Evaluation of two nonculture antigen tests and three serotests for detection of anti-chlamydial antibodies in the diagnosis of ocular chlamydial infections

Abstract

PCR proved to be a good alternative to cell culture; DFA is useful for quick diagnosis. Genus-specific serotests cannot compete with chlamydial antigen detection. They differ in sensitivity and specificity because of the antigen type they present. They are still of only supportive value in cases where chlamydial antigen detection is not possible. Recently introduced species-specific antibody tests should be of greater value.

Comparison of Direct Immunofluorescence and Giemsa Staining in Chlamydia trachomatis Follicular Conjunctivitis

“…After the age of 50, a significant decrease in the number of positive cases was witnessed in our study and this in accord with similar studies [10][11][12][13]. Our study was mainly based on adult chronic follicular conjunctivitis and we only had one pediatric case aged less than one year because neonates usually receive treatment in child therapeutic centers and are less frequently referred to ophthalmologic hospitals.…”

“…In our study from the total 285 patients referred to the lab, 109 of them (38.24%) were positive in terms of chlamydial infection. Similar studies have reported positive results of 8.6% and 38% in sample sizes of 93 and 100 patients, respectively [12,13]. It should be noted that neither our study nor others' detected a significant sex-based difference in chlamydial conjunctivitis contraction [2,9,11].…”

“…In general, serologic methods face some limitations due to low sensitivity and specificity and should be confirmed by other assays [7,12] because in many individuals the antibodies that are found are related to a previous infection and because chlamydial infections are mostly localized, a 4-fold increase in Ab titer is not useful for diagnosis. Also, the Ab titer may not rise until two weeks and this could cause an inacceptable delay in diagnosis of the disease.…”

Die Chlamydieninfektion des Auges

“…Ein Hybridisierungstest (Gen-Probe®, Pfizer) und ein direkter Immunfluoreszenztest (Microtrak©, Syva) erwiesen sich am sensitivsten und spezifischsten. Eigene Untersuchungen mittels direkter Immunfluoreszenz an Lidbindehautabstrichen (Microtrak®, Syva) zeigten ebenfalls ausreichende Sensitivität und Spezifität im Vergleich zu Zellkultur und PCR [17].…”

“…Der Nachteil dieser Methoden liegt in den hohen Kosten, dem aufwendigen Laborequipment und der Tatsache, dass sie nicht als "patientside" Tests eingesetzt werden können [11]. Von den "Non-Culture"-Techniken kann die direkte Immunfluoreszenzfärbung an Lidbindehaut-Abstrichen für eine geringe Probenanzahl empfohlen werden [17,28]. Für eine exakte Auswertung ist allerdings eine gewisse Erfahrung auf dem Gebiet der Fluoreszenzmikroskopie unerlässlich.…”