Chlamydia Trachomatis Infection Inentified in Routine Cervical Cytological Smears Verified by Serology

Overview

objective:
A study of the possibility and meaning of identification of clinically undetected cervicalChlamydia trachomatis infection by means of routine cytology.Design: A serological confirmation of cytological suspition of chlamydial infection of the uterinecervix.Setting: Institute of Pathology, Medical Faculty of the P. J. −afárik University and the Laboratoryfor specific serology of syphilis of the Department of Dermatovenerology of the Louis Pasteur´sFaculty Hospital in Košice.Methods: Endocervical and exocervical smears prepared by means of the Cytobrush were immediately fixed in absolute etanol and stained with hematoxylin and eosin. For serologic analysis thekit for indirect immunofluorescence assay (IFA) Chlamydia IgG/IgM/IgA was used (a product ofViro-Immun Labor-Diagnostika GmbH. Austria). 50 women of various age groups were examinedretrospectively.Results: The suspected chlamydial infection by cytology was confirmed by the immunofluorescence test in all cases examined. The number of infected cells per smear outnumbered four timestheir presence in exocervical smears. Also in all cases there was a marked purulent exudate. Thesigns of chronicity were cytologically detected only in 1/5 of cases contrary to their 100 per centdetection by serology. The most frequent concommitant infectious agents were bacterial rodsfollowed by cocci, Gardnerella vaginalis, fungi and HPV in substantially lesser frequency.Conclusion: The possibility of detection of chlamydial infection in the routine cytology overranksthe clinical detection. The serologic confirmation of this diagnostic suspition represents an im-portant step in the strategy of the fight against this most common sexually transmitted disease.

Key words:
Chlamydia trachomatis, cervicitis, cytological screening, cytology, uterine cervix, indi-rect immunofluorescence assay