Comparison of Culture, Multiplex PCR and Histopathology for the Detection of Etiological Agents of Cervicitis
Afsana Mahbub
Afsana Mahbub, Assistant Professor, Department of Microbiology, Ad-din Akij Medical College, Khulna, Bangladesh, afsanasbmc34@gmail.com
Abdulla AlMamun
Abdulla Al Mamun, Assistant Professor, Department of ENT and Head-Neck Surgery, Ad-din Akij Medical College, Khulna, Bangladesh, drmamunent@gmail.com
Tania Zaman
Tania Zaman, Registrar, Department of ENT and Head-Neck Surgery, Ad-din Akij Medical College, Khulna, Bangladesh, taniazaman068@gmail.com
Tasnim Jannat
Tasnim Jannat, Research Associate, Department of Clinical, Novus Clinical Research Services Limited, Dhaka, Bangladesh, 638tasnim.rch2122@gmail.com
Sadia Islam
Sadia Islam, Scientific Officer, Department of Laboratory Medicine, Bangladesh Specialized Hospital Limited, Dhaka, Bangladesh, sadia.buhs.6700@gmail.com
Md. AshiqurRahman
Md. Ashiqur Rahman, Quality Manager, Department of Laboratory Medicine, Novus Clinical Research Services Limited, Dhaka, Bangladesh, ararashiqur@gmail.com
DOI: https://doi.org/mmr.v3i1.8744
Keywords: Cervicitis; PCR, Gram stain; Culture; Histopathology
Abstract
Background: Cervicitis, an inflammation of the uterine cervix, is often associated with sexually transmitted infections (STIs), and its early detection is crucial for effective management. Neisseria gonorrhoeae, Chlamydia trachomatis, and other pathogens are common causes. Diagnostic methods such as Gram staining, culture, PCR, and histopathology are used to identify the etiological agents. However, their comparative efficacy remains debated. Objective: The objective of this study was to compare the diagnostic accuracy of culture, multiplex PCR, and histopathology in detecting the etiological agents of cervicitis. Methods: A total of 248 endocervical samples were collected from women with suspected cervicitis. These samples were examined using Gram stain, culture, multiplex PCR, and histopathological analysis. The sensitivity, specificity, and diagnostic performance of each method were assessed. Results: Among the samples, Gram stain identified 8.87% N. gonorrhoeae, while culture and PCR detected 5.64% and 10.48%, respectively. Histopathology revealed chronic cervicitis in 20% of cases, cervical intraepithelial neoplasia (CIN) in 43.33%, and squamous cell carcinoma (SCC) in 36.67%. PCR demonstrated the highest sensitivity (100%) for N. gonorrhoeae detection compared to culture, which had lower sensitivity. Gram stain showed high specificity (96.58%) but was less sensitive than PCR. The multiplex PCR method was superior in detecting mixed infections and pathogens that failed to grow in culture. Histopathology, while important for identifying tissue abnormalities, had limited sensitivity in detecting specific microbial agents. Conclusion: PCR is the most reliable and sensitive method for detecting cervicitis-causing pathogens, outperforming culture and Gram stain. Histopathology, though valuable for identifying tissue changes, is not as effective in diagnosing the microbial etiology. A combination of PCR and histopathology may provide a comprehensive diagnostic approach for cervicitis.
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