Detection of Chlamydia trachomatis in urethral scraps

Abstract

Cytological studies were performed on urethral infections due to Chlamydia trachomatis (C. trachomatis) in male patients. Ninety-three urethral scrapings from patients with symptoms and signs of urethritis were investigated. Direct Papanicolaou-stained smears were compared with those of immunofluorescence (IF) and immunoperoxidase (PAP) methods.
In the Papanicolaou-stained smears, urethral cells with vacoulated, mucoid, reticular and granular inclusions were present in gonococcal urethritis (25%) and nongonococcal urethritis (38%). In contrast, the PAP reaction on Papanicolaou-destained smears for these inclusions was negative. In cases with inclusion-bearing cells, C. trachomatis was demonstrated in 72% of cases by both IF and PAP methods. In gonococcal urethritis, the detection rate of C. trachomatis was 25% with the IF method and 33% with the PAP method. In contrast, in nongonococcal urethritis, the detection rate was 52% with the IF method and 36% with the PAP method. With the IF method, typical elementary and reticulate bodies were observed in intracellular as well as extracellular spaces in the urethral specimens. In the PAP test, most of the positive granules in columnar epithelial cells were located in the Golgi area. None of the cases demonstrated C. trachomatis as an inclusion form in either the IF or PAP method. Nearly 26% of men with gonococcal urethritis were coinfected with C. trachomatis.
Detection of C. trachomatis infections is exremely difficult by routine Papanicolaou, Giemsa and periodic acid-shiff stainings. Thus, immunocytochemical techniques such as the IF and PAP methods will undoubtedly be of great diagnostic value for detecting C. trachomatis infections in male patients.