Cytobrush versus swab endocervical sampling for the detection of obstetric chlamydial infection

Timely detection and treatment of chlamydial infections during pregnancy is an important public health issue. Exfoliated, infected cells must be present for successful detection of endocervical infection. We compared samples obtained using a cytobrush versus a Dacron-tipped applicator swab for tissue culture isolation of Chlamydia trachomatis from the cervices of 605 pregnant women. The prevalence of chlamydial infection was 5.1%. Cytobrush and Dacron-tipped swab sampling were equally accurate; each detected 80% of all chlamydial infections identified. There were no clinically significant obstetric complications following cytobrush sampling. Bacterial contamination was present in one third more samples obtained using the cytobrush than those obtained using the swab (p = .0001). Culture-independent diagnostic methods such as immunoassays may be preferable for diagnosis of chlamydial infection when cytobrush samples are processed from such clinical specimens.