Zusammenfassung
Die Polymerase Chain Reaction (PCR) hat sich zum Nachweis von C. trachomatis in Genitalabstrichen als hochsensitiv und -spezifisch erwiesen.
Der seit kurzem kommerziell erhältliche Amplicor Chlamydia trachomatis PCR-Test (Roche) wurde an Konjunktival- und Pharyngealabstrichen von Patienten mit Verdacht auf Chlamydienkonjunktivitis mit konventionellen Methoden verglichen. Die Abstriche der Konjunktivae wurden neben der PCR-Testung mittels direkter Immunfluoreszenz (DIF, Syva Microtrak) und McCoy Zellkultur mit Immunfluoreszenzfärbung getestet, die Pharyngealabstriche nur mittels PCR und Zellkultur.
Es wurden 104 Patienten im Alter von 12 bis 87 Jahren mit Verdacht auf Chlamydienkonjunktivitis untersucht. Ein positiver Erregernachweis aus der Konjunktiva und/oder dem Pharynx gelang bei 12 Patienten. In 5 Fällen waren die Konjunktivalabstriche in allen 3 Tests positiv; 2 beidseitig, 3 einseitig. Ein Patient zeigte beidseits lediglich in DIF und PCR ein positives Resultat, die Zellkultur verlief negativ. Bei 4 DIF-negativen Patienten war jeweils ein Konjunktivalabstrich PCR-positiv, in 2 Fällen auch die Zellkultur.
Insgesamt 6 Pharyngealabstriche waren PCR-positiv, 4 auch kulturpositiv. Bei 2 Patienten mit positivem Rachenabstrich waren die Bindehautabstriche in allen 3 Tests negativ.
Der Amplicor PCR-Test stellt somit auch für Konjunktival- und Pharyngealabstriche ein spezifisches Verfahren zur Identifikation von C. trachomatis dar, das die Zellkultur und die direkte Immunfluoreszenz an Sensitivität übertrifft.
Summary
The polymerase chain reaction is well known as specific and highly sensitive for the identification of C. trachomatis in urogenital specimens.
The new, commercially available Amplicor Chlamydia trachomatis PCR-assay (Roche) was evaluated on conjunctival and pharyngeal swabs of patients with conjunctivitis, compatible with chlamydial infection, and compared with conventional methods.
Conjunctival swabs were tested by PCR, direct immunofluorescence (DIF, Syva Micro-trak) and McCoy cell culture with fluorescent immunostaining, the pharyngeal swabs by PCR and cell culture.
We examined the swabs from 104 patients, aged 12 to 87 years, with clinical signs for chlamydial conjunctivitis. The conjunctival and/or pharyngeal swabs of 12 patients were positive for C. trachomatis. The conjunctival swabs of 5 patients were positive in all tests; 2 in both eyes, 3 in one eye. One patient was positive in DIF and PCR, while cellculture was negative, 4 patients with DIF-negative swabs were PCR-positive in one eye, 2 of them showing a positive cell-culture, too.
The pharyngeal swabs of 6 patients were positive in PCR, 4 of them were culture-positive. The conjunctival swabs of 2 patients with positive pharyngeal specimens were negative in all three tests.
According to our results the Amplicor PCR assay is a highly specific method for the detection of C. trachomatis in conjunctival and pharyngeal swabs which shows higher sensitivity than McCoy cell-culture and direct immunofluorescence.
Similar content being viewed by others
Literatur
Bass CA, Jungkind DL, Silverman NS, Bondi JM (1993) Clinical evaluation of a new polymerase chain reaction assay for detection of Chlamydia trachomatis in new endocervical specimens. J Clin Microbiol 31: 2648–2653
Bavastrelli M, Midulla M, Rossi D, Salzano M (1992) Chlamydia trachomatis infection in children with wheezing simulating asthma. Lancet 339: 8802
Cimolai N (1993) Chlamydia species and mycoplasma species in recurrent tonsilities. Arch Otolaryngol — Head Neck Surg 119: 1043–1044
Ehgartner E-M, Vidic B, Auerbach B, Fellinger Chr, Frieß H-G (1989) Zur Diagnostik von okulären Chlamydieninfektionen. Erfahrungen mit zwei unterschiedlichen Testprinzipien. Klin Monatsbl Augenheilkd 194: 156–160
Hammerschlag MR, Roblin PM, Cummings C, Williams TH, Worku M, Howard LV (1987) Comparison of enzyme immunoassay and culture for diagnosis of infections in infants. J Clin Microbiol 25: 1306–1308
Hawkins DA, Wilson RS, Thomas BJ, Evans RT (1985) Rapid, reliable diagnosis of chlamydial ophthalmia by means of monoclonal antibodies. Br J Ophthalmol 69: 640–644
