Comparison between cell culture and serology for detecting Chlamydia trachomatis in women seeking abortion.

Abstract

SUMMARY The efficiency of an immunoperoxidase serological assay and culture of Chlamydia trachomatis were compared in 127 women seeking first trimester abortion. Serum IgG and IgA antibodies specific for C trachomatis wer.e detected by a single serovar (L2) inclusion immunoperoxidase assay (IPA). Eighty (63%) women were seropositive for chlamydial IgG and 31 (24%) for IgA antibodies. C trachomatis was isolated from 21 of 127 (17%) women. Twenty of the 80 women (25%) seropositive for specific IgG antibodies and one of 47 (2%) patients without these antibodies were culture positive (p < 0-001). Compared with isolation, chlamydial antibodies at a titre of > 16 showed high sensitivity and negative predictive value (95% and 98%, respectively), but low specificity and efficiency (43% and 52%, respectively). Chlamydial IgA antibodies at a titre of > 8 showed low sensitivity (52%), but a higher specificity, negative predictive value, and efficiency of 81%, 90%, and 76%, respectively. C trachomatis IgG antibodies at a titre of 16 as determined by IPA can be used as an efficient negative exclusion marker for active chlamydial infection in screening women seeking abortion. Postabortal salpingitis may complicate postoperative recovery in about 20% of women infected with C trachomatis.' To avoid this complication screening for C trachomatis by direct immunofluorescence and culture isolation has recently gained wider application for women wanting an abortion. Although culture is the standard reference method, it is costly, time consuming, and requires considerable experience. The results may also arrive too late and therefore be oflittle help in deciding on appropriate management. Direct detection methods are speedier, but they, too, require expensive equipment, skill, and may be less sensitive than culture.2 In this study we compared the efficiency of a new and sensitive serological method with the standard cell culture. The results of cell culture were correlated with serology for specific chlamydial IgG and IgA antibodies by the single serovar (L2) IPA. Patients and methodsOne hundred and twenty seven women presenting for first trimester abortion were included in the study. The

Detection of anti-Chlamydia trachomatis antibodies in Patients with Acquired Immune Deficiency Syndrome in Abuja, Nigeria

“…Serological detection of specific IgG antibodies usually facilitates diagnosis for chlamydial infections. Clinical studies have shown a high correlation between the serological detection of IgG for C. trachomatis in sera and the presence of chlamydial antigen (Csángo et al, 1988). Since ImmunoComb test results have been shown in an earlier study to correlate well with those of the MIF test (Clad et al, 1994), detection of anti-C. trachomatis IgG using ImmunoComb assay provides a valid reason to suspect past or active chlamydial infections in those patients.…”

Accuracy of tests used to detect infection with Chlamydia trachomatis in asymptomatic pregnant women: a systematic review

“…The studies evaluated a following tests: PCR, direct enzyme immunoassay (MicroTrak SYVA), direct immunofluorescence assay (MicroTrak SYVA), Chlamydiazyme (Abbott Laboratories), chlamydia immunoglobulin A (IgA) Rapid SeroTest ELISA (Savyon Diagnostics), Gen-Probe PACE 2 (Gen Probe Inc AQ8 . ), immunoglobulin G (IgG) level via immunofluorescence techniques, Papanicolaou smear, and wet mount gram stain (Table 1) [9][10][11][12][13][14][15][16][17][18][19][20]. Seven studies recruited women in antenatal care settings [9][10][11][12][13][14][15] and five women who were present at the clinic for termination of pregnancy [16,[17][18][19][20].…”

“…), immunoglobulin G (IgG) level via immunofluorescence techniques, Papanicolaou smear, and wet mount gram stain (Table 1) [9][10][11][12][13][14][15][16][17][18][19][20]. Seven studies recruited women in antenatal care settings [9][10][11][12][13][14][15] and five women who were present at the clinic for termination of pregnancy [16,[17][18][19][20]. The prevalence of the infection ranged from 2 to 87%.…”

“…The prevalence of the infection ranged from 2 to 87%. All studies except one [11] were carried out in high-income countries (Table 2) [9][10][11][12][13][14][15][16][17][18][19][20].…”

“…A total of 8 out of 12 included studies did not provide sufficient description of women's enrolment (unclear risk of bias). The majority of the studies were assessed as a low risk of bias regarding implementation of the index test (Table 3) [9][10][11][12][13][14][15][16][17][18][19][20]. The risk of bias in 75% (9/12) of studies on the reference standard was considered as unclear due to insufficient information.…”