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[Detection of Chlamydia trachomatis in children with acute lower respiratory infection]
V Savy1, N Vizioli, E Baumeister
1Servicio de Virosis Respiratorias, Instituto Nacional de Microbiología Dr. Carlos G. Malbrán, Ministerio de Salud, Buenos Aires.
Insights
Rapid diagnostic methods for pediatric Chlamydia trachomatis respiratory infections showed poor performance. Current enzyme immunoassay and immunofluorescence techniques are not recommended for diagnosing Chlamydia in children.
Area of Science:
- Pediatric infectious diseases
- Microbiology
- Diagnostic test evaluation
Context:
- Chlamydia trachomatis infections in children can lead to serious complications.
- Accurate and rapid diagnosis of pediatric respiratory infections is crucial.
Purpose:
- To evaluate the diagnostic performance of rapid Chlamydia trachomatis detection methods in pediatric lower acute respiratory disease.
- To compare enzyme immunoassay (EIA) and immunofluorescence (IF) against cell culture for Chlamydia spp. detection.
Summary:
- Chlamydia spp. were detected in 14.4% of nasopharyngeal aspirates by cell culture, 19.8% by IF, and 6.5% by EIA.
- Sensitivity and specificity for IF were 37.5% and 83.1%, respectively.
- Sensitivity and specificity for EIA were 26% and 96.8%, respectively, using cell culture as the gold standard.
Impact:
- Current rapid diagnostic methods (EIA, IF) demonstrate unacceptable performance for diagnosing Chlamydia spp. in pediatric nasopharyngeal aspirates.
- Further research is needed to develop or modify techniques for reliable and rapid Chlamydia diagnosis in children.
Background:
Diagnosis of respiratory tract infections due to Chlamydia trachomatis in pediatric patients is very important because of its complications and sequelae. The aim of the present study was to evaluate the performance of rapid methods for reading this diagnosis in 111 children with lower acute respiratory disease.
Material And Methods:
Their nasopharyngeal aspirates were studied for detection of Chlamydia spp. antigens using enzyme immunoassay, indirect immunofluorescence and isolation in cell culture. The presence of respiratory viruses was also investigated for immunofluorescence.
Results:
Chlamydia spp. were isolated from 16 samples (14.4%) using cell monolayer cultures. They were detected in 22 samples by immunofluorescence (19.8%) and in seven samples by enzyme immunoassay (6.5%). Respiratory viruses were detected in 77 samples (69.4%). Sixty two percent of cell culture positive samples for Chlamydia were also positive for respiratory syncytial virus and 6% were positive for adenovirus. Sensitivity and specificity of immunofluorescence were 37.5% and 83.1% respectively using Chlamydia cell culture as "golden standard". For enzyme immunoassay these percentages were 26 and 96.8% respectively.
Conclusions:
The values obtained are not acceptable for recommending these methods for detecting Chlamydia spp. from nasopharyngeal aspirates. It will be necessary to modify these techniques or to develop alternative methods in order to rapidly and easily obtain a diagnosis of respiratory tract infections due to Chlamydia spp.