Materiały źródłowe

• #1 Chlamydia Test: What It Is, Purpose, Procedure & Results

  https://my.clevelandclinic.org/health/diagnostics/22352-chlamydia-test

  A chlamydia test detects the bacteria that cause chlamydia, a sexually transmitted infection (STI). This test tells you if you have a chlamydia infection. Your provider takes a sample of urine or secretions from your vagina, penis or rectum and sends it to a lab for testing. Results are usually ready in a day. […] This test detects a chlamydia infection, the most common bacterial sexually transmitted infection (STI) in the world. A chlamydia test looks for the bacteria that cause the infection (Chlamydia trachomatis). […] For this test, you provide a urine sample. Or your provider takes a swab of fluid from your vagina, anus, throat or eye (depending on where the infection might be). […] The most common type of chlamydia test is called a nucleic acid amplification test (NAAT). A NAAT detects the DNA of the bacteria that cause the chlamydia infection.

• #2 The laboratory diagnosis of Chlamydia trachomatis infections

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2095010/

  Lower genital tract infections with Chlamydia trachomatis are predominantly asymptomatic in men and women. Diagnostic technology has provided several approaches to the diagnosis of C trachomatis. […] Most invasive specimens, such as cervical or urethral swabs, may be collected for culture, antigen or nucleic acid detection. Noninvasive samples such as first-void urine and vaginal swabs can be easily collected by the patient; these samples must be tested by more sensitive nucleic acid amplification tests. […] Laboratories providing C trachomatis diagnosis require participation in continuous quality improvement programs. […] Most requests for the laboratory diagnosis of C trachomatis are for the following situations: male patients with nongonococcal urethritis, postgonococcal urethritis, epididymitis or Reiter’s syndrome; female patients with mucopurulent cervicitis, urethral syndrome, endometritis, salpingitis, perihepatitis, ectopic pregnancy, tubal factor infertility or pelvic pain; all patients with gonorrhea; sexual contacts of symptomatic patients or patients with a positive laboratory diagnosis (contact testing); pregnant women; infants with conjunctivitis and/or pneumonia; asymptomatic sexually active patients; and finally, donors of semen for assisted fertilization.

• #3 Chlamydia: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/4023-chlamydia

  Chlamydia testing is recommended by the Centers for Disease Control and Prevention (CDC) as part of your regular health maintenance. […] The most common test for chlamydia is called a nucleic acid amplification test (NAAT). Your provider takes a sample of fluid by doing a vaginal/cervical swab or collecting a urine sample. Then, they send the sample off to a lab to check for the bacteria that causes chlamydia. […] Because most chlamydia cases are asymptomatic, it’s important to get screened for chlamydia even if you don’t notice any signs of infection. The CDC recommends that sexually active women who are high-risk for chlamydia get screened regularly. […] For this reason, women should be screened regularly, too. […] You’re considered high-risk if you: Are under 25. […] Regardless of your age, reproductive anatomy, or other risk factors you should discuss your sexual history and sexual activity with your healthcare provider.

• #4 Chlamydia Trachomatis Infections: Screening, Diagnosis, and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/1215/p1127.html/amp/

  Currently, the U.S. Preventive Services Task Force recommends routine screening in all sexually active women 24 years and younger, and in women 25 years and older who are at increased risk because of having multiple partners or a new sex partner. Because of the high risk of intrauterine and postnatal complications if left untreated, all pregnant women at increased risk should be routinely screened for chlamydia during the first prenatal visit. Additionally, any pregnant woman undergoing termination of pregnancy should be tested for chlamydia infection. […] There is insufficient evidence to recommend screening in men, although a small number of studies suggest that screening high-risk groups may be useful and cost-effective.

• #5 Chlamydial Infections – STI Treatment GuidelinesMinusSASstats

  https://www.cdc.gov/std/treatment-guidelines/chlamydia.htm

  Chlamydia screening programs have been demonstrated to reduce PID rates among women. […] For women, C. trachomatis urogenital infection can be diagnosed by vaginal or cervical swabs or first-void urine. For men, C. trachomatis urethral infection can be diagnosed by testing first-void urine or a urethral swab. NAATs are the most sensitive tests for these specimens and are the recommended test for detecting C. trachomatis infection. […] Rectal and oropharyngeal C. trachomatis infection among persons engaging in receptive anal or oral intercourse can be diagnosed by testing at the anatomic exposure site. NAATs have been demonstrated to have improved sensitivity and specificity, compared with culture, for detecting C. trachomatis at rectal and oropharyngeal sites. […] POC tests for C. trachomatis among asymptomatic persons can expedite treatment of infected persons and their sex partners. Among symptomatic patients, POC tests for C. trachomatis can optimize treatment by limiting unnecessary presumptive treatment at the time of clinical decision-making and improve antimicrobial stewardship. Thus, using a POC test will likely be a cost-effective diagnostic strategy for C. trachomatis infection.

• #6 Chlamydia and LGV guide: Screening and diagnostic testing – Canada.ca

  https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/chlamydia-lgv/screening-diagnostic-testing.html

  Screening and diagnostic testing guidance for Chlamydia trachomatis infections (including lymphogranuloma venereum (LGV)). […] Screening for chlamydia is essential for detecting and treating asymptomatic infections and preventing transmission. […] The use of non-invasive samples (i.e., urine or self-obtained vaginal swab) can increase acceptance of screening for C. trachomatis infections. […] Offer universal annual screening in all sexually active persons under the age of 30 years. […] For persons with multiple sexual partners or a new partner since last tested, offer screening every three to six months. […] Consider implementing an opt-out approach to chlamydia screening as frequently as every 3 months in populations or communities experiencing high prevalence of chlamydia. […] Screen all pregnant people during the first trimester or at the first antenatal visit. Rescreen during the third trimester.

• #7 Recommendations for the Laboratory-Based Detection of Chlamydia trachomatis and Neisseria gonorrhoeae — 2014

  https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6302a1.htm

  Studies assessing the performance of NAATs might include test algorithms that use multiple NAATs, nonculture and culture tests as reference standards. […] Nevertheless, despite the absence of a criterion standard, valid generalizations can be made. […] All diagnostic tests including NAATs can generate inaccurate results, and it is important for laboratorians and clinicians to understand test limitations. […] However, NAATs are far superior in overall performance compared with other C. trachomatis and N. gonorrhoeae culture and nonculture diagnostic methods. […] NAATs offer greatly expanded sensitivities of detection, usually well above 90%, while maintaining very high specificity, usually 99%. […] Screening programs have been demonstrated to reduce both the prevalence of C. trachomatis infection and rates of PID in women.

• #8 Diagnostic Procedures to Detect Chlamydia trachomatis Infections

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5039585/

  The intracellular life style of chlamydia and the ability to cause persistent infections with low-grade replication requires tests with high analytical sensitivity to directly detect C. trachomatis (CT) in medical samples. Nucleic acid amplification tests (NAATs) are the most sensitive assays with a specificity similar to cell culture and are considered the method of choice for CT detection. […] Detection of CT antigens by enzyme immunoassay (EIAs) or rapid diagnostic tests (RDTs) are unsuitable due to insufficient sensitivity and specificity. Recent PCR-based RDTs, however, are non-inferior to standard NAATs, and might be used at the point-of-care. […] NAATs are the most sensitive tests to detect chlamydia. These tests also have a high specificity comparable to culture, but in contrast to culture, do not depend on viable pathogens, facilitating specimen transport. Therefore, NAATs are generally considered the test of choice for chlamydia and have replaced culture as the diagnostic gold standard.

• #9 Chlamydia Trachomatis Infections: Screening, Diagnosis, and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/1215/p1127.html/amp/

  Nucleic acid amplification tests (NAATs) are the most sensitive tests for detecting chlamydia and gonococcal infections. NAATs can be performed on endocervical, urethral, vaginal, pharyngeal, rectal, or urine samples (first-void is preferred). The accuracy of NAATs on urine samples has been found to be nearly identical to that of samples obtained directly from the cervix or urethra. On wet mount, a finding of leukorrhea (more than 10 white blood cells per high-power field on microscopic examination of vaginal fluid) has been associated with chlamydial and gonococcal infections of the cervix. Oropharyngeal and rectal swabs may be obtained in persons who engage in receptive oral or anal intercourse. […] Point-of-care testing at a physician’s office is recommended, although increasingly, researchers have begun to evaluate commercially available mail-in kits. To date, commercial kits have not been shown to be reliable, and have lower sensitivity and specificity than NAATs.

• #10 Recommendations for the Laboratory-Based Detection of Chlamydia trachomatis and Neisseria gonorrhoeae — 2014

  https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6302a1.htm

  Chlamydia culture capability also should be maintained in some laboratories to monitor future changes in antibiotic susceptibility and to support surveillance and research activities such as detection of lymphogranuloma venereum (LGV) or rare infections caused by variant or mutated C. trachomatis. […] Nucleic acid amplification tests (NAATs) are recommended for detection of urogenital infections caused by C. trachomatis and N. gonorrhoeae infections in women and men with and without symptoms. […] These tests have been shown to be cost-effective in preventing sequelae due to these infections. […] A list of FDA-cleared specimen types and transport and storage requirements is provided. […] Because NAATs are so sensitive, efforts are warranted to prevent contamination of specimens in the clinic or spread of environmental amplicon in the laboratory.

