Skip to main content
PMC home page
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1995 Nov;33(11):2847–2849. doi: 10.1128/jcm.33.11.2847-2849.1995

PCR and direct fluorescent-antibody staining confirm Chlamydia trachomatis antigens in swabs and urine below the detection threshold of Chlamydiazyme enzyme immunoassay.

J Krepel 1, I Laur 1, A Sproston 1, K Luinstra 1, D Jang 1, J Mahony 1, M Chernesky 1
PMCID: PMC228592  PMID: 8576331

Abstract

In order to test the hypothesis that specimens blocking with a neutralizing reagent below the cutoff of the Chlamydiazyme enzyme immunoassay represent infected patients, we used direct fluorescent-antibody staining for elementary bodies (EBs) and PCR to confirm results for cervical swabs collected from 55,963 women and urethral swabs or first-void urine (FVU) samples collected from 5,781 men attending physicians' offices in the Toronto, Canada, area. Within a grey zone arbitrarily selected to represent values up to 40% below the positive threshold of the test run, 134 cervical swabs, 44 urethral swabs, and 39 FVU specimens exhibited a blocking response ( > 50% reduction in signal). Three or more EBs were observed in each of 98 cervical swabs (73.1%), 38 urethral swabs (86.4%), and 21 FVU specimens (53.8%). Of the 36 cervical swabs with fewer than three EBs, 33 were PCR positive; the positive PCR results for male specimens were 6 of 6 urethral swabs and 17 of 18 FVU samples. Application of the blocking test to specimens negative in the Chlamydiazyme enzyme immunoassay but having optical densities within 40% of the cutoff added 14.2% (217 of 1,531 specimens) more positive results to the survey. A total of 213 of 217 samples (98.2%) were reconfirmed as having EBs or DNA.

Full Text

The Full Text of this article is available as a PDF (154.9 KB).

