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Diagnosis of chlamydial infection in the pediatric population
1Department of Pediatrics, State University of New York Health Science Center at Brooklyn 11203-2098, USA.
Insights
Diagnosing Chlamydia trachomatis and Chlamydia pneumoniae infections in children presents unique challenges. New diagnostic methods are needed to accurately identify these common childhood infections.
Area of Science:
- Medical Microbiology
- Pediatric Infectious Diseases
Background:
- The genus Chlamydia includes important human pathogens: Chlamydia trachomatis and Chlamydia pneumoniae.
- Infections in children present unique diagnostic and clinical challenges compared to adults.
Purpose of the Study:
- To review the diagnostic challenges associated with Chlamydia trachomatis and Chlamydia pneumoniae infections in children.
- To highlight the need for improved diagnostic tools for these pediatric infections.
Main Methods:
- Review of current diagnostic limitations for Chlamydia trachomatis in pediatric populations, including issues with non-culture tests.
- Evaluation of diagnostic approaches for Chlamydia pneumoniae in children, focusing on serologic methods and culture availability.
- Discussion of the potential impact of molecular diagnostic tests, such as PCR, for Chlamydia pneumoniae.
Main Results:
- Chlamydia trachomatis testing in children is complicated by the lack of approved non-culture tests for pediatric sites and high false positive rates in rectal/vaginal specimens.
- Current serologic methods for diagnosing Chlamydia pneumoniae infections in children are often insensitive.
- Polymerase chain reaction (PCR) testing shows promise for improved diagnosis of Chlamydia pneumoniae in pediatric patients.
Conclusions:
- Accurate diagnosis of Chlamydia trachomatis and Chlamydia pneumoniae in children is hindered by existing diagnostic limitations.
- There is a significant need for sensitive and specific diagnostic tests for Chlamydia infections in pediatric populations.
- The development and availability of commercial PCR tests could greatly improve the diagnosis of Chlamydia pneumoniae infections in children.
Abstract:
The genus Chlamydia now contains 4 species, 2 of which, Chlamydia trachomatis and C. pneumoniae are important human pathogens. Both organisms cause infections in children and adults, but infection in children pose a unique set of problems. As C. trachomatis is primarily a sexually transmitted disease, the presence of rectal or genital infection in a prepubertal child has been used as evidence of sexual abuse. Although there are several categories of non-culture tests that have bear approved for genital sites in adults, these tests are not approved for these sites in children. Of these tests in rectal and vaginal specimens in children have been associated with a high rate of false positives. C. pneumoniae is emerging as a frequent cause of community acquired pneumonia in adults and children. Because culture is not generally available, serologic diagnosis is used more frequently. However, currently available serologic methods appear to be insensitive in children. The availability of a commercial PCR test will greatly facilitate the diagnosis of C. pneumoniae infections in children.