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PubMed2005

Use of polymerase chain reaction on pooled cervical swabs to detect Chlamydia trachomatis infections in female sex workers in Singapore.

INTRODUCTION: Infections caused by Chlamydia trachomatis (C. trachomatis) is one of the commonest sexually transmitted infections (STI). As there is currently no laboratory in Singapore that offers the chlamydia culture tests, alternative laboratory methods were developed and antigen detection methods such as enzyme immunoassays (EIA) proved to be even less sensitive than cell culture. This study was done to assess the accuracy and sensitivity of pooling five endocervical swabs collected for C. trachomatis testing by polymerase chain reaction (PCR) technology, as compared to the currently used EIA on individual swabs, in female sex workers who were seen at a STI clinic in Singapore. METHODS: A total of 1,182 endocervical swab specimens were analysed by EIA as well as in pools of five specimens using PCR. Any pool with a positive PCR result for C. trachomatis infections was subjected to repeat PCR testing of the five individual specimens in the pool. RESULTS: There were a total of 48 confirmed cases of C. trachomatis infection. EIA detected 19 positive samples for C. trachomatis, yielding a prevalence of 1.6 percent among the sex workers tested. Pooled PCR testing showed a higher prevalence rate of 4.1 percent, with 48 PCR positive samples. All cases that were EIA positive were also PCR positive. Individual runs on 200 random samples as well as on 220 individual samples from positive pooled results showed PCR inhibition rates ranging from 1.5 percent to 2.3 percent. However, the PCR inhibition rate was 0 percent with the use of pooling. Sensitivity of EIA was 39.6 percent, with 100 percent specificity. EIA tests had a false negative rate of 60.4 percent. PCR was found to be 100 percent sensitive and specific. CONCLUSION: C. trachomatis infections among female sex workers attending the clinic were found to be higher using PCR technology. Less sensitive methods such as EIA result in undertreatment of otherwise undetected cases. The pooling strategy using pool sizes of five specimens, with a disease prevalence of 4.1 percent is reliable and cost-effective, and has since been introduced in the current medical surveillance scheme for sex workers in the clinic.

Cervix Uteri↗
PubMed2006

Predictors of partner notification for C. trachomatis and N. gonorrhoeae: an examination of social cognitive and psychological factors.

Efforts to control chlamydial and gonococcal infections include notifying eligible sexual partners of possible infection, primarily by asking the diagnosed patient to notify their partners. This approach, known as patient referral, is widely used but poorly understood. The current study examined psychosocial and cognitive factors associated with patient referral among an urban, minority sample of 168 participants recently diagnosed with Chlamydia trachomatis or Neisseria gonorrhoeae. At a follow-up interview 1-month from diagnosis, participants were more likely to have notified all eligible partners if they had greater intention to notify at baseline (OR = 3.72; 95% CI = 1.34, 10.30) and if they had only one partner at baseline (OR = 4.08; 95% CI = 1.61, 10.31). There were also gender differences as well as differences based on type of partner (i.e., regular, casual, one-time). The implications of these findings for the design of programs to promote patient referral for sexually transmitted infections are discussed.

Adolescent↗
PubMed1992

Mechanism of C. trachomatis attachment to eukaryotic host cells.

A novel trimolecular mechanism of microbial attachment to mammalian host cells was characterized for the obligate intracellular pathogen Chlamydia trachomatis. Using purified glycosaminoglycans (GAGs) and specific GAG lyases, we demonstrated that a heparan sulfate-like GAG present on the surface of chlamydia organisms is required for attachment to host cells. These observations were supported by inhibition of attachment following binding of heparan sulfate receptor analogs to chlamydiae and by demonstrating that chlamydiae synthesize a unique heparan sulfate-like GAG. Furthermore, exogenous heparan sulfate, as an adhesin analog, restored attachment and infectivity to organisms that had lost these attributes following treatment with heparan sulfate lyase. These data suggest that a GAG adhesin ligand mediates attachment by bridging mutual GAG receptors on the host cell surface and on the chlamydial outer membrane surface.

Animals↗
PubMed2005

Child sexual abuse examination: is there a need for routine screening for N gonorrhoeae and C trachomatis?