Selected References

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

  1. Bauwens J. E., Clark A. M., Stamm W. E. Diagnosis of Chlamydia trachomatis endocervical infections by a commercial polymerase chain reaction assay. J Clin Microbiol. 1993 Nov;31(11):3023–3027. doi: 10.1128/jcm.31.11.3023-3027.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Chan E. L., Brandt K., Kozoriz D., Mushanski L., Spence C., Horsman G. B. The use of a confirmatory assay to increase the sensitivity and specificity of the Chlamydiazyme test. Am J Clin Pathol. 1994 Dec;102(6):724–728. doi: 10.1093/ajcp/102.6.724. [DOI] [PubMed] [Google Scholar]
  3. Chernesky M. A., Lee H., Schachter J., Burczak J. D., Stamm W. E., McCormack W. M., Quinn T. C. Diagnosis of Chlamydia trachomatis urethral infection in symptomatic and asymptomatic men by testing first-void urine in a ligase chain reaction assay. J Infect Dis. 1994 Nov;170(5):1308–1311. doi: 10.1093/infdis/170.5.1308. [DOI] [PubMed] [Google Scholar]
  4. Chernesky M., Castriciano S., Sellors J., Stewart I., Cunningham I., Landis S., Seidelman W., Grant L., Devlin C., Mahony J. Detection of Chlamydia trachomatis antigens in urine as an alternative to swabs and cultures. J Infect Dis. 1990 Jan;161(1):124–126. doi: 10.1093/infdis/161.1.124. [DOI] [PubMed] [Google Scholar]
  5. Chernesky M., Jang D., Sellors J., Castriciano S., Pickard L., Luinstra K., Mahony J. Confirmatory testing demonstrates that false-positive rates in the chlamydiazyme assay are influenced by gender and genital specimen type. Sex Transm Dis. 1993 Nov-Dec;20(6):301–306. [PubMed] [Google Scholar]
  6. Hallander H., Jonsson P., Gästrin B. Value of confirmation of Chlamydiazyme enzyme immunoassay results in the detection of Chlamydia trachomatis. Eur J Clin Microbiol Infect Dis. 1992 Jun;11(6):550–552. doi: 10.1007/BF01960813. [DOI] [PubMed] [Google Scholar]
  7. Jaschek G., Gaydos C. A., Welsh L. E., Quinn T. C. Direct detection of Chlamydia trachomatis in urine specimens from symptomatic and asymptomatic men by using a rapid polymerase chain reaction assay. J Clin Microbiol. 1993 May;31(5):1209–1212. doi: 10.1128/jcm.31.5.1209-1212.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Kellogg J. A., Seiple J. W., Stroll E. S. Direct fluorescent-antibody confirmation of chlamydial antigen below the detection threshold of the chlamydiazyme enzyme-linked immunosorbent assay. J Clin Microbiol. 1993 Jun;31(6):1646–1647. doi: 10.1128/jcm.31.6.1646-1647.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Mahony J. B., Luinstra K. E., Sellors J. W., Jang D., Chernesky M. A. Confirmatory polymerase chain reaction testing for Chlamydia trachomatis in first-void urine from asymptomatic and symptomatic men. J Clin Microbiol. 1992 Sep;30(9):2241–2245. doi: 10.1128/jcm.30.9.2241-2245.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Mahony J. B., Luinstra K. E., Sellors J. W., Pickard L., Chong S., Jang D., Chernesky M. A. Role of confirmatory PCRs in determining performance of Chlamydia Amplicor PCR with endocervical specimens from women with a low prevalence of infection. J Clin Microbiol. 1994 Oct;32(10):2490–2493. doi: 10.1128/jcm.32.10.2490-2493.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Moncada J., Schachter J., Bolan G., Engelman J., Howard L., Mushahwar I., Ridgway G., Mumtaz G., Stamm W., Clark A. Confirmatory assay increases specificity of the chlamydiazyme test for Chlamydia trachomatis infection of the cervix. J Clin Microbiol. 1990 Aug;28(8):1770–1773. doi: 10.1128/jcm.28.8.1770-1773.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Olsen M. A., Sambol A. R. Confirmation of positive results for chlamydial antigen by the Chlamydiazyme assay: value of repeated testing and a blocking antibody assay. J Clin Microbiol. 1993 Jul;31(7):1892–1895. doi: 10.1128/jcm.31.7.1892-1895.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Schachter J., Stamm W. E., Quinn T. C., Andrews W. W., Burczak J. D., Lee H. H. Ligase chain reaction to detect Chlamydia trachomatis infection of the cervix. J Clin Microbiol. 1994 Oct;32(10):2540–2543. doi: 10.1128/jcm.32.10.2540-2543.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Schwebke J. R., Stamm W. E., Handsfield H. H. Use of sequential enzyme immunoassay and direct fluorescent antibody tests for detection of Chlamydia trachomatis infections in women. J Clin Microbiol. 1990 Nov;28(11):2473–2476. doi: 10.1128/jcm.28.11.2473-2476.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Sellors J. W., Mahony J. B., Jang D., Pickard L., Goldsmith C. H., Gafni A., Chernesky M. A. Comparison of cervical, urethral, and urine specimens for the detection of Chlamydia trachomatis in women. J Infect Dis. 1991 Jul;164(1):205–208. doi: 10.1093/infdis/164.1.205. [DOI] [PubMed] [Google Scholar]
  16. Williams T. W., Tyler S. D., Giercke S., Pollard D. R., McNicol P., Rozee K. R. Comparison of polymerase chain reaction and chlamydiazyme for the detection of Chlamydia trachomatis in clinical specimens. Eur J Clin Microbiol Infect Dis. 1992 Mar;11(3):233–236. doi: 10.1007/BF02098085. [DOI] [PubMed] [Google Scholar]
  17. de Barbeyrac B., Pellet I., Dutilh B., Bébéar C., Dumon B., Géniaux M., Bébéar C. Evaluation of the Amplicor Chlamydia trachomatis test versus culture in genital samples in various prevalence populations. Genitourin Med. 1994 Jun;70(3):162–166. doi: 10.1136/sti.70.3.162. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES