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Forward Genetic Approaches in Chlamydia trachomatis
Published on: October 23, 2013
Standardizing Chlamydia pneumoniae assays: recommendations from the Centers for Disease Control and Prevention (USA)
S F Dowell1, R W Peeling, J Boman
1National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA. sdowell@cdc.gov
Insights
Standardized diagnostic methods for Chlamydia pneumoniae are crucial due to variable results. This review recommends specific serological tests, culture confirmation, and validated polymerase chain reaction (PCR) assays for accurate detection.
Area of Science:
- Microbiology
- Immunology
- Infectious Diseases
Background:
- Chlamydia pneumoniae is linked to chronic diseases like atherosclerosis.
- Current diagnostic methods show high variability and lack gold standards.
- Standardized testing is needed for reliable Chlamydia pneumoniae detection.
Purpose of the Study:
- To review and recommend standardized approaches for Chlamydia pneumoniae diagnostics.
- To establish criteria for reliable serological, culture, and molecular testing.
- To improve accuracy and reduce variability in Chlamydia pneumoniae diagnosis.
Main Methods:
- Review of available serological testing, culture, DNA amplification (PCR), and tissue diagnostics.
- Inclusion of leading researchers in the field for expert recommendations.
- Development of validation criteria for diagnostic assays.
Main Results:
- Microimmunofluorescence is the recommended serological method.
- Standardized definitions for acute infection and past exposure are proposed.
- Specific criteria were set for PCR assay validation and immunohistochemical staining.
Conclusions:
- Standardized diagnostic protocols are essential for Chlamydia pneumoniae research.
- Adoption of recommended methods will improve diagnostic accuracy.
- Periodic modification of standards is necessary as new data emerges.
Abstract:
Chlamydia pneumoniae has been associated with atherosclerosis and several other chronic diseases, but reports from different laboratories are highly variable and "gold standards" are lacking, which has led to calls for more standardized approaches to diagnostic testing. Using leading researchers in the field, we reviewed the available approaches to serological testing, culture, DNA amplification, and tissue diagnostics to make specific recommendations. With regard to serological testing, only use of microimmunofluorescence is recommended, standardized definitions for "acute infection" and "past exposure" are proposed, and the use of single immunoglobulin (Ig) G titers for determining acute infection and IgA for determining chronic infection are discouraged. Confirmation of a positive culture result requires propagation of the isolate or confirmation by use of polymerase chain reaction (PCR). Four of 18 PCR assays described in published reports met the proposed validation criteria. More consistent use of control antibodies and tissues and improvement in skill at identifying staining artifacts are necessary to avoid false-positive results of immunohistochemical staining. These standards should be applied in future investigations and periodically modified as indicated.
