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G Mumtaz

Publications and source records attributed to G Mumtaz.

At least 19 recordsLinked to original sources
PubMed1996

Comparison of the ligase chain reaction with cell culture for the diagnosis of Chlamydia trachomatis infection in women.

OBJECTIVE: To determine the sensitivity and specificity of ligase chain reaction (LCR) analysis of cervical and urine specimens from women compared with cell culture of cervical and urethral specimens for the diagnosis of genitourinary chlamydial infection. METHODS: Women (n = 624) attending the Genitourinary Medicine Clinic at University College London Hospitals, were enrolled. Patients who had received antibiotics within the previous two weeks were excluded. Specimens were obtained from the urethra and cervix for chlamydial culture, and from the cervix for LCR. A specimen of first void urine was also obtained for LCR. Discrepancies were resolved by direct immunofluorescence or a major outer membrane protein targeted LCR, or both. RESULTS: The prevalence of Chlamydia trachomatis in 600 patients, using an expanded standard of a positive cell culture or two confirmed positive non-culture tests, was 13.2% (79/600). Cervical culture detected 68.4% and urethral culture 62% of all positive results compared with 81% detected by cervical LCR and 69% by urine LCR. Cervical and urethral culture combined detected 87.3% whereas cervical and urine LCR combined detected 91.1% of positive cases. Specificity of LCR was 100% in the cervix and 99.8% in urine. CONCLUSION: This study demonstrates that LCR analysis of cervical and urine specimens is a reliable method for the diagnosis of chlamydial genital infection in women. However, the study also demonstrates that no single test will detect all chlamydial infections. Conventional non-culture tests and cell culture may grossly underestimate the prevalence of chlamydial infection. LCR analysis of a cervical specimen was superior to conventional cell culture without blind passage as a single test for diagnosing chlamydial infection in women, followed by LCR of a urine specimen.

Cell Culture Techniques↗
PubMed1995

Clinical, laparoscopic and microbiological findings in acute salpingitis: report on a United Kingdom cohort.

OBJECTIVE: To determine the clinical features and microbial aetiology of acute salpingitis in women attending an inner city teaching hospital. DESIGN: Prospective, longitudinal cohort study. SUBJECTS: One hundred and forty-seven women presenting consecutively with acute abdominal pain and clinical signs of acute salpingitis were evaluated microbiologically and laparoscopically. RESULTS: One hundred and four women (70.7%) had acute salpingitis diagnosed at laparoscopy. Other pathological conditions were identified in 20 women (13.6%). No visually identifiable pathology was found in 23 (15.6%). Thirty-five women with acute salpingitis had evidence of pelvic adhesions (33.7%). Bilateral tubal occlusion was present in 6 (5.8%) cases. Chlamydia trachomatis was identified in the genital tract in 40 (38.5%) of the women with acute salpingitis and Neisseria gonorrhoeae in 15 (14.4%). A dual infection was present in eight cases (7.7%). Serological evidence suggested that a further seven women (6.7%) had acute chlamydial infections at the time of diagnosis. C. trachomatis was identified in the genital tract of 5/23 (21.7%) of the women who had no laparoscopic evidence of intra-abdominal pathology. CONCLUSIONS: The responsible care of women with suspected acute salpingitis depends on establishing an accurate diagnosis, so that appropriate therapy can be instigated. This study provides evidence to challenge the outpatient management of acute salpingitis on clinical grounds alone as potentially inadequate. Early laparoscopy in hospitalised women improves diagnostic precision and accurately determines disease severity, providing prognostic information for future fertility. In this urban population, sexually transmitted micro-organisms were the commonest pathogens found in the genital tract of women with acute salpingitis. The high prevalence of C. trachomatis in these women suggests that appropriate chemotherapy for acute salpingitis should always include a specific antichlamydial agent.

Acute Disease↗
PubMed1993

Mandatory use of confirmation stage with Chlamydiazyme during urinary sediment analysis.

AIMS: To assess whether false positive results found when the first stage Chlamydiazyme test is performed on urinary sediment could be reduced by using the more specific second stage blocking assay. METHODS: Sediment from 173 urine samples from patients with suspected urinary tract infection caused by Gram negative bacteria and 23 control urine samples were tested using the Chlamydiazyme assay system, which included a blocking assay. RESULTS: A reaction result with the first stage Chlamydiazyme assay test was seen in 102 (58.9%) of the test urine samples. First stage reactivity was not blocked by the Chlamydiazyme confirmatory assay performed on repeat testing. All were correctly identified as true negative (first test false positive) results. CONCLUSIONS: Use of a second (specific) blocking assay for the analysis of urinary sediment using Chlamydiazyme eliminates false positive results in Gram negative urinary tract infections.

