Skip to main content
PMC home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1997 Jun;81(6):497–500. doi: 10.1136/bjo.81.6.497

Polymerase chain reaction for detection of Chlamydia trachomatis in conjunctival swabs

E Elnifro 1, C Storey 1, D Morris 1, A Tullo 1
PMCID: PMC1722213  PMID: 9274416

Abstract

AIMS/BACKGROUND—Ocular Chlamydia trachomatis infection in the west occurs as ophthalmia neonatorum, acquired from the mother, or adult paratrachoma which is also associated with current genital tract infection. Accurate rapid laboratory diagnosis facilitates management, but the relative merits of antigen detection or DNA amplification tests are unresolved.
METHODS—A polymerase chain reaction (PCR) test was developed which amplified part of the plasmid shared by all the serovars of C trachomatis. Conjunctival swabs were tested using an in house immune dot-blot test (IDBT) for chlamydial lipopolysaccharide antigen, a commercial direct fluorescent antibody (DFA) test for chlamydial elementary bodies, and the PCR (DNA extracted using guanidinium lysis buffer).
RESULTS—The PCR achieved a detection limit of 100 plasmid copies (10 elementary bodies). In a combined retrospective and prospective clinical evaluation, the PCR and IDBT gave identical results with 21 positive and 57 negative eye swabs. However, interpretation of the DFA test required meticulous examination of the stained smear, sometimes by two microscopists.
CONCLUSIONS—The PCR is likely to play an increasing role in the diagnosis of ocular C trachomatis infection because of its excellent sensitivity and specificity.



