Rapid diagnosis of chlamydial infection of the cervix.

Abstract

A rapid serodiagnostic test for the presumptive diagnosis of chlamydial infection of the cervix has been developed. The method used is based on the modified micro-immunofluorescence test using pooled chlamydial antigens and the detection of different immunoglobulin classes of chlamydial antibody in sera and cervical secretions. The presence of IgG chlamydial antibody at a level of 1/64, or IgM antibody at a level of 1/8 or greater, or both in sera and IgG or IgA antibody at a level of 1/8 or more or both in cervical secretions was closely associated with the isolation of Chlamydia trachomatis and non-specific genital infection. In general, serodiagnosis was three to nine times more sensitive than cultural methods, and the detection of IgG chlamydial antibody in cervical secretions alone provided the most sensitive of the serological tests. This sensitive, low-cost, rapid, and simple serodiagnostic test for the presumptive diagnosis of chlamydial infection of the cervix, coupled with transportation of specimens by post, offers advantages over conventional isolation techniques for the routine diagnosis and management of chlamydial genital infections.

Diagnostic efficacy of chlamydial antibodies in cervical secretions from pregnant women and adolescent girls.

“…[5][6][7][8] In the study of Treharne et al 7 the authors focused on the sensitivity of the method. For cervical IgG titres of > 8 they found a sensitivity of 0-74 compared with 0-64 in our study and a PPV of 0-39 (26/66) for cervical IgG (our calculation) and in our study 0-18 for the pregnant group but 0-53 for the teenage group.…”

“…The sensitivity and positive predictive value (PPV) have ranged from 0 64-100 and 0-26-0.78 respectively.' [5][6][7][8] The most useful attribute of a diagnostic test for the clinician is a high PPV as pointed out by Schacter et a18 who found a sensitivity of 1 00 but PPV of only 0.26 for cervical IgG in a high prevalence population (20% positive culture). None of the studies mentioned above has found that local antibodies safely predict a positive outcome of culture of a single cervical specimen.…”

Chlamydia trachomatis infection in primary unexplained infertility

“…In addition to isolation of C. trachomatis in cell culture, immunofiuorescence direct staining of genital samples and enzyme-linked immunosorbent assay seem to be of much interest (2,6,15,18,29).…”

Immunoglobulin Contents in Cervical Secretions of Women with Chlamydial Cervicitis

“…No contamination from blood could be detected by hemoglobin analyses. By using a special method for separating the proteins from the mu cins in the cervical secretions we were able to quantify the protein content by the use of nephelometry [8], Other investigators have used cervical vaginal washings and cellulose sponges combined with immunofluorescence tests [1][2][3][4][5]. The methods used in this study design allow for higher recovery of proteins and less bias in interpre tations.…”

“…Infection with Chlamydia trachomatis in the female genital tract has been shown to increase antibody contents in local secretions [1][2][3][4][5][6][7]. Quantification of the antibody content has been intricate because of the rheo logical properties of the mucins in the secretions.…”