950. Chlamydia trachomatis Infection in Infertile Women in North India: Diagnostic efficacy of an in-house Real-Time PCR assay
Session: Poster Abstract Session: Sexually Transmitted Infections
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
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  • Background: Little is known about the prevalence of Chlamydia  trachomatis infection in Indian women with infertility. To improve the diagnosis of C. trachomatis infection in developing countries, there is an urgent need to establish cost-effective in-house nucleic acid amplification techniques (NAATs). This study was conducted to determine the prevalence of C. trachomatis infection in infertile women using an in-house real-time polymerase chain reaction (PCR). We also compared the in-house real-time PCR assay with a commercial real-time PCR based detection system. 

    Methods: Endocervical swabs, collected from 200 infertile women were tested for C. trachomatis by three different PCR assays viz. in-house real-time PCR targeting the cryptic plasmid using published primers, along with omp1 gene and cryptic plasmid based conventional PCR assays. Specimens were also subjected to Direct Fluorescence Assay (DFA) and Enzyme Immunoassay (EIA). Performance of in-house real-time PCR was compared with that of COBAS Taqman Chlamydia trachomatis Test,version 2.0 (Roche Diagnostics, USA) on all in-house real-time PCR positive samples and 30 consecutive negative samples. 

    Results: The prevalence of C. trachomatis infection in infertile women was 13.5% (27/200) by in-house real-time PCR, 11.5% (23/200) by cryptic plasmid and/or omp1 gene based conventional PCR, 9%(18/200) by DFA and 6.5%(7/200) by EIA. The in-house real-time PCR exhibited a sensitivity of 100% (95% CI, 87.5% - 100%) and specificity of 100% (95% CI, 88.7% - 100%), considering COBAS Taqman CT Test as the gold standard. The positive predictive value of the in-house real-time PCR was 100% (95% CI, 87.5% - 100%). The negative predictive value was also 100% (95% CI, 88.7% - 100%). The in-house real-time PCR could detect as low as 10 copies of C. trachomatis DNA per reaction.


    We observed a high prevalence of C. trachomatis infection in our infertile women by in-house real-time PCR which exhibited an excellent sensitivity and specificity similar to that of COBAS Taqman CT Test, v2.0. In an effort to prevent chlamydia infection associated infertility, we recommend screening of women with infertility for C. trachomatis infection by in-house molecular methods as a cost-effective solution in resource limited settings.

    Benu Dhawan, MD1, Jyoti Rawre, PhD2, Arnab Ghosh, M.D.3, Neena Malhotra, M.D.4, Mir Muneer Ahmed, Ph.D.2, Vishnubhatla Sreenivas, Ph.D.5 and Rama Chaudhry, M.D.2, (1)Microbiology, ALL India Institute Of Medical Sciences (AIIMS), NEW DELHI, India, (2)Microbiology, All India Institute of Medical Sciences, New Delhi, India, (3)Microbiology, All India Institute of Medical Sciences, new Delhi, India, (4)Gynaecology and Obstetrics, All India Institute of Medical Sciences, New Delhi, India, (5)Biostatistics, All India Institute of Medical Sciences, New Delhi, India


    B. Dhawan, None

    J. Rawre, None

    A. Ghosh, None

    N. Malhotra, None

    M. Muneer Ahmed, None

    V. Sreenivas, None

    R. Chaudhry, None

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