Full Text

The Full Text of this article is available as a PDF (100.7 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. An Q., Radcliffe G., Vassallo R., Buxton D., O'Brien W. J., Pelletier D. A., Weisburg W. G., Klinger J. D., Olive D. M. Infection with a plasmid-free variant Chlamydia related to Chlamydia trachomatis identified by using multiple assays for nucleic acid detection. J Clin Microbiol. 1992 Nov;30(11):2814–2821. doi: 10.1128/jcm.30.11.2814-2821.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bishop P. N., Tullo A. B., Killough R., Richmond S. J. An immune dot-blot test for the diagnosis of ocular infection with Chlamydia trachomatis. Eye (Lond) 1991;5(Pt 3):305–308. doi: 10.1038/eye.1991.48. [DOI] [PubMed] [Google Scholar]
  3. Casas I., Powell L., Klapper P. E., Cleator G. M. New method for the extraction of viral RNA and DNA from cerebrospinal fluid for use in the polymerase chain reaction assay. J Virol Methods. 1995 May;53(1):25–36. doi: 10.1016/0166-0934(94)00173-e. [DOI] [PubMed] [Google Scholar]
  4. Comanducci M., Ricci S., Ratti G. The structure of a plasmid of Chlamydia trachomatis believed to be required for growth within mammalian cells. Mol Microbiol. 1988 Jul;2(4):531–538. doi: 10.1111/j.1365-2958.1988.tb00060.x. [DOI] [PubMed] [Google Scholar]
  5. Darougar S., Monnickendam M. A., Woodland R. M. Management and prevention of ocular viral and chlamydial infections. Crit Rev Microbiol. 1989;16(5):369–418. doi: 10.3109/10408418909104473. [DOI] [PubMed] [Google Scholar]
  6. Darougar S., Woodland R. M., Walpita P. Value and cost effectiveness of double culture tests for diagnosis of ocular viral and chlamydial infections. Br J Ophthalmol. 1987 Sep;71(9):673–675. doi: 10.1136/bjo.71.9.673. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Dunlop E. M. Chlamydial genital infection and its complications. Br J Hosp Med. 1983 Jan;29(1):6–11. [PubMed] [Google Scholar]
  8. GREENWOOD F. C., HUNTER W. M., GLOVER J. S. THE PREPARATION OF I-131-LABELLED HUMAN GROWTH HORMONE OF HIGH SPECIFIC RADIOACTIVITY. Biochem J. 1963 Oct;89:114–123. doi: 10.1042/bj0890114. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Garland S. M., Malatt A., Tabrizi S., Grando D., Lees M. I., Andrew J. H., Taylor H. R. Chlamydia trachomatis conjunctivitis. Prevalence and association with genital tract infection. Med J Aust. 1995 Apr 3;162(7):363–366. [PubMed] [Google Scholar]
  10. Jackson R., Morris D. J., Cooper R. J., Bailey A. S., Klapper P. E., Cleator G. M., Tullo A. B. Multiplex polymerase chain reaction for adenovirus and herpes simplex virus in eye swabs. J Virol Methods. 1996 Jan;56(1):41–48. doi: 10.1016/0166-0934(95)01903-0. [DOI] [PubMed] [Google Scholar]
  11. Jebakumar S. P., Storey C., Lusher M., Nelson J., Goorney B., Haye K. R. Value of screening for oro-pharyngeal Chlamydia trachomatis infection. J Clin Pathol. 1995 Jul;48(7):658–661. doi: 10.1136/jcp.48.7.658. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Kessler H. H., Pierer K., Stuenzner D., Auer-Grumbach P., Haller E. M., Marth E. Rapid detection of Chlamydia trachomatis in conjunctival, pharyngeal, and urethral specimens with a new polymerase chain reaction assay. Sex Transm Dis. 1994 Jul-Aug;21(4):191–195. doi: 10.1097/00007435-199407000-00002. [DOI] [PubMed] [Google Scholar]
  13. Kowalski R. P., Uhrin M., Karenchak L. M., Sweet R. L., Gordon Y. J. Evaluation of the polymerase chain reaction test for detecting chlamydial DNA in adult chlamydial conjunctivitis. Ophthalmology. 1995 Jul;102(7):1016–1019. doi: 10.1016/s0161-6420(95)30919-0. [DOI] [PubMed] [Google Scholar]
  14. Mearns G., Richmond S. J., Storey C. C. Sensitive immune dot blot test for diagnosis of Chlamydia trachomatis infection. J Clin Microbiol. 1988 Sep;26(9):1810–1813. doi: 10.1128/jcm.26.9.1810-1813.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Morris D. J., Bailey A. S., Cooper R. J., Turner P. C., Jackson R., Corbitt G., Tullo A. B. Polymerase chain reaction for rapid detection of ocular adenovirus infection. J Med Virol. 1995 Jun;46(2):126–132. doi: 10.1002/jmv.1890460208. [DOI] [PubMed] [Google Scholar]
  16. Morris D. J., Klapper P. E., Killough R., Bailey A. S., Nelson J., Tullo A. B. Prospective study of adenovirus antigen detection in eye swabs by radioimmune dot-blot. Eye (Lond) 1995;9(Pt 5):629–632. doi: 10.1038/eye.1995.152. [DOI] [PubMed] [Google Scholar]
  17. Møller B. R. Postgonococcal conjunctivitis caused by Chlamydia trachomatis. Case report. Br J Vener Dis. 1983 Apr;59(2):109–110. [PMC free article] [PubMed] [Google Scholar]
  18. Ossewaarde J. M., Rieffe M., Rozenberg-Arska M., Ossenkoppele P. M., Nawrocki R. P., van Loon A. M. Development and clinical evaluation of a polymerase chain reaction test for detection of Chlamydia trachomatis. J Clin Microbiol. 1992 Aug;30(8):2122–2128. doi: 10.1128/jcm.30.8.2122-2128.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Ostergaard L., Birkelund S., Christiansen G. Use of polymerase chain reaction for detection of Chlamydia trachomatis. J Clin Microbiol. 1990 Jun;28(6):1254–1260. doi: 10.1128/jcm.28.6.1254-1260.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Palmer L., Falkow S. A common plasmid of Chlamydia trachomatis. Plasmid. 1986 Jul;16(1):52–62. doi: 10.1016/0147-619x(86)90079-x. [DOI] [PubMed] [Google Scholar]
  21. Peterson E. M., Markoff B. A., Schachter J., de la Maza L. M. The 7.5-kb plasmid present in Chlamydia trachomatis is not essential for the growth of this microorganism. Plasmid. 1990 Mar;23(2):144–148. doi: 10.1016/0147-619x(90)90033-9. [DOI] [PubMed] [Google Scholar]
  22. Postema E. J., Remeijer L., van der Meijden W. I. Epidemiology of genital chlamydial infections in patients with chlamydial conjunctivitis; a retrospective study. Genitourin Med. 1996 Jun;72(3):203–205. doi: 10.1136/sti.72.3.203. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Rao S. K., Madhavan H. N., Padmanabhan P., Lakshmi G. S., Natarajan K., Garg D. Ocular chlamydial infections. Clinicomicrobiological correlation. Cornea. 1996 Jan;15(1):62–65. [PubMed] [Google Scholar]
  24. Rönnerstam R., Persson K., Hansson H., Renmarker K. Prevalence of chlamydial eye infection in patients attending an eye clinic, a VD clinic, and in healthy persons. Br J Ophthalmol. 1985 May;69(5):385–388. doi: 10.1136/bjo.69.5.385. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Scott B. D., Fortenberry J. D. Postgonococcal conjunctivitis due to Chlamydia trachomatis. Sex Transm Dis. 1986 Jul-Sep;13(3):172–173. doi: 10.1097/00007435-198607000-00013. [DOI] [PubMed] [Google Scholar]
  26. Spencer W. N., Johnson F. W. Simple transport medium for the isolation of Chlamydia psittaci from clinical material. Vet Rec. 1983 Dec 3;113(23):535–536. [PubMed] [Google Scholar]
  27. Talley A. R., Garcia-Ferrer F., Laycock K. A., Loeffelholz M., Pepose J. S. The use of polymerase chain reaction for the detection of chlamydial keratoconjunctivitis. Am J Ophthalmol. 1992 Dec 15;114(6):685–692. doi: 10.1016/s0002-9394(14)74045-0. [DOI] [PubMed] [Google Scholar]
  28. Tam J. E., Davis C. H., Thresher R. J., Wyrick P. B. Location of the origin of replication for the 7.5-kb Chlamydia trachomatis plasmid. Plasmid. 1992 May;27(3):231–236. doi: 10.1016/0147-619x(92)90025-6. [DOI] [PubMed] [Google Scholar]
  29. Taylor H. R., Fitch C. P., Murillo-Lopez F., Rapoza P. The diagnosis and treatment of chlamydial conjunctivitis. Int Ophthalmol. 1988;12(2):95–99. doi: 10.1007/BF00137132. [DOI] [PubMed] [Google Scholar]
  30. Thornley M. J., Zamze S. E., Byrne M. D., Lusher M., Evans R. T. Properties of monoclonal antibodies to the genus-specific antigen of Chlamydia and their use for antigen detection by reverse passive haemagglutination. J Gen Microbiol. 1985 Jan;131(1):7–15. doi: 10.1099/00221287-131-1-7. [DOI] [PubMed] [Google Scholar]
  31. Vaughan-Jackson J. D., Dunlop E. M., Darougar S., Dwyer R. S., Jones B. R. Chlamydial infection. Results of tests for Chlamydia in patients suffering from acute Reiter's disease compared with results of tests of the genital tract and rectum in patients with ocular infection due to TRIC agent. Br J Vener Dis. 1972 Dec;48(6):445–451. doi: 10.1136/sti.48.6.445. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES