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Three methods to detect Chlamydia trachomatis in endocervical swab specimens collected from 502 women with genitourinary or abdominopelvic symptoms were evaluated: (1) a direct immunofluorescence assay, (2) an enzyme-linked immunoabsorbent assay, confirming positive samples with a blocking assay, and (3) conventional tissue cell culture. C. trachomatis was detected by at least one method in 72 specimens, of which 56 (11%) were determined to be true-positive results by repeated testing and by performing a confirmatory assay. The sensitivity, specificity, and positive and negative predictive values were 91%, 100%, 100%, and 99%, respectively, for culture and the enzyme-linked immunoabsorbent assay plus blocking assay and 74%, 98%, 83%, and 96%, respectively, for the direct immunofluorescence assay. In this population of women, using the enzyme-linked immunoabsorbent assay with the confirmatory assay is a rapid, reliable, and cost-effective alternative to culture for diagnosing infection with C. trachomatis.
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