External Quality Assessment for the Detection of Chlamydia trachomatis in Urine Using Molecular Techniques in Belgium

Abstract

Chlamydia trachomatis is a major cause of sexually transmitted bacterial disease worldwide. C. trachomatis is an intracellular bacterium and its growth in vitro requires cell culture facilities. The diagnosis is based on antigen detection and more recently on molecular nucleic acid amplification techniques (NAAT) that are considered fast, sensitive, and specific. In Belgium, External Quality Assessment (EQA) for the detection of C. trachomatis in urine by NAAT was introduced in 2008. From January 2008 to June 2012, nine surveys were organized. Fifty-eight laboratories participated in at least one survey. The EQA panels included positive and negative samples. The overall accuracy was 75.4%, the overall specificity was 97.6%, and the overall sensitivity was 71.4%. Two major issues were observed: the low sensitivity (45.3%) for the detection of low concentration samples and the incapacity of several methods to detect the Swedish variant of C. trachomatis. The reassuring point was that the overall proficiency of the Belgian laboratories tended to improve over time.

Suboptimal Chlamydia trachomatis Detection Method Is Still Widely Used in China: Results of External Quality Assessments from 2013 to 2018

“…The Chlamydia EQA program in China enables an unbiased comparison of the C. trachomatis detection proficiency among laboratories and also among methodologies, promoting continued maintenance and improvements in clinical diagnostic standards and optimization of test methods. To our knowledge, the current EQA program using mock samples with inactivated C. trachomatis is the first program in China that has monitored the performance of different diagnostic methods for Chlamydia, focusing on not only the nucleic acid [12][13][14] but also the antigen.…”

Performance of Sexually Transmitted Disease Laboratories for Chlamydia trachomatis Detection in Guangdong, China

“…8 Nucleic acid amplification tests have recently been considered the diagnostic criterion standard for chlamydia detection. [9][10][11] Evaluating the diagnostic ability of clinical laboratories and monitoring their performance via external quality assessment (EQA) programs is important for maintaining and improving the detection rate of chlamydia and the quality of laboratory diagnosis. 12 In 2002, Land et al 13 reported the first field assessment of C. trachomatis NAATs in Australia by comparing 2 commercial NAATs for the detection of C. trachomatis in urine samples.…”

“…Nucleic acid amplification tests are highly sensitive (>90%) and specific (>99%) and can be used with urine, vaginal, cervical, urethral, rectal, and throat swabs 8 . Nucleic acid amplification tests have recently been considered the diagnostic criterion standard for chlamydia detection 9–11 …”