PURPOSE: To determine the yield of routine vaginal cultures for Neisseria gonorrhoeae and Chlamydia trachomatis from girls evaluated following sexual abuse. METHODS: Retrospective chart review evaluating results of cultures that were obtained from 2008 prepubertal girls seen within 72 hours following an assault over two periods of 3 years each. RESULTS: It was found that only 16 (0.8%) of cultures were positive for either gonorrhea or chlamydia. All but one of the prepubertal girls who had positive vaginal cultures for sexually transmitted disease had signs of acute vulvovaginitis. CONCLUSION: Routine vaginal cultures in asymptomatic pre-pubertal girls have a very low yield. Prospective studies are required to change current protocols for the evaluation of child victims of sexual abuse.

Child↗
PubMed2002

COBAS Amplicor: an automated PCR system for detection of C. trachomatis and N. gonorrhoeae.

Diagnosis of chlamydial and gonococcal infections is the foundation of most sexually transmitted infection control programs. Early detection and treatment of disease is essential for disruption of transmission. DNA-based assays have been shown to have the highest available sensitivity and specificity but are often time-consuming and technically demanding. The COBAS Amplicor is an automated system that performs a combined chlamydia and gonorrhea diagnostic assay suitable for use in either public health or reference laboratories.

Chlamydia Infections↗
PubMed1992

[Study on the infections of U. urealyticum, M. hominis, and C. trachomatis in patients with venereal diseases and healthy controls in three areas of China].

Two hundred and thiry-nine patients with venereal diseases and 264 healthy controls, from Yichang, Liuzhou, and Beijing, were detected for the antibodies to Ureaplasma urealyticum (Uu). Mycoplasma hominis (Mh), and Chlamydia trachomatis (Ct) by indirect hemagglutination (IHA) in 1990. The results showed that: 1) in patients with venereal diseases, the positive rates was the highest in Ct (27.62%), higher in Uu (17.57%), and lower in Mh (4.18%); 2) the levels of antibody to Ct and Uu were significantly higher in the patients than in the healthy controls; 3) in the patients, the positive rate of antibody to Ct was the highest in Beijing (55.88%), whereas, the lowest in Yichang (15.28%); the prevalence rate of antibody to Uu was the highest in Liuzhou (26.23%), whereas, the lowest in Beijing (5.88%); the level of antibody to Mh was not significantly different in the areas mentioned; and 4) the patients with venereal diseases were commonly complicated with infections caused by Ct, Uu, and Mh, there was a new problem to control and treat venereal diseases.

Adolescent↗
PubMed1989

Some characteristics of a secreted chlamydial antigen recognized by IgG from C. trachomatis patient sera.

Chlamydia trachomatis serovars release a glycolipid antigen (GLXA) into the culture supernatant during the infective cycle. This antigen is recognized by IgG isolated from humans with a natural chlamydial infection; GLXA may be a major antigenic determinant of chlamydia. It can be immunopurified by molecular shift or affinity chromatography. Silver staining of SDS-PAGE gels demonstrates a pattern of bands that is essentially the same for preparations isolated by either method. GLXA can also be extracted from mature elementary bodies (EB). These preparations show the same pattern of silver staining bands, and the major bands are immunoreactive as shown by Western blot analysis. Isoelectric focusing studies demonstrate that purified GLXA has an acidic pI.

Antigens, Bacterial↗
PubMed1985

An application of fluorescein-conjugated monoclonal antibodies to the diagnosis of Chlamydia trachomatis infection in children.

A method for rapid identification of Chlamydia trachomatis (C. trachomatis) from clinical specimens using fluorescein-conjugated monoclonal antibodies was evaluated. Attempts to isolate C. trachomatis by McCoy cell cultures were simultaneously performed. C. trachomatis was isolated from 8 of 62 newborns with neonatal conjunctivitis in tissue culture as compared with 12 positives using monoclonal antibodies. C. trachomatis was isolated from 2 of 7 infants with pneumonia in tissue cultures as compared with 3 positives using monoclonal antibodies. In order to identify either elementary bodies (EB) or reticulate bodies (RB) in clinical specimens, EB and RB of C. trachomatis L2/434 strain were isolated, purified and reacted with monoclonal antibodies. Majority of fluorescence observed in the clinical specimens was considered to be EB.

Antibodies, Monoclonal↗