Chlamydia Infections↗
PubMed1993

Comparison of an enzyme immuno assay (Antigenz Chlamydia) with cell culture for the detection of genital chlamydial infection in high and low risk populations.

OBJECTIVE: To evaluate a new enzyme immuno assay, Antigenz Chlamydia, for the detection of chlamydial antigen in urogenital samples using cell culture as the gold standard for comparison and direct immuno fluorescence to aid resolving the discrepancies. SUBJECTS: 212 men and 303 women attending an STD clinic and 404 women of child bearing age attending gynaecological clinics. RESULTS: Sensitivity, specificity, predictive value of positive result and predictive value of negative result of the new test were 77.6%, 99.0%, 94.3%, and 95.7% respectively in the high risk population with a prevalence of 16.5%. In the low risk population the figures were 84.2%, 94.5%, 43.2% and 99.2% respectively with a prevalence of 4.7%. CONCLUSION: Antigenz Chlamydia is an easy and quick test to perform. The test is suitable for use in high risk and low risk populations provided all positive samples are confirmed.

Adult↗
PubMed1991

The in-vitro activity of clarithromycin and other macrolides against the type strain of Chlamydia pneumoniae (TWAR).

The activity of oxytetracycline and seven macrolide antibiotics was investigated against a prototype strain of Chlamydia pneumoniae in cell culture. Following incubation, inoculated cell monolayers were fixed in methanol and stained with a genus specific immunofluorescent monoclonal antibody before examination for inhibition of inclusion formation. The most active agent was clarithromycin (MIC 0.007 mg/l), followed by erythromycin (0.06 mg/l). Other macrolides were less active; josamycin and roxithromycin (0.25 mg/l), midecamycin acetate and azithromycin (0.5 mg/l) and spiramycin (4.0 mg/l). The MIC of oxytetracycline was 0.25 mg/l. Clinical evaluation of clarithromycin for C. pneumoniae lower respiratory infection is indicated.

Anti-Bacterial Agents↗
PubMed1990

The in-vitro antibiotic susceptibility of Chlamydia pneumoniae.

A cell culture technique was used to test the in-vitro susceptibility of the type strain of Chlamydia pneumoniae to 23 antibiotics including macrolides, tetracyclines and quinolones. The activity of the antibiotics tested was similar to previous findings with C. trachomatis. Clarythromycin had the lowest MIC overall (0.007 mg/l). Other macrolides were found to have similar MICs to erythromycin (0.06 mg/l). Both the macrolides and the tetracyclines were more active than the quinolones. It is proposed that the tetracyclines and erythromycin should be the drugs of choice for treating infections with C. pneumoniae; however several other antibiotics need to be evaluated.

4-Quinolones↗
PubMed1990

Confirmatory assay increases specificity of the chlamydiazyme test for Chlamydia trachomatis infection of the cervix.

Enzyme immunoassays for the detection of chlamydial antigens are commonly used to diagnose Chlamydia trachomatis infection. As is true for all nonculture methods, the specificities of these tests are a concern. A confirmatory blocking assay (Abbott Laboratories, North Chicago, Ill.) was evaluated at four sexually transmitted disease test sites. This assay is designed to confirm true-positive Chlamydiazyme (CZ) specimens and to identify false-positive CZ reactions caused by cross-reacting bacteria. Cervical specimens were collected from 2,891 women. Chlamydia prevalence by tissue culture (TC) was 9.2% (266 of 2,891 specimens). Compared with TC, the sensitivity and specificity of CZ were 78.9% (210 of 266 specimens) and 98.2% (2,577 of 2,625 specimens), respectively. There were 48 CZ false-positive reactions. The direct fluorescent-antibody test (DFA) was positive for 31 of 48 false-positive reactions, indicating culture misses. Thus, when the standard was both TC and DFA, CZ sensitivity was 81.1% and CZ specificity was 99.3%. Of the 17 CZ-positive patients who were negative by both TC and DFA, 3 were negative on repeat CZ and 11 of 14 were identified as false positive by the confirmatory assay. The confirmatory test was positive for CZ-positive women who were positive by TC or DFA. Use of the confirmatory test, which increased the specificity to 99.9%, would increase confidence in positive CZ results and make the test more useful for screening populations with a low prevalence of C. trachomatis infection.

