Supervisors info:
Γεώργιος Κρεατσάς, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Γεώργιος Μαστοράκος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Νικόλαος Βλάχος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
AUTHORS: Athanasia Tsaliki, Vassilis Tsilivakos, Georgios Kreatsas, Nikolaos Vlachos, Georgios Mastorakos. ORIGIN OF WORK: Locus Medicus, at 246 Mesogeion Avenue, Athens.
OBJECTIVE: Which method should be the most reliable and economical for chlamydial infection diagnosis. Although PCR is considered the gold standard, flow cytometry is an equally good and much more cost-effective chlamydia diagnostic method.
METHODOLOGY: It is a comparative study of a cohort with 58 patients where each underwent vaginal fluid culture with the 3 methods (PCR, flow cytometry and immunofluorescence) from 7/1/2022 until 30/4/2023 at the diagnostic center "Locus Medicus"
RESULTS: When the sample size increased from 41 to 58 cases, in PCR the negative cases increased and the positive cases decreased, while in flow cytometry the reverse occurred and the negative predictive value increased. The result of logistic regression of the 2 methods was not statistically significant with Odds Ratio 3.2 (S.D 3.05, p-value=0.228).
Flow cytometry has low overall accuracy, sensitivity and positive predictive value, but good specificity and negative predictive value. In the ROC curve, the AUC decreases when the sample increases from 41 to 58 cases.
Immunofluorescence had no positive diagnosis.
CONCLUSIONS: In the diagnosis of chlamydial infection, the PCR method is the gold standard, followed by flow cytometry in the row, while immunofluorescence has no diagnostic ability at all. Classic vaginal cultures for detection of chlamydia covered by most public insurances are completely useless because they rely on immunofluorescence.
The coexistence of inflammation can make the results true or false positive unpredictably.
Keywords:
Diagnosis of chlamydia, Reliable method for chlamydia, Cervical chlamydia, Vaginal chlamydia
