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. 1995 Mar;48(3):214–217. doi: 10.1136/jcp.48.3.214

Detection of Chlamydia trachomatis antigen by enzyme immunoassay: importance of confirmatory testing.

K Fonseca 1, D W Megran 1, C M Anand 1
PMCID: PMC502445  PMID: 7730479

Abstract

AIM--To determine when a fluorescence assay for Chlamydia trachomatis elementary bodies in the specimen buffer is of most value as a verification test for genital specimens reactive on screening enzyme immunoassay (EIA). METHOD--Genital swabs from high and medium prevalence populations were tested using EIA. Samples with absorbance values greater than the positive threshold and those within the range of 30% below this value were verified by the MicroTrak direct fluorescence assay (DFA) test. Quotients derived from the threshold value and specimen absorbances were used to establish confidence limits for the EIA. RESULTS--Of 13,283 swabs tested, 474 from the high risk group and 236 from the medium risk group were reactive on EIA and confirmed by DFA. Thirty six (5.9%) patients with confirmed reactive samples would have been missed if the kit criteria alone were followed. When confidence limits were applied to the calculated quotients, only those samples with an EIA quotient of > or = 4.0 were universally confirmed by the DFA. CONCLUSION--A scheme of testing which uses the DFA to verify EIA reactive specimens over a specified range was found to improve the sensitivity and specificity of the EIA screening test.

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Selected References

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

  1. Beebe J. L., Rau M. P., Albrecht K. D. Confirmatory testing of Chlamydia trachomatis Syva enzyme immunoassay gray zone specimens by Syva direct fluorescent antibody test. Sex Transm Dis. 1993 May-Jun;20(3):140–142. doi: 10.1097/00007435-199305000-00004. [DOI] [PubMed] [Google Scholar]
  2. Chisholm S. M., Matheson B. A., Do Ho-Yen Limitations of Chlamydiazyme in general hospital laboratories. J Clin Pathol. 1988 Mar;41(3):357–358. doi: 10.1136/jcp.41.3.357-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Clark A., Stamm W. E., Gaydos C., Welsh L., Quinn T. C., Schachter J., Moncada J. Multicenter evaluation of the AntigEnz Chlamydia enzyme immunoassay for diagnosis of Chlamydia trachomatis genital infection. J Clin Microbiol. 1992 Nov;30(11):2762–2764. doi: 10.1128/jcm.30.11.2762-2764.1992. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Gaydos C. A., Reichart C. A., Long J. M., Welsh L. E., Neumann T. M., Hook E. W., 3rd, Quinn T. C. Evaluation of Syva enzyme immunoassay for detection of Chlamydia trachomatis in genital specimens. J Clin Microbiol. 1990 Jul;28(7):1541–1544. doi: 10.1128/jcm.28.7.1541-1544.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Ilstrup D. M. Statistical methods in microbiology. Clin Microbiol Rev. 1990 Jul;3(3):219–226. doi: 10.1128/cmr.3.3.219. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. LeBar W., Schubiner H., Jemal C., Herschman B., Criswell K., Curtin N., Sherbeck M. Comparison of the Kallested Pathfinder EIA, cytocentrifuged direct fluorescent antibody, and cell culture for the detection of Chlamydia trachomatis. Diagn Microbiol Infect Dis. 1991 Jan-Feb;14(1):17–20. doi: 10.1016/0732-8893(91)90081-p. [DOI] [PubMed] [Google Scholar]
  7. 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]
  8. Moncada J., Schachter J., Bolan G., Nathan J., Shafer M. A., Clark A., Schwebke J., Stamm W., Mroczkowski T., Seliborska Z. Evaluation of Syva's enzyme immunoassay for the detection of Chlamydia trachomatis in urogenital specimens. Diagn Microbiol Infect Dis. 1992 Nov-Dec;15(8):663–668. doi: 10.1016/0732-8893(92)90068-5. [DOI] [PubMed] [Google Scholar]
  9. 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]
  10. 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]
  11. Taylor-Robinson D., Thomas B. J., Osborn M. F. Evaluation of enzyme immunoassay (Chlamydiazyme) for detecting Chlamydia trachomatis in genital tract specimens. J Clin Pathol. 1987 Feb;40(2):194–199. doi: 10.1136/jcp.40.2.194. [DOI] [PMC free article] [PubMed] [Google Scholar]

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