than Hispanics (24.1%) (p>.05), nor were oral contraceptive users more likely to be infected with Chlamydia (33.3%) than girls using another or no method (19.1%) (p>.05). Sixteen (64%) girls with Chlamydia were asymptomatic. N. gonorrhaeae was identified in 8 (8.4%) females and 5 (50%) males. Concomitant infection with both organisms was found in 3.8% of subjects (3 females, 1 male). Accurate, convenient, and rapid, the direct specimen test is the method of choice for screening all sexually active adolescents for genital Chlamydia.