Comparison of antigen detection assays and serum antibody tests for diagnosis of infection with Chlamydia trachomatis

english

1995

volume 4, issue 4

Združenje slovenskih dermatovenerologov

Objectives. Rapid antigen detection in patients with lower urinary tract infection caused by Chlamydia trachomatis by direct immunofluorescence and an enzyme-linked immunosorbent assay (ELISA) was compared with cell culture as well as polymerase chain reaction (PCR). Furthermore, the performance of two serum antibody ELISAs was compared with an immunoperoxidase test. Methods. A total of 143 urethral, conjuctival, and pharyngeal swabs were investigated. McCoy cell culture and a molecular assay including PCR served as standard methods. An elementary body direct fluorescent antibody assay (DFA) was performed on urethral and conjuctival specimens, and an ELISA antigen test was performed on urethral specimens. Serum samples of 49 patients were analyzed for IgA and IgG antibodies. Results. Antigen ELISA testing of urethral specimens was comparable to culture and PCR concerning specificity and sensitivity. The antibody ELISas were significantly better in the detection of IGA in comparison with the immunoperoxidase test. Conclusions. The antigen ELISA was found to be the best rapid diagnostic assay and has sufficient specificity as well as sensitivity. PCR can serve as gold standard equivalent to cell culture. Serum antibody assays are only of value in clinical situations when antigen dection is not possible.

16.09.2022