Use of PCR for the detection of genital Chlamydia trachomatis infection on self-obtained mailed vaginal samples.

BACKGROUND: To determine whether the patient self-obtained and mailed vaginal sample might be used for the detection of genital C. trachomatis infection by the PCR.
METHODS: Women with genital symptoms, younger than 35 years of age and sexually active were enrolled. Cervical and urethral samples collected by the physician were tested by PCR and cell culture. Three vaginal samples were collected: the first and second - by the physician and the patient at the time of the visit to the clinic. The third vaginal sample was collected by the patient at home and posted dry to the laboratory. All vaginal samples were PCR-tested, including also the internal control for the detection of the inhibitors.
RESULTS: The prevalence of chlamydial infection was 19.2%. C. trachomatis was detected in the cervix of 18.5%, in the urethra of 4.4% and in the vagina of 19.2% of the women, when all vaginal samples were considered. Each separate vaginal sampling detected 88.8% of the C. trachomatis infected women. Nearly 10% of the cervical, 3% of the urethral and 12-19% of the vaginal samples were inhibitory. Inhibitors were destroyed by storage of the samples for five days at +4 degrees C or the dilution at 1:10.
CONCLUSIONS: Self-collected and mailed vaginal sample is convenient for the patient and useful for the PCR-testing for genital C. trachomatis infections. Sensitivity of sampling might improve if several consecutive samples were to be collected. This self-sampling approach would help to reach section of the population in which pelvic examination and cervical sampling is not routinely performed.