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Diagnosis of Chlamydia trachomatis infection — culture versus serology

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Abstract

The diagnostic value of different laboratory methods in detecting Chlamydia trachomatis infections in high risk groups was analysed. The efficiency of a direct specimen test was compared with serology (IgG and IgM ELISA) and culture in L929 cells, stained either with fluorescein conjugated monoclonal antibodies or with iodine. Patients (no. = 1041) with localized genital infections attending a STD clinic, sexual contacts and patients with ascending infections from urological and gynecological clinics were examined. Chlamydia trachomatis was detected in 225 patients: 210 (93.3% were reactive in the direct test (smears stained with monoclonal antibodies), whereas culture missed only 5 (sensitivity 97.8%) when stained by the same method. Cultures stained with iodine produced the lowest recovery rate (73.8%), but this rate increased to 80.9% when a second passage was performed. In addition the prevalence of Neisseria gonorrhoeae, Mycoplasma hominis, Ureaplasma urealyticum, Candida albicans and Trichomonas vaginalis was investigated.

In patients with non-gonococcal urethritis (no. = 331) and cervicitis (no. = 353), Chlamydia trachomatis was isolated in 32.3% and 12.8% respectively. However, this pathogen could be isolated in only 3 (15.8%) out of 19 patients with epididymitis and 15 (14%) out of 107 patients with adnexitis, although 66.7% and 93.3% respectively had specific IgG antibodies. Specific IgM could by detected with a sandwich ELISA in patients with adnexitis (46.7%), epididymitis (33.3%), cervicitis (22.2%), non-gonococcal urethritis (14%) and in the sexual partners of patients with genital infections (35.7%).

The direct specimen test with monoclonal antibodies is the method of choice for the diagnosis of a C. trachomatis infection in patients with urethritis and cervicitis. In ascending infections of the genital tract, however, even culture may give negative results, and serology may be of diagnostic assistance.

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Authors and Affiliations

  1. Ludwig Boltzmann-Institute of dermato-venerological serodiagnosis, Wolkersbergenstrasse 1, A-1130, Vienna, Austria

    E. Schoenwald, G. Steinmetz & A. Luger

  2. Department of dermatology of the hospital of Lainz, Vienna

    B. L. Schmidt

  3. Department of gynecology I and obstetrics, University of Vienna, Vienna, Italy

    J. Hosmann

  4. Department of dermatology of the hospital of Salzburg, Salzburg, Italy

    G. Pohla-Gubo

  5. Department of urology of the hospital of Lainz, Vienna

    G. Gasser

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  1. E. Schoenwald
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Schoenwald, E., Schmidt, B.L., Steinmetz, G. et al. Diagnosis of Chlamydia trachomatis infection — culture versus serology. Eur J Epidemiol 4, 75–82 (1988). https://doi.org/10.1007/BF00152696

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