Adult↗
PubMed1990

Is a test of cure necessary following treatment for cervical infection with Chlamydia trachomatis?

Tests of cure (TOC) were performed on specimens from 106 women following treatment for chlamydial infection of the cervix. 91 women attended for the first TOC with enzyme immunoassay (EIA) within one week of finishing antibiotics. Three were EIA positive, 88 were EIA negative. These three women were subsequently EIA and culture negative although they received no further antibiotics. Ninety women returned for the second TOC with EIA and culture between seven and 27 days after completing treatment. All the results were negative. Routine TOC is unnecessary following appropriate antichlamydial therapy. If TOC is indicated antigen-detection methods should not be used immediately after finishing antibiotics as misleading positive results may be obtained. EIA or culture at one week or later after treatment is reliable.

Chlamydia Infections↗
PubMed1990

Comparison of an enzyme immunoassay (Ortho) with cell culture and immunofluorescence for the detection of genital chlamydial infection.

An enzyme immunoassay (EIA) test (Ortho Diagnostic Systems Ltd) was evaluated against cell culture for the detection of chlamydial genital infection. Specimens were obtained from 409 patients (204 men and 205 women). Sensitivity, specificity, predictive value of a positive result (PVP) and predictive value of a negative result (PVN) for the new test compared to cell culture were respectively 73.1%, 93.8%, 63.3% and 96% for men and 80%, 95.6%, 71.4% and 97.2% for women. Discrepancies were further evaluated by repeating the EIA, and by direct immunofluorescence (IF) on the EIA transport buffer. The sensitivity, specificity, PVP and PVN of the EIA against the combination of cell culture and direct IF were respectively 76.7%, 96%, 76.7% and 96% for men, and unchanged for women. Overall agreement between the EIA and the combination of cell culture and direct IF was 93.4%. The EIA is rapid and simple to perform and does not require elaborate equipment.

Cells, Cultured↗
PubMed1989

Enzyme immunoassay compared with cell culture and immunofluorescence for detecting genital chlamydia.

A novel enzyme immunoassay test (Pharmacia EIA) was evaluated against cell culture for the detection of chlamydial genital infection. Specimens were obtained from 525 patients (257 men and 268 women). Sensitivity, specificity, predictive value of positive (PVP) and predictive value of negative (PVN) for the new test were, respectively, 83.6, 98.5, 94.4 and 95.1% for men and 86, 97.2, 87.8 and 96.8% for women. Discrepancies were further evaluated by repeating the EIA, and by direct immunofluorescence on the EIA transport buffer. The sensitivity, specificity, PVP and PVN of the EIA against the combination of cell culture and direct immunofluorescence were, respectively 85.9, 100, 100, and 95.5% for men, and 90.5, 98.1, 92.3 and 97.7% for women. Overall agreement between the EIA and the combination of cell culture and direct immunofluorescence was 97%. The Pharmacia EIA is rapid and simple to perform and does not require elaborate equipment.

Bacteriological Techniques↗
PubMed1988

In vitro activity of sulphamethoxazole/trimethoprim and sulfadoxine/pyrimethamine against Chlamydia trachomatis SA2f in McCoy cell culture.

Chequerboard titrations of sulphamethoxazole/trimethoprim and sulfadoxine/pyrimethamine were performed against Chlamydia trachomatis (strain SA2f) using McCoy cell monolayers in vials. The experiments were continued for ten passages each. The mean fractional inhibitory concentration index for each combination was calculated. Results demonstrated synergistic activity between sulphamethoxazole and trimethoprim, and between sulfadoxine and pyrimethamine.

Cell Line↗
PubMed1985

Enzyme immunoassay for the detection of Chlamydia trachomatis antigen in urethral and endocervical swabs.

An enzyme immunoassay technique based on the direct detection of Chlamydia trachomatis antigen in urethral or cervical swabs was used for the rapid diagnosis of chlamydial genital infection. Urethral and cervical samples from 140 patients were tested in parallel by enzyme immunoassay and cell culture using iodine staining. The direct test had a sensitivity of 92.5% and specificity of 97.2% when compared with the cell culture system. The enzyme immunoassay technique provides a rapid and simple method for diagnosing chlamydial genital infection and may be performed on a large number of samples in laboratories which do not have tissue culture facilities or a trained microscopist.

Antigens, Bacterial↗