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Chlamydia trachomatis: Serological diagnosis

Chlamydia trachomatis: Serologische Diagnose

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Summary

Satisfactory methods for the serodiagnosis ofChlamydia trachomatis have been widely discussed in recent years. Until a decade ago, the complement-fixation test measuring group-specific antibody was the most widely applied technique. However, despite showing relatively high diagnostic sensitivity in systemic chlamydial infections, it is of little value in the serodiagnosis of localized chlamydial oculo-genital infections or of trachoma. The more recently developed micro-immunofluorescence (micro-IF) test is not only a very sensitive technique, but can also reach a high degree of serodiagnostic specificity in certain chlamydial infections. Unlike the complement-fixation test, it measures type-specific antibody which may be directed against one or moreC. trachomatis serotypes. By nature, chlamydial infections often lead to high background rates of antibody in affected populations. Interpretation of serological results may therefore be difficult, particularly when only single-serum samples are available. However, in seroepidemiological work, in the study of transmission patterns and in the detection of predominant serotypes in a community, the micro-IF test is especially valuable, and if results are interpreted with care, the test may also serve as an indicator of chlamydial infection. The predictability, sensitivity and specificity of serological tests forC. trachomatis will be discussed.

Zusammenfassung

Das Problem befriedigender serodiagnostischer Methoden zum Nachweis vonChlamydia trachomatis wurde in den vergangenen Jahren ausführlich diskutiert. Bis vor etwa zehn Jahren war der Komplementbindungstest zur Bestimmung des gruppenspezifischen Antikörpers am weitesten verbreitet. Trotz seiner relativ hohen Empfindlichkeit besitzt dieser Test jedoch für die Serodiagnose lokalisierter okulo-genitaler Chlamydieninfektionen oder des Trachoms nur geringen Wert. Der kürzlich entwickelte Immunfluoreszenz-(micro-IF-)Test ist methodisch sehr empfindlich und kann bei bestimmten Chlamydieninfektionen einen hohen Grad an diagnostischer Spezifität erreichen. Im Gegensatz zum Komplementbindungstest erfaßt er den typenspezifischen Antikörper, der gegen einen oder mehrere Serotypen vonC. trachomatis gerichtet sein kann. Chlamydieninfektionen führen in der betroffenen Bevölkerung zu einem oft erheblichen Vorkommen von Antikörpern. Daher kann die Interpretation serologischer Befunde schwierig sein, insbesondere, wenn nur eine einzige Serumprobe verfügbar ist. Der Micro-IF-Test ist für seroepidemiologische Studien, die Untersuchung von Übertragungsmustern und Feststellung von dominierenden Serotypen besonders wertvoll. Bei vorsichtiger Interpretation der Ergebnisse kann der Test auch als Hinweis für eine Chlamydieninfektion gewertet werden. Die diagnostische Wertigkeit, Sensibilität und Spezifität serologischer Tests fürC. trachomatis werden diskutiert.

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  1. Sub-Department of Virology, Department of Preventive Ophthalmology, Institute of Ophthalmology, Judd Street, WC1H 9QS, London, England, U.K.

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Treharne, J.D. Chlamydia trachomatis: Serological diagnosis. Infection 10 (Suppl 1), S25–S31 (1982). https://doi.org/10.1007/BF01640711

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