Chlamydia trachomatis PCR

Products containing carbomer(s), including vaginal lubricants, creams and gels may interfere with the test and should not be used during or prior to collecting urogenital specimens.

• • To minimize the risk of invalid test results:
    • Refrain from using carbomer-containing products to lubricate a speculum as part of the collection procedure, or collect sample prior to use of lubricant/performing pelvic exam
    • Ask patients to refrain from using feminine hygiene products for approximately 24 hours prior to their scheduled visit
    • If patient is known to be using feminine hygiene products at time of collection, an alternative non-vaginal swab sample type may be considered

• • Examples of carbomer-containing products include:
    • DynaLube Lubricating Jelly
    • McKesson Lubricating Jelly
    • Cardinal Health Lubricating Jelly
    • Medline Lubricating Jelly
    • RepHresh Clean Balance
    • RepHresh Vaginal Gel Prefilled
    • Vagisil Anti-itch Cream
    • Vagisil Crème Regular Strength
    • Vagisil ProHydrate
    • Vagisil Sensitive Cream
    • IsoLove Balancing Gel
    • Replens Long-Lasting Vaginal Moisturizer
    • Metronidazole Vaginal Gel

The specimen collection kit consists of a paper packet containing 2 swabs and a yellow topped plastic tube containing transport media.

• • For an endocervical swab, it is essential to visualize the cervix. Any discharge or blood should be wiped away. Insert the swab into the cervix and rotate with the aim of removing epithelial cells.

• • For taking a low vaginal swab, ensure the patient is not wearing a tampon. The labia should be parted to open the vagina. Insert a swab gently to about 5cm. Rotate all the way around the vagina

• • If preferred the patient can take her own low vaginal swab ( instructions below)

• • Please take only one sample per patient (vials with 2 swabs in will be rejected)

1. Open the plastic bag. Open the paper packet which contains two swabs. Throw away the thin ended swab – you need to use the THICKER swab ONLY.

2. Stand with your feet apart and your knees bent, or sit down with your knees apart.

3. Take the thicker of the two swabs by the non-fluffy end. With your free hand hold open the skin around the vaginal opening.

4. Place the soft swab tip into the vagina approximately the length of your finger. Rotate the swab all the way around the vagina. Remove the swab and continue to hold it. Do not put it down.

5. Holding the yellow topped tube upright, unscrew the cap and put the swab inside with the fluffy end down. There is a faintly scored ring around the white stick about 2/3 of the way up. Hold the swab stick firmly with the score mark against the top of the tube; bend it until it breaks off at the top of the tube. (There is liquid in the tube – DO NOT pour this away as it is meant to be there, without it the specimen cannot be processed.)

6. Screw the cap on firmly. Label the tube with your full name, date of birth and the date of the sample. Ensure that the tube only contains the thicker swab. The laboratory will not be able to process the sample if both swabs are in the tube.

7. You may discard the broken stick, packaging and unused swab into a household rubbish bag.

Caused by a subset of C. trachomatis (Serovars L1, L2 or L3), which can cause a more severe infection (attacking lymph nodes, causing inflammation and invasive disease.)

• As standard practice we refer all Chlamydia positive rectal swabs from Males for LGV testing. (Also from all sites for HIV+ MSM if Chlamydia positive.)
• We can refer Chlamydia positive rectal swabs from females on request, but do not do so routinely (LGV in females is rare in the UK.)
  • • Please note the reference lab will only test samples from females who either:
      • • Have proctitis
        • Are a contact of a LGV positive patient
        • Are trans-gender female
    • Please provide this information with the request
• We DO NOT refer samples for LGV that have tested NEGATIVE for Chlamydia on our in-house PCR test.
  • • All requests received for LGV only will be tested for Chlamydia in-house prior to referral for LGV testing

LGV testing is performed by the Bacteriology Reference Department, UKHSA Colindale – UKHSA – Referral form for LGV Testing

For further information on LGV – Terrence Higgins Trust – LGV