Nonculture Methods for Diagnosing Chlamydial Infection in Patients with Trachoma: A Clue to the Pathogenesis of the Disease?

We studied five different tests for diagnosing conjunctival Chlamydia trachomatis infection in specimens obtained from 100 children with moderate-to-severe trachoma. The tests were Giemsa stain, isolation in cell culture, direct fluorescein-conjugated monoclonal antibody, enzyme immunoassay, and a D...

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Bibliographic Details
Published in:The Journal of infectious diseases 1988-12, Vol.158 (6), p.1347-1352
Main Authors: Schachter, J., Dawson, C. R., Sheppard, J., Courtright, P., Said, M. E., Zaki, S., Hafez, S. F., Lorincz, A.
Format: Article
Language:English
Subjects:
Antigens
Azure Stains
Bacterial diseases
Bacterial diseases of the eye and orbit
Biological and medical sciences
Cell culture techniques
Child
Child, Preschool
Chlamydia
Chlamydia trachomatis
Chlamydia trachomatis - genetics
Chlamydia trachomatis - isolation & purification
Conjunctiva - microbiology
DNA Probes
False Positive Reactions
Female
Fixatives
Fluorescent Antibody Technique
Genitalia
Human bacterial diseases
Humans
Immunoenzyme Techniques
Infant
Infections
Infectious diseases
Male
Medical sciences
Original Articles
Pathogenesis
Predictive Value of Tests
Specimens
Trachoma
Trachoma - diagnosis
Trachoma - etiology
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Summary:We studied five different tests for diagnosing conjunctival Chlamydia trachomatis infection in specimens obtained from 100 children with moderate-to-severe trachoma. The tests were Giemsa stain, isolation in cell culture, direct fluorescein-conjugated monoclonal antibody, enzyme immunoassay, and a DNA probe. The Giemsa stain was least sensitive at 29%. The other tests gave essentially equivalent performances: sensitivity ranged from 73% to 84% and specificity from 93% to 100%. Seven of the 45 positive specimens were only positive in cell culture, whereas 11 of the 45 were negative in culture but positive in at least two nonculture tests. We speculate that these discordant results actually reflect the biologic status of the chlamydial infection. There appears to be a stage in the infection where chlamydial antigens and nucleic acids can be detected in the absence of infectivity. This stage of infection may contribute to the pathogenesis of trachoma by providing a source of sensitizing antigen.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/158.6.1347