Diagnostic Procedures to Detect Chlamydia trachomatis Infections

Abstract

The intracellular life style of chlamydia and the ability to cause persistent infections with low-grade replication requires tests with high analytical sensitivity to directly detect C. trachomatis (CT) in medical samples. Nucleic acid amplification tests (NAATs) are the most sensitive assays with a specificity similar to cell culture and are considered the method of choice for CT detection. In addition, NAATs can be performed on various clinical specimens that do not depend on specific transport and storage conditions, since NAATs do not require infectious bacteria. In the case of lower genital tract infections, first void urine and vaginal swabs are the recommended specimens for testing males and females, respectively. Infections of anorectal, oropharyngeal and ocular epithelia should also be tested by NAAT analysis of corresponding mucosal swabs. In particular, anorectal infections of men who have sex with men (MSM) should include evaluation of lymphogranuloma venereum (LGV) by identification of genotypes L1, L2 or L3. Detection of CT antigens by enzyme immunoassay (EIAs) or rapid diagnostic tests (RDTs) are unsuitable due to insufficient sensitivity and specificity. Recent PCR-based RDTs, however, are non-inferior to standard NAATs, and might be used at the point-of-care. Serology finds application in the diagnostic work-up of suspected chronic CT infection but is inappropriate to diagnose acute infections.

Development of aChlamydia suis-specific antibody enzyme-linked immunosorbent assay based on the use of a B-cell epitope of the polymorphic membrane protein C

“…Chlamydia are auxotrophic for tryptophan and respond to this stress situation with generation of morphological aberrant, non‐replicative, persistent forms that presumably convert into replicative forms as environmental conditions improve (Bastidas, Elwell, Engel, & Valdivia, ). As for C. trachomatis (Meyer, ), which is phylogenetically highly related to C. suis , persistent C. suis infections most likely are associated with a positive antibody response, and thus, negative serology may assist to rule out the involvement of chlamydia. In addition, as for C. trachomatis (Meyer, ), low‐grade replication possibly also occurs during chronic C. suis infections and serology might be useful in the diagnostic work‐up of such suspected chronic infections.…”

“…As for C. trachomatis (Meyer, ), which is phylogenetically highly related to C. suis , persistent C. suis infections most likely are associated with a positive antibody response, and thus, negative serology may assist to rule out the involvement of chlamydia. In addition, as for C. trachomatis (Meyer, ), low‐grade replication possibly also occurs during chronic C. suis infections and serology might be useful in the diagnostic work‐up of such suspected chronic infections. However, serology is inappropriate for immediate diagnosis of acute C. suis infections as convalescent sera are needed to this purpose.…”

Chlamydial eye infections: Current perspectives

“…[63] Other nucleic acid detection/amplification tests such as gene probe assay, loop-mediated isothermal amplification assay, ligase chain reaction assay, and strand displacement amplification have been tried or are under development for C. trachomatis detection, but none are used routinely. [64]…”

“…However, serology may be helpful in the diagnosis of chronic and invasive infections such as LGV. [64] Later, it was observed that the antibodies against Chlamydophila pneumoniae are highly cross-reactive with C. trachomatis antibodies. Therefore, it became clear that the exact prevalence of C. trachomatis infection cannot be easily determined from antibody detection.…”

Single-domain adapted antibodies against Chlamydia trachomatis, preserving the development of chlamidic infection in vitro

“…Во-вторых, ввиду того, что постановка диагноза хламидийной инфекции требует проведения интенсивного курса антибиотикотерапии, часто с использованием нескольких препаратов, при диагностике урогенитального хламидиоза необходимо использовать не менее 2-х методов, отвечающих требованиям строгой специфичности и чувствительности. Одним из таких методов является ПЦР, который должен быть подтвержден методом иммунодетекции возбудителя [3,4]. И, в-третьих, в последнее время в связи с актуальностью контроля за распространением хламидийной инфекции особое значение приобретает разработка быстрых скрининговых тестов, что позволит поставить диагноз и начать лечение уже после первого обследования пациента, так называемые "point of care" (РОС) тесты.…”