Several studies of endocervical specimens submitted for Chlamydia trachomatis (CT) testing have found 25-40% of specimens unsatisfactory due to an inadequate number of cells. Since testing for specimen adequacy had not been previously performed, the Region I, National Infertility Prevention Advisory Board (Chlamydia Project), developed a program to increase the rate of satisfactory specimens. All participating clinicians were trained in specimen and data collection by a team consisting of a family planning manager, laboratorian and an epidemiologist. Subsequently, clinicians were requested to collect 25 duplicate swab specimens: one for submission for routine CT testing; one as a direct smear for assesment of specimen adequacy.
Upon receipt in the Lab, the slides were stained with basic fuchsin and examined to determine the number and type of cells present. We defined an adequate specimen as containing 20 or greater columnar and/or cuboidal epithelial cells.
If at least 80% of the 25 submitted smears contained the minimum number of appropriate cells, the set was considered satisfactory. If less than 20 smears contained an adequate number of appropriate cells, the provider was required to submit an additional 10 specimens and achieve 100% adequacy.
A total of 611 specimens submitted from ME, NH and MA have been analyzed to date with a 92% (562) adequacy rate. No positive specimens were found in those specimens accompanying inadequate smears.
We conclude that an adequacy rate of >90% can be achieved for specimens submitted for CT testing. Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.