Multiplex PCR testing requires a robust multi-disciplinary strategy to effectively manage identified cases of chlamydial conjunctivitis

Abstract

New PCR technology has resulted in a shared care approach to address corresponding implications of testing. Effective communication with a structured protocol and a central point of contact has improved follow-up and ensures appropriate best practice management of chlamydial conjunctivitis.

Adult inclusion conjunctivitis diagnosed by polymerase chain reaction and Giemsa stain

“…At that time, the inability of viral culture for this pathogen led the investigators to assume that it was a virus. With improved diagnostic technology, physicians currently use PCR or ELISA to help detect the pathogen [7] , [8] . In our case, we also performed Giemsa statin and obtained the intracytoplasmic inclusion, which made us more confident of our diagnosis.…”

How to use… eye swabs

“…A recent study in Scotland showed that 4% of eye swabs tested by a multiplex PCR panel were positive for chlamydia 8. This study highlighted the importance of having a robust follow-up system in place for parents to ensure that treatment is not delayed.…”

Ten-year review of a shared care approach in the management of ocular chlamydia trachomatis infections

“…Our aim was to compare the recorded clinical management with these locally chosen standards and to see if the lessons and solutions identified previously were still being followed [19].…”

“…This means positive OC results can be identified following routine conjunctival swabbing, and this situation led to a formal complaint regarding a positive test in a young teenager, raising medico-legal implications regarding STI testing in children [16][17][18]. We have previously published that 4% of the 1914 patients swabbed for presumed viral conjunctivitis in the West of Scotland region in the calendar year following the introduction of this testing method in 2007 were found to have OC [19]. This represented a potentially undiagnosed cohort of individuals with a STI and it follows that a robust system should be in place to address this predictable clinical situation.…”

“…Our initial published audit of the clinical management of positive OC results arising from ophthalmology departments in NHS Greater Glasgow and Clyde performed in the calendar year following the introduction of this multiplex assay identified significant issues with incomplete assessments, inadequate treatments and poor contact tracing, particularly when ophthalmologists initiated the management of OC infections [19]. Only 25% of eye patients with positive OC results subsequently attended sexual health services despite referral and/or received adequate treatment and contact tracing [19]. In light of this, we set up a shared care network with the Sandyford Sexual Health services in 2009.…”