Establishing Chlamydia trachomatis isolation capability in a local laboratory.
A system for the culture and identification of Chlamydia trachomatis was established in a local health department laboratory. The McCoy cell-cycloheximide procedure was adopted with use of on-site monolayer production and iodine staining. Several procedural modifications were analyzed for sensitivity, including two-vial vs. one-vial inoculation, overnight refrigeration vs. immediate inoculation of the monolayer, and use of transport media with vancomycin (100 micrograms/ml) vs. transport media without vancomycin. Costs associated with establishing and maintaining this procedure over a one-year period were documented. Inoculation of two monolayers improved sensitivity only slightly (87/292 vs. 85/292). Loss in sensitivity following overnight refrigeration of the sample was approximately 7%; 42 of 45 positive cultures were detected. Addition of 100 micrograms of vancomycin/ml to the transport media increased apparent sensitivity from 27.4% to 29.6% among females with gonorrhea. The cost was $.06 per culture. On the basis of this information, cultures for isolation of C. trachomatis are now offered to our clinic for sexually transmitted diseases as well as to some private physicians and clinics. We are using one-vial inoculation of a specimen transported in sucrose-phosphate buffer containing 100 micrograms vancomycin/ml. The specimen is either cultured immediately or snap frozen at -77 C.
D001431:Bacteriological Techniques / Q000191:economics; D002692:Chlamydia trachomatis / Q000254:growth & development / Q000302:isolation & purification*; D005260:Female; D005615:Freezing; D006801:Humans; D008297:Male; D013048:Specimen Handling