Diagnosis and follow-up of genital chlamydial infection by direct methods and by detection of serum IgG, IgA and secretory IgA.
OBJECTIVE
To determine the prevalence of Chlamydia trachomatis infection in a high-risk population by direct and indirect methods and to evaluate the diagnosis of secretory immunoglobulin A (sIgA).


METHODS
Urethral or endocervical specimens from 78 patients (48 females and 30 males) were examined by cell culture, direct fluorescence assay, PCR Cobas Amplicor (Roche Molecular Diagnostics), and sIgA was detected by the recombinant lipopolysaccharide (LPS)-enzyme-linked immunoassay (rELISA). Serum from each patient was also obtained and analysed for the presence of IgG and IgA antibody by in-house microimmunofluorescence (MIF) and by the rELISA method (Medac, Hamburg, Germany).


RESULTS
The overall C. trachomatis prevalence determined by direct methods was 28%. The detection of sIgA antibodies was significantly higher in the group of patients with a positive direct detection (50%) than in the group of negative direct detection (10.7%). The Chlamydia-specific IgA antibodies were detected by the rELISA in 40.9 and 53.6% of group I (positive direct detection) and group II patients (negative direct detection), respectively. The species-specific IgA antibodies were detected by the MIF method in 18.2 and 16.1% of group I and II patients, respectively. Chlamydia genus-specific IgG antibodies were detected by the rELISA in 86.4 and 83.9% of group I and group II patients and, C. trachomatis specific IgG were present in 81.8 and 73.2% of group I and group II patients, respectively, as assessed by the MIF test.


CONCLUSIONS
Combining the positive direct methods and/or positive sIgA antibody results from cervical or urethral specimens had an indication of current C. trachomatis infection.
Departmental Laboratory of Picardie, Amiens University Hospital, France.
A S
AS
Fresse
J M
JM
Sueur
F
F
Hamdad
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D002478:Cells, Cultured; D002584:Cervix Uteri / Q000382:microbiology; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification*; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D005831:Genital Diseases, Female / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology; D005832:Genital Diseases, Male / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology; D006801:Humans; D007124:Immunoenzyme Techniques / Q000379:methods; D007070:Immunoglobulin A / Q000097:blood; D007071:Immunoglobulin A, Secretory / Q000032:analysis; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D016133:Polymerase Chain Reaction; D015231:Sexually Transmitted Diseases, Bacterial / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology; D014521:Urethra / Q000382:microbiology; D055815:Young Adult
D000907:Antibodies, Bacterial; D007070:Immunoglobulin A; D007071:Immunoglobulin A, Secretory; D007074:Immunoglobulin G