Summary
The ImmunoComb® Chlamydia Bivalent IgG/IgA (Orgenics, Israel) is a new quantitative serologic test that employs LPS extractedChlamydia trachomatis L2 and LPS extractedChlamydia pneumoniae elementary bodies on two separate antigenic spots. The BivalentC. trachomatis specific test results were compared with microimmunofluorescence (MIF), the gold standard of chlamydial species specific serology. ForC. trachomatis IgG the Bivalent was highly concordant with the MIF: the rate of positive titres (IgG≥1:8) was 10% vs. 11% in 100 blood donors, 18% vs. 16% in 111 obstetric patients (6% antigen prevalence), 26% vs. 22% in sterile women with open (n=54) and 86% vs. 84% with occluded (n=51) tubes, and 88% vs. 85% in 103 women withC. trachomatis positive cervical smears. Surprisingly, the Bivalent differed considerably from the MIF in IgA prevalence: in obstetric patients (8% vs. 4%), sterile women with open (13% vs. 6%) and occluded (71% vs. 20%) tubes, and women with positive cervical smears (78% vs. 24%). Bivalent IgA appeared to be more sensitive than MIF IgA and showed a stronger correlation with positive cervical smears in obstetric patients (sensitivity 67% vs. 0%, specificity 95% vs. 96%, positive prediction 44% vs. 0%, negative prediction 98% vs. 94%) and with tubal occlusion in sterile women (sensitivity 71% vs. 20%, specificity 87% vs. 94%, positive prediction 84% vs. 77%, negative prediction 76% vs. 55%). MIF IgM was of little diagnostic help. Supplemental to the often difficultC. trachomatis antigen detection, the easily performed Bivalent IgG/IgA appears to be of great value in routine diagnosis of genital chlamydial infections.
Zusammenfassung
Der ImmunoComb® Chlamydia Bivalent IgG/IgA (Orgenics, Israel) ist ein neuer serologischer Test, der LPS extrahierteChlamydia trachomatis L2 und LPS extrahierteChlamydia pneumoniae Elementarkörperchen auf zwei getrennten Antigenpunkten verwendet. Die BivalentC. trachomatis spezifischen Testergebnisse wurden mit dem Mikroimmunfluoreszenztest (MIF), dem Goldstandard der spezies-spezifischen Chlamydienserologie, verglichen. In Bezug aufC. trachomatis IgG zeigte der Bivalent hohe Übereinstimmung mit dem MIF: Der Anteil positiver Titer (IgG ≥ 1:8) lag bei 10% vs. 11% bei 100 Blutspendern, 18% vs. 16% bei 111 Wöchnerinnen (6% Antigenprävalenz), 26% vs. 22% bei sterilen Frauen mit offenen (n=54) und 86% vs. 84% mit verschlossenen (n=51) Tuben und 88% vs. 85% bei 103 Frauen mitC. trachomatis positivem Zervixabstrich. Überraschenderweise zeigten Bivalent und MiF sehr unterschiedliche IgA Prävalenzen: bei Wöchnerinnen (8% vs. 4%), sterilen Frauen mit offenen (13% vs. 6%) und verschlossenen (71% vs. 20%) Tuben und Frauen mit positivem Zervixabstrich (78% vs. 24%). Der Bivalent IgA Test zeigte sich sensitiver als der MIF IgA bei gleichzeitig höherer Korrelation zu positivem Zervixabstrich bei Wöchnerinnen (Sensitivität 67% vs. 0%, Spezifität 95% vs. 96%, positive Vorhersage 44% vs. 0%, negative Vorhersage 98% vs. 94%) und zum Tubenverschluß bei sterilen Frauen (Sensitivität 71% vs. 20%, Spezifität 87% vs. 94%, positive Vorhersage 84% vs. 77%, negative Vorhersage 76% vs. 55%). MIF IgM erwies sich als diagnostisch wenig hilfreich. Als Ergänzung zum oft schwierigenC. trachomatis Antigennachweis erscheint der einfach durchzuführende Bivalent IgG/IgA als sehr nützlich in der Routinediagnostik genitaler Chlamydieninfektionen.
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Clad, A., Plünnecke, J., Petersen, E.E. et al. Chlamydia trachomatis species specific serology: ImmunoComb chlamydia bivalent versus microimmunofluorescence (MIF). Infection 22, 165–173 (1994). https://doi.org/10.1007/BF01716696
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DOI: https://doi.org/10.1007/BF01716696