Diagnosis of Chlamydia trachomatis infection ? culture versus serology

Abstract

The diagnostic value of different laboratory methods in detecting Chlamydia trachomatis infections in high risk groups was analysed. The efficiency of a direct specimen test was compared with serology (IgG and IgM ELISA) and culture in L929 cells, stained either with fluorescein conjugated monoclonal antibodies or with iodine. Patients (no. = 1041) with localized genital infections attending a STD clinic, sexual contacts and patients with ascending infections from urological and gynecological clinics were examined. Chlamydia trachomatis was detected in 225 patients: 210 (93.3%) were reactive in the direct test (smears stained with monoclonal antibodies), whereas culture missed only 5 (sensitivity 97.8%) when stained by the same method. Cultures stained with iodine produced the lowest recovery rate (73.8%), but this rate increased to 80.9% when a second passage was performed. In addition the prevalence of Neisseria gonorrhoeae, Mycoplasma hominis, Ureaplasma urealyticum, Candida albicans and Trichomonas vaginalis was investigated. In patients with non-gonococcal urethritis (no. = 331) and cervicitis (no. = 353), Chlamydia trachomatis was isolated in 32.3% and 12.8% respectively. However, this pathogen could be isolated in only 3 (15.8%) out of 19 patients with epididymitis and 15 (14%) out of 107 patients with adnexitis, although 66.7% and 93.3% respectively had specific IgG antibodies. Specific IgM could by detected with a sandwich ELISA in patients with adnexitis (46.7%), epididymitis (33.3%), cervicitis (22.2%), non-gonococcal urethritis (14%) and in the sexual partners of patients with genital infections (35.7%). The direct specimen test with monoclonal antibodies is the method of choice for the diagnosis of a C. trachomatis infection in patients with urethritis and cervicitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Prevalence of Chlamydophila Abortus in Aborted Small Ruminants in Slemani And Duhok Governorates

“…Because of its simplicity, the direct microscopic examination was chosen; however, the test is not commonly used due to low sensitivity and specificity compared with other methods (Black, 1997). Since staining artifacts can be considered as chlamydial inclusions, the reading of the stained slides needs to be performed by expert staff (Schoenwald et al, 1988). However, for the purpose of diagnosing it, Giemsa staining was unreliable (El-Berbawy and El-Khabaz, 2014).…”

Current Methods of Laboratory Diagnosis of Chlamydia Trachomatis Infections

“…Historically, other stains including Gram, Giemsa, or iodine staining have been used to visualize chlamydial inclusions in cell culture, but these are not commonly used today due to their lack of sensitivity and specificity compared to fluorescentantibody staining (185,200,206). Although the chlamydiae are classified as gram negative, the Gram stain is of little practical use because the staining reaction is so variable.…”

Current Methods of Laboratory Diagnosis of Chlamydia Trachomatis Infections

“…Historically, other stains including Gram, Giemsa, or iodine staining have been used to visualize chlamydial inclusions in cell culture, but these are not commonly used today due to their lack of sensitivity and specificity compared to fluorescentantibody staining (185,200,206). Although the chlamydiae are classified as gram negative, the Gram stain is of little practical use because the staining reaction is so variable.…”