The laboratory diagnosis ofChlamydia trachomatisinfections

Abstract

Lower genital tract infections withChlamydia trachomatisare predominantly asymptomatic in men and women. Diagnostic technology has provided several approaches to the diagnosis ofC trachomatis. Outside of cells,Chlamydiacan die or degrade without optimal storage and transportation. Because some of the other assays perform better on certain specimen types, it is important for laboratories to recognize these differences and provide advice to physicians and nurses collecting patient specimens, with the objective of diagnosing lower genital tract infections to prevent transmission and upper tract damage. Most invasive specimens, such as cervical or urethral swabs, may be collected for culture, antigen or nucleic acid detection. Noninvasive samples such as first-void urine and vaginal swabs can be easily collected by the patient; these samples must be tested by more sensitive nucleic acid amplification tests. These newer investigative strategies should enable implementation of screening programs to identify and treat partners. Serology has not been particularly useful for the diagnosis of acuteC trachomatisinfections in adults. Presently, it appears that antibiotic-resistantC trachomatisis not a clinical problem. Laboratories providingC trachomatisdiagnosis require participation in continuous quality improvement programs.