Tests for infection with Chlamydia trachomatis

Taylor‐Robinson, David

doi:10.1258/0956462961917159

Cited by 24 publications

(19 citation statements)

References 28 publications

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“…5 The ranges of sensitivity of antigen tests in different studies are not only influenced by the quality of the test itself but also by the quality of culture or other comparative tests used for the calculation. 6 Including amplification assays as gold standard the detection rate of EIAs is decreased to 40-80%. The test performance of EIAs is simple, for some are already fully automatic and reading the results is objective, allowing a high test capacity.…”

Section: Antigen Detectionmentioning

confidence: 99%

Chlamydia screening: which sample for which technique?

Stary¹

1997

Sexually Transmitted Infections

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Section: Antigen Detectionmentioning

confidence: 99%

Chlamydia screening: which sample for which technique?

Stary¹

1997

Sexually Transmitted Infections

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“…The majority of laboratories have moved away from culture, as it is expensive, time-consuming and technically difficult. The use of an expanded gold standard, commonly consistent results with two non-culture techniques, is considered to be more useful as a research tool, but most laboratories use only one nonculture method as their routine test for detection of chlamydia [8].…”

Section: Introductionmentioning

confidence: 99%

The accuracy and efficacy of screening tests for Chlamydia trachomatis: a systematic review

Watson¹,

Templeton²,

Russell

et al. 2002

Journal of Medical Microbiology

192

114

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Screening women for lower genital tract infection with Chlamydia trachomatis is important in the prevention of pelvic inflammatory disease, ectopic pregnancy and infertility. This systematic review aims to state clearly which of the available diagnostic tests for the detection of C. trachomatis would be most effective in terms of clinical effectiveness. The review included all studies published from 1990 onward that evaluated diagnostic tests in asymptomatic, young, sexually active populations. Medline and Embase were searched electronically and key journals were hand-searched. Further studies were identified through the Internet and contact with experts in the field. All studies were reviewed by two reviewers and were scored by Irwig's assessment criteria. Additional quality assessment criteria included a documented sexual history and recording of previous chlamydial infection. The reviews were subjected to meta-analysis and meta-regression. The 30 studies that were included examined three types of DNAbased test -ligase chain reaction (LCR), PCR and gene probe -as well as enzyme immuno-assay (EIA). The results showed that while specificities were high, sensitivities varied widely across the tests and were also dependent on the specimen tested. Pooled sensitivities for LCR, PCR, gene probe and EIA on urine were 96.5%, 85.6%, 92% and 38%, respectively, while on cervical swabs the corresponding sensitivities of PCR, gene probe and EIA were 88.6%, 84% and 65%. Meta-analysis demonstrated that DNA amplification techniques performed best for both urine and swabs in low prevalence populations. We conclude that nucleic acid amplification tests used on non-invasive samples such as urine are more effective at detecting asymptomatic chlamydial infection than conventional tests, but there are few data to relate a positive result with clinical outcome.

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“…Evidenced-based information suggests that FDA-approved NAAT should be the preferred assay for the laboratory diagnosis of all C. trachomatis infections from all patient populations. All positive NAAT for C. trachomatis obtained from children should be verified by another FDA-approved method (such as DFA, enzyme immunoassay, or NAAT) to ensure specificity of the results (7,9,14,17).…”

Section: Vol 43 2005mentioning

confidence: 99%

Prospective Comparison of Cell Cultures and Nucleic Acid Amplification Tests for Laboratory Diagnosis of Chlamydia trachomatis Infections

et al. 2005

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Specimens submitted in M5 medium for cell culture detection of Chlamydia trachomatis were tested by nucleic acid amplification testing (NAAT) and in cell cultures. Of 35 (genital) and 26 (nongenital) specimens positive for C. trachomatis, 21 and 14 specimens, respectively, were detected exclusively by NAAT. NAAT is significantly (P < 0.0001) more sensitive than cell culture and should be considered the new "gold standard" for the laboratory diagnosis of C. trachomatis infections.Chlamydia trachomatis is the most common cause of reportable cases of sexually transmitted infections (7, 16). Sensitive, Food and Drug Administration (FDA)-approved nucleic acid amplification testing (NAAT) has replaced poorly standardized cell culture methods for the laboratory diagnosis of these infections (5,13,15,17).Specimens submitted to our laboratory with a specific request for C. trachomatis culture in M5 medium (Remel, Lenexa, KS) were inoculated into cell cultures and simultaneously processed by NAAT for both C. trachomatis and Neisseria gonorrhoeae (BDProbeTec ET). The goal of our study was to assess the performance characteristics of NAAT as a possible exclusive replacement for cell cultures for the testing of all specimens submitted for the laboratory diagnosis of C. trachomatis infections.Shell vials containing cycloheximide-treated McCoy cells (Diagnostic Hybrids Inc., Athens, OH) on coverslips were inoculated with 0.1 ml of the specimen extract in M5 transport medium and centrifuged at 700 ϫ g for 60 min. Cell cultures were incubated at 35°C for 48 h, stained with fluoresceinconjugated monoclonal antibody specific for C. trachomatis (Trinity Biotech Co., Wicklow, Ireland), and examined at 200 ϫ for the detection of C. trachomatis-infected cells (18).For NAAT, specimens (200 l) in M5 medium were placed into BD diluent, lysed by heating at 114°C for 30 min, and assayed by the BDProbeTec ET system using the BD Viper (BD Biosciences, Sparks, MD) for sample processing and detection of C. trachomatis and N. gonorrhoeae following the manufacturer's instructions.Of 383 genital specimens (cervix, 179; vagina, 166; urethra, 38) submitted to Mayo Clinic for cell culture diagnosis of C. trachomatis infections processed also by NAAT, 14 (3.7%) were positive for the organism by both methods (Table 1). Two specimens (cervix) were toxic in cell culture, and diagnostic results were not available by that method. In addition, 21 specimens were exclusively positive for C. trachomatis by NAAT (150% increase in the rate of detection compared with that of cell cultures). These 21 discrepant results were confirmed as positive by direct fluorescent antibody to specifically detect the elementary bodies of C. trachomatis (Tables 1 and 2). Importantly, there were no specimens that were detected by culture that were not detected by NAAT (100% specificity) ( Table 1). Of the 35 (14 plus 21) NAAT-positive C. trachomatis specimens, 5 (cervix, 4; vagina, 1) (14.3%) were also positive for both C. trachomatis and N. gonorrhoeae (Table 2). In addition,...

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Tests for infection with Chlamydia trachomatis

Cited by 24 publications

References 28 publications

Chlamydia screening: which sample for which technique?

Chlamydia screening: which sample for which technique?

The accuracy and efficacy of screening tests for Chlamydia trachomatis: a systematic review

Prospective Comparison of Cell Cultures and Nucleic Acid Amplification Tests for Laboratory Diagnosis of Chlamydia trachomatis Infections

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