Use of the Cytobrush for concurrent endocervical cytology and chlamydia sampling

Cervical sampling for diagnosis of genital chlamydial infection with a new brush device

OBJECTIVES

To compare a new sampling device, a brush, Accellone-Multi-Instrument (AMI), with a dacron-tipped swab for detection of Chlamydia trachomatis in endocervical specimens, and to evaluate if consecutive multiple cervical sampling as compared with such a single specimen would increase the sensitivity.

METHODS

501 females attending an STD clinic and 172 females attending a family planning clinic were examined prospectively. Two cervical specimens were collected from each woman. C trachomatis were detected by culture or enzyme immunoassay (IDEIA-III). Positive EIA samples were confirmed by a direct immunofluorescent test.

RESULTS

When cervical specimens were collected with the brush as the first device, 92% of the culture-positive cases were detected, and when the samples were collected with the dacron-tipped-swab first, 84% of the culture-positive cases were detected (p < 0.05). The first collected specimen detected 89% of the culture-positive cases and 81% of those that were positive by IDEIA.

CONCLUSIONS

The study indicates that the AMI brush is superior to non-toxic, dacron-tipped swabs for detection of C trachomatis in cervical samples by cell culture but not by ELISA, and that the sensitivity could be improved by analysing multiple cervical samples.