Molecular Detection of Chlamydia Trachomatis Pak Armed Forces Med J 2022; 72 (4): 1253 Molecular Detection of Chlamydia Trachomatis in Patients with Pelvic Inflammatory Disease Visiting a Tertiary Care Hospital in Pakistan Afnan Naeem, Hafsa Waseem, Sakhawat Ali, Javaid Usman, Mehreen Gilani, Amna Javed Army Medical College/National University of Medical Sciences (NUMS), Rawalpindi Pakistan ABSTRACT Objective: To detect the frequency of Chlamydia trachomatis in urine samples of women with Pelvic Inflammatory Disease visiting a tertiary care hospital using a Polymerase Chain Reaction assay and find an association between different risk factors. Study Design: Cross-sectional study. Place and Duration of Study: Department of Microbiology, Army Medical College/National University of Medical Sciences Rawalpindi Pakistan, from Mar 2018 to Jan 2019. Methodology: Over eleven months, 60 diagnosed urine samples of married females with pelvic inflammatory disease between the ages of 14-49 years were included in the study. DNA of Chlamydia trachomatis from urine samples was extracted manually using the commercially available kit. It was detected by performing a real-time Polymerase Chain Reaction assay using a forward primer (5’-CATGAAAACTCGTTCCGAAATAGAA-3’) and a reverse primer (5’-TCAGAGCTTTACC- TAACAACGCATA-3’) of sequence mentioned above for amplification of target sequences, of the Chlamydia trachomatis. Results: Out of sixty cases included in this study, Chlamydia trachomatis DNA was detected in 12 cases (20%), and 48 cases (80%) were negative. So, the frequency of Chlamydia trachomatis in our study population was estimated at 20%. In addition, age, socioeconomic status, education and no of sexual partners were all risk factors were evaluated for their role in acquiring infection. Conclusion: Females having Chlamydia trachomatis infection and other sexually transmitted infections are at an increased risk of developing Pelvic Inflammatory disease due to the presence of risk factors and the asymptomatic nature of the disease. Keywords: Chlamydia trachomatis, Pelvic inflammatory disease, Polymerase chain reaction, Sexually transmitted infections. How to Cite This Article: Naeem A, Waseem H, Ali S, Usman J, Gilani M, Javed A. Molecular Detection of Chlamydia Trachomatis in Patients with Pelvic Inflammatory Disease Visiting a Tertiary Care Hospital in Pakistan. Pak Armed Forces Med J 2022; 72(4): 1253-1257. DOI: https://doi.org/10.51253/pafmj.v72i4.7047 INTRODUCTION Sexually transmitted infections (STIs) are a silent epidemic with substantial health and economic con- sequences. STIs carry not only a risk of morbidity but also considerable mortality. According to World Health Organization (WHO), 350 million new STIs occur per annum, out of which 131 million cases are of Chlamydia trachomatis. It is the most common sex- ually transmitted bacterial infection worldwide. 1 Around 75 percent of total cases of Chlamydia trachomatis take place in the developing world, ma- king the situation more worrisome as these countries lack diagnostic and treatment facilities. 2 Centers for Disease Control and Prevention (CDC) reported 1.7 million infections in the United States in 2017. 3 Chlamydia trachomatis infection is mostly asym- ptomatic. In females, it causes endometritis, cervicitis, ectopic pregnancy, Pelvic Inflammatory Disease (PID), infertility and sometimes death due to ruptured ecto- pic pregnancy. 4 One of the main challenges of Chlamydia tracho- matis infection is its asymptomatic nature. It occurs more frequently in young women, putting them at risk of acquiring and transmitting infection, especially in our setup where most cases go undetected due to lack of knowledge, screening programs, testing facilities and cultural barriers. 5 In our study, we used a urine sample over an endocervical swab as the sensitivity of PCR of both swab and urine is equal, but urine specimen is a non- invasive sample collection technique. 6 Pelvic Inflammatory Disease is ascending inflam- mation of the endometrium, fallopian tubes, ovaries or pelvic peritoneum. Clinically it is diagnosed as pelvic pain combined with inflammation of the lower genital tract. Infection with Chlamydia trachomatis is the foremost cause of it in females. 7 There is no gold standard diagnostic test for detecting Chlamydia trachomatis DNA. Traditionally tissue culture was used for its diagnosis, but it has limitations. The sensitivity of culture is between 70-90 percent, and specificity is around 99 percent. 8 Other methods used for diagnosis are serology and antigen This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Correspondence: Dr Afnan Naeem, Department of Microbiology, Army Medical College, Rawalpindi Pakistan Received: 08 Jul 2021; revision received: 30 Nov 2021; accepted: 20 Dec 2021 faannaeem@gmail.com Original Article Open Access