Laboratory diagnosis of human chlamydial infections

Barnes, Ralph W.

doi:10.1128/cmr.2.2.119

Cited by 167 publications

(105 citation statements)

References 199 publications

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“…The diagnostic quality of each specimen was assessed by three criteria: adequacy, interference, and mucous [4]. For endocervical specimens "adequate" is the presence of whole columnar cells, and for the oral specimens cuboidal cells were used [39,54].…”

Section: Resultsmentioning

confidence: 99%

Oral Chlamydia trachomatis in patients with established periodontitis

Reed

Lopatin

Foxman

et al. 2000

Clinical Oral Investigations

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Periodontitis is considered a consequence of a pathogenic microbial infection at the periodontal site and host susceptibility factors. Periodontal research supports the association of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, and Bacteroides forsythus, and periodontitis; however causality has not been demonstrated. In pursuit of the etiology of periodontitis, we hypothesized that the intracellular bacteria, Chlamydia trachomatis, may play a role. As a first step, a cross-sectional study of dental school clinic patients with established periodontitis were assessed for the presence of C. trachomatis in the oral cavity, and in particular from the lining epithelium of periodontal sites. C. trachomatis was detected using a direct fluorescent monoclonal antibody (DFA) in oral specimens from 7% (6/87) of the patients. Four patients tested positive in specimens from the lining epithelium of diseased periodontal sites, one patient tested positive in healthy periodontal sites, and one patient tested positive in the general mucosal specimen. In conclusion, this study provides preliminary evidence of C. trachomatis in the periodontal sites. Planned studies include the use of a more precise periodontal epithelial cell collection device, the newer nucleic acid amplification techniques to detect C. trachomatis, and additional populations to determine the association of C. trachomatis and periodontitis.

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Section: Resultsmentioning

confidence: 99%

Oral Chlamydia trachomatis in patients with established periodontitis

Reed

Lopatin

Foxman

et al. 2000

Clinical Oral Investigations

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“…Long-term C. trachomatis infection may result in chronic salpingitis, and may eventually be complicated with tubal infertility and ectopic pregnancy (2,3). The detection of C. trachomatis genital infection to prevent transmission and its spread to the upper reproductive tract is challenging for both clinicians and laboratory workers (4). C. trachomatis genital infections are often asymptomatic, and this unique nature allows it to persist in relatively asymptomatic populations.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of Chlamydia trachomatis infection

Mania‐Pramanik

Potdar

Kerkar

2006

Clinical Laboratory Analysis

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Important progress in the diagnosis of Chlamydia trachomatis (C. trachomatis) includes the development of nucleic acid amplification techniques such as polymerase chain reaction (PCR) and ligase chain reaction (LCR). Commercial kits are available, but they are costly, sporadic in availability, must be imported, and are economically beyond the reach of common people. To overcome this limitation, most research laboratories have standardized their in‐house‐developed PCR methods for diagnosing this infection. However, each laboratory has to spend a great deal of time and money to accomplish this. Published reports do not always elaborate the steps involved in standardizing a test so that it can immediately be reproduced in another setting. In the present study we attempted to elaborate the steps involved in standardizing a sensitive and specific PCR technique followed by hybridization with specific C. trachomatis probe to diagnose this infection in cervical, introital, and urine specimens, and used it to determine the infection rate in a clinical population. J. Clin. Lab. Anal. 20:8–14, 2006. © 2006 Wiley‐Liss, Inc.

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“…In an effort to overcome this problem and develop an improved reference standard, investigators in the mid-1980s began to consider additional test results when classifying the true infection status of subjects who tested as culture negative but tested as positive by a new test assay (2,15,18). Initially, other nonamplified tests were combined with culture as a reference standard (e.g., culture plus an antigen test such as direct fluorescent-antibody staining) (15,18).…”

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confidence: 99%

Head-to-Head Multicenter Comparison of DNA Probe and Nucleic Acid Amplification Tests for Chlamydia trachomatis Infection in Women Performed with an Improved Reference Standard

et al. 2002

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Few evaluations of tests for Chlamydia trachomatis have compared nucleic acid amplification tests (NAATs)with diagnostic tests other than those by culture. In a five-city study of 3,551 women, we compared the results of commercial ligase chain reaction (LCR) and PCR tests performed on cervical swabs and urine with the results of PACE 2 tests performed on cervical swabs, using independent reference standards that included both cervical swabs and urethral swab-urine specimens. Using cervical culture as a standard, the sensitivities of PACE 2, LCR, and PCR tests with cervical specimens were 78.1, 96.9, and 89.9%, respectively, and the specificities were 99.3, 97.5, and 98.2%, respectively. Using either cervical swab or urine LCR-positive tests as the standard decreased sensitivities to 60.8% for PACE 2 and to 75.8 and 74.9% for PCR with cervical swabs and urine, respectively. Specificities increased to 99.7% for PACE 2 and to 99.7 and 99.4% for PCR with cervical swabs and urine, respectively. Sensitivities with a cervical swab-urine PCR standard were 61.9% for PACE 2 and 85.5 and 80.8% for LCR with cervical swabs and urine, respectively. Specificities were 99.6% for PACE 2 and 99.0 and 98.9% for LCR with cervical swabs and urine, respectively. Cervical swab versus urine differences were significant only for PCR specificities (P ‫؍‬ 0.034). Overall, LCR sensitivity exceeded that of PCR, and sensitivities obtained with cervical swabs exceeded those obtained with urine specimens by small amounts. These data have substantiated, using a large multicenter sample and a patient standard, that LCR and PCR tests performed on endocervical swabs and urine are superior to PACE 2 tests for screening C. trachomatis infections in women. In our study, NAATs improved the detection of infected women by 17 to 38% compared to PACE 2.Chlamydia trachomatis is the most prevalent bacterial sexually transmitted infection in the United States (6). Untreated infections can have devastating consequences for the female reproductive tract by causing pelvic inflammatory disease with serious sequelae such as infertility, ectopic pregnancy, and chronic pelvic pain. Because the majority of infections, particularly in women, are unrecognized clinically, screening with laboratory tests followed by antibiotic treatment is the most important means of intervention and control. The diagnostics industry has responded to this large public health need with steady improvements in test technologies. Concomitantly, methodology used for evaluation of these newly developed tests has evolved in a parallel fashion.Historically, isolation of C. trachomatis in culture was used as the reference standard for classifying patients as infected or uninfected in new test evaluations (3). Culture was chosen for this purpose because it has nearly 100% specificity, resulting from the highly distinctive morphology of specifically stained chlamydial inclusion bodies grown in host cells, and because it was the most sensitive method available at the time. Thus, virtually all of th...

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Laboratory diagnosis of human chlamydial infections

Cited by 167 publications

References 199 publications

Oral Chlamydia trachomatis in patients with established periodontitis

Oral Chlamydia trachomatis in patients with established periodontitis

Diagnosis of Chlamydia trachomatis infection

Head-to-Head Multicenter Comparison of DNA Probe and Nucleic Acid Amplification Tests for Chlamydia trachomatis Infection in Women Performed with an Improved Reference Standard

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