Holland SM, Hudson AP, Bobo L, Whittum-Hudson JA, Viscidi RP, Quinn TC, Taylor HR (1992) Demonstration of Chlamydial RNA and DNA during a culture-negative state. Infect Immun 60: 2040–2047
Kessler HH, Pierer K, Stünzner D, Auer-Grumbach P, Haller E-M, Marth E (1993) Rapid detection of Chlamydia trachomatis in conjunctival, pharyngeal, and urethral specimens with a new polymerase chain reaction assay. Sex Transm Dis (im Druck)
Lin JSL, Jones WE, Yan LL, Wirthwein KA, Flaherty EE, Haivanis RM, Rice RA (1992) Underdiagnosis of Chlamydia trachomatis infection — diagnostic limitations in patients with lowlevel infection. Sex Transm Dis 19: 259–265
Mahoney JB, Chernesky MA (1985) Effect of swab type and storage temperature on the isolation of Chlamydia trachomatis from clinical specimens. J Clin Microbiol 22: 865–867
Mahoney JB, Luinstra KE, Sellors JW, Chernesky MA (1993) Comparison of plasmid- and chromosome-based polymerase chain reaction assays for detecting Chlamydia trachomatis nucleic acids. J Clin Microbiol 31: 1753–1758
Miyasha N, Iijima Y, Matsumoto A (1994) Evaluation of the the sensitivity and specificity of polymerase chain reaction test kit, Amplicor Chlamydia trachomatis. Microbiol Immunol 38: 81–85
Nakagawa H, Nakagawa Y, Tokushima K, Ito Y, Ogiso M (1990) Five cases of neonatal inclusion conjunctivitis developed respiratory tract infection. Jap J Clin Ophthalmol 44: 1141–1145
Numazaki U, Chiba S (1993) Diagnostic value of rapid detection of Chlamydia trachomatis by using amplified enzyme immunoassay in infants with respiratory infections. Diagn Microbiol Inf Dis 17: 233–234
Preece PM, Anderson JM, Thompson RG (1989) Chlamydia trachomatis infection in infants: a prospective study. Arch Dis Child 64: 525–529
Ratti G, Moroni A, Cevenini R (1991) Detection of Chlamydia trachomatis DNA in patients with non-gonococcal urethritis using the polymerase chain reaction. J Clin Pathol 44: 564–568
Ridgway GL, Taylor-Robinson D (1991) Current problems in microbiology. I. Chlamydial infections: which laboratory test? J Clin Pathol 44: 1–5
Saikku P, Ruutu P, Leinonen M, Kleemola M, Paladin F, Tupasi TE (1993) Mycoplasma pneumoniae and Chlamydia trachomatis in acute lower respiratory infections in Filipino children. Am J Trop Med Hyg 49: 88–92
Schachter J, Dawson CR (1977) Comparative efficiency of various diagnostic methods for chlamidial infections. In: Hobson D et al (eds) Nongonococcal urethritis and related infections. American Society for Microbiology, Washington DC, pp 337–341
Schachter J (1984) Biology of Chlamydia trachomatis. In: Holmes KK et al (eds) Sexually transmitted diseaes. Mc Graw-Hill, New York, pp 243–257
Schönian G, Bollmann R, Schweynoch C, Gudd D, Halle H, Schwarz M, Presber W (1994) Evaluierung eines PCR-Testsystems für den Direktnachweis von Chlamydia trachomatis. Lab Med 18: 138–142
Stamm WE, Holmes KK (1990) Chlamydia trachomatis infections of the adult. In: Holmes KK et al (eds) Sexually transmitted diseases. Mc Graw-Hill, New York, pp 181–193
Talley AR, Garcia-Ferrer F, Laycock KA, Loeffelholz M, Pepose JS (1992) The use of polymerase chain reaction for the detection of chlamydial keratoconjunctivitis. Am J Ophthalmol 117: 50–57
Talley AR, Farcia-Ferrer F, Laycock KA, Essary LR, Holcomb WL, Flower BE, Loeffelholz M, Lewinski C, Pepose JS (1994) Comparative diagnosis of neonatal chlamydial conjunctivitis by polymerase chain reaction and McCoy cell culture. Am J Ophthalmol 117: 50–57
Taylor-Robinson D (1992) Laboratory methods for chlamydial infections. J Infect 25 [Suppl 1]: 61–67
Thomas BJ, Mc Leod EJ, Taylor-Robinson D (1993) Evaluation of sensitivity of ten diagnostic assays for Chlamydia trachomatis by use of a simple laboratory procedure. J Clin Pathol 46: 408–410
Veringa EM, Zuyderwijk MAM, Schellekens H (1994) Detection of Chlamydia trachomatis in clinical specimens — comparison of culture, direct antigen detection, DNA probe hybridization and PCR. J Microbiol Meth 19: 117–125
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Haller, E.M., Stünzner, D., Kessler, H.H. et al. Nachweis von Chlamydia trachomatis in Konjunktival- und Pharyngealabstrichen mittels PCR im Vergleich zu herkömmlichen Methoden. Spektrum Augeheilkd 10, 28–31 (1996). https://doi.org/10.1007/BF03164166
Issue Date:
DOI: https://doi.org/10.1007/BF03164166