Comparison of enzyme immunoassay antigen detection, nucleic acid hybridization and PCR assay in the diagnosis of Chlamydia trachomatis infection.

An enzyme immunoassay (EIA) antigen detection system (MicroTrak, Syva), nucleic acid hybridization (PACE 2, Gen-Probe) and polymerase chain reaction (PCR) assay (Amplicor, Hoffmann-La Roche) were evaluated for the detection of Chlamydia trachomatis in a high-risk female population. Of 234 specimens, 42 (18%) were positive. The respective sensitivity of the EIA, RNA hybridization and the PCR was 81, 90 and 88%. When additionally performed on diluted specimens, PCR gave positive results for three of four PCR-negative specimens from EIA- and RNA-hybridization-positive women and a sensitivity of 95%. Thus, both techniques employing gene technology offered a clear improvement in sensitivity over the EIA. Future improvements in the PCR should be directed towards the elimination of polymerase inhibition.