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Clinical sciences oral session 3—diagnostic testing: chlamydia & gonorrhoeae
O3-S3.01 Comparison of a new APTIMA specimen collection and transportation kit to L-Pap for detection of C trachomatis, N gonorrhoeae and T vaginalis in cervical and vaginal specimens
  1. M Chernesky
  1. McMaster University, Hamilton, Canada


Background Control of sexually transmitted infections in women has focused on screening using cervical, vaginal or urine samples. The objective was to compare a new specimen collection and transportation (SCT) kit to PreservCyt (PC) and SurePath (SP) liquid-based Pap (L-Pap) for cervical sampling and self- and physician-collected vaginal samples.

Methods Women (n=562) attending a gynaecology clinic (GYC) (n=435) or a youth health clinic (YHC) (n=127) signed consent for a physician to collect two L-Pap samples with a Cervex broom, cervical (CSCT) and vaginal (VSCT) samples and a self-collected VSCT. All specimens were tested for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) by APTIMA Combo 2 (AC2) and Trichomonas vaginalis (TV) by APTIMA TV on a TIGRIS instrument. Each patient was asked on a scale of one to five to express strength of agreement or disagreement with ease or comfort of the 6 step self collection process for the VSCT.

Results There were a total of 22 CT, 19 TV and 2 NG infections with dual infections in 6 people (one CT and NG, one NG and TV and four CT and TV). Prevalences were as follows: CT 3.9% (GYC 1.3% and YHC 12.6%); NG 0.3% (2.0% in YHC); TV 3.4% (GYC 0.4% and YHC 13.4%). Sensitivity for CT infections were CSCT 100%, PC 100%, SP 81.8%; VSCT-self 100%, VSCT-physician 95.4%: for TV infections CSCT 89.4%, PC 84.2%, SP 63.2%; both VSCT 100%: for NG all collections 100%. There were no false positives (% specificity 100). Results of the survey revealed that the majority of patients found opening the package, self sampling, insertion of the SCT swab into preservation media and uncapping and recapping the tube were relatively easy to perform. Eighty two per cent experienced no discomfort using the SCT kit for collection.

Conclusions APTIMA testing on the TIGRIS showed that the cervical and vaginal SCT and PC L-Pap samples were 100% sensitive in detecting CT and NG infections. VSCT samples detected all TV infections but cervical SCT and PC L-Pap were less sensitive. SP L-Pap samples showed reduced sensitivity for CT and TV. Overall, patients were in strong agreement with the ease of use of the VSCT and most found the process comfortable.

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