• #11 The laboratory diagnosis of Chlamydia trachomatis infections

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2095010/

  Diagnostic tests involving monoclonal antibodies are based on detecting elementary bodies (EBs) in smears. […] The NAA assays have become the tests of choice for the diagnosis of C trachomatis infection in routine clinical laboratories. […] Serology is not recommended for diagnosing chlamydial infections, with the exception of infection in neonates, patients with tubal factor infertility and occasionally for LGV infections when bubo aspirates are not available. […] The microimmunofluorescence test, developed by Wang and Grayston, is the current method of choice for the serodiagnosis of chlamydial infection.

• #12 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Chlamydia-Diagnosis.aspx

  Chlamydia screening plays an important role in the detection and treatment of this infection to prevent long term consequences such as infertility. […] The bacteria are usually detected on analysis of a urine sample or a genital swab. For the swab, a cotton bud is used to gently wipe the area and collect some cells, which are then checked for the bacteria under a microscope. […] In women, a urine sample is often enough to check for chlamydia infection. Swabs may also be taken from the cervix, inside the lower vagina or the opening of the urethra. […] In men, a urine samples is also usually adequate but swabs may be taken from the opening of the urethra at the tip of the penis. […] The main tests for chlamydia that are used today are the nucleic acid amplification tests (NAATs) which include: Polymerase chain reaction (PCR), Transcription mediated amplification (TMA), DNA strand displacement amplification (SDA). […] These test can be perfomed using the urine, swab samples or rectal specimens.

• #13 Recommendations for the Laboratory-Based Detection of Chlamydia trachomatis and Neisseria gonorrhoeae — 2014

  https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6302a1.htm

  Of the nonculture tests available, only nucleic acid amplification testing (NAAT) is recommended for routine use whereas other tests (e.g., enzyme immunoassays, nucleic acid probe tests, and genetic transformation tests) are not recommended. […] Since 2002, improvements in chlamydia and gonorrhea NAAT technologies have enabled significant implementation and expansion of screening programs using less invasive specimen collection. […] The performance of NAATs with respect to overall sensitivity, specificity, and ease of specimen transport is better than that of any of the other tests available for the diagnosis of chlamydial and gonococcal infections. […] The primary drawback of these tests, especially for C. trachomatis, was that they failed to detect a substantial proportion of infections.

• #14 Chlamydia trachomatis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chlamydia/diagnosis-treatment/drc-20355355

  The Centers for Disease Control and Prevention recommends chlamydia testing for anyone with chlamydia symptoms. […] Screening and diagnosis of chlamydia is relatively simple. You may be able to use a test that’s available without a prescription, sometimes called an at-home test, to see if you have chlamydia. If that test shows you have chlamydia, you’ll need to see a healthcare professional to confirm the diagnosis and start treatment. […] To determine whether you have chlamydia, your healthcare professional will analyze a sample of cells. Samples can be collected with: […] A urine test. A sample of urine is analyzed in the laboratory for presence of this infection. This can be done for males and females. […] A swab. A sample from the cervix, vagina, throat or anus is collected on a swab for testing. From the cervix, a member of your healthcare team collects a sample of the discharge from the cervix on a swab for testing. This can be done during a routine Pap test. For a swab from the vagina, either you or the healthcare professional can do the swab. For males and females, depending on sexual history, a swab may be taken from the throat or the anus. […] Three months after treatment, the Centers for Disease Control and Prevention recommends getting tested for chlamydia again. This is to make sure people haven’t been reinfected with the bacteria, which can happen if sex partners aren’t treated, or new sex partners have the bacteria.

• #15 Diagnostic Procedures to Detect Chlamydia trachomatis Infections

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5039585/

  In principle, all relevant clinical materials can be analyzed by NAATs, including urethral, cervical, vulvo-vaginal, anorectal and ocular swabs, first void urine (FVU), sperm or tissues. […] To detect extra-genital CT infections (conjunctivitis, anorectal or pharyngeal infections, incl. LGV) testing of corresponding swabs or tissue samples is required. […] Rapid tests that detect chlamydia antigens, however, have insufficient sensitivity and specificity. Novel rapid tests based on NAAT have much better performance, comparable to standard NAATs. These fully automated systems are independent of central laboratories and may improve the point-of-care testing for Chlamydia trachomatis infections in future.

• #16 Diagnostic Procedures to Detect Chlamydia trachomatis Infections

  https://www.mdpi.com/2076-2607/4/3/25

  The intracellular life style of chlamydia and the ability to cause persistent infections with low-grade replication requires tests with high analytical sensitivity to directly detect C. trachomatis (CT) in medical samples. Nucleic acid amplification tests (NAATs) are the most sensitive assays with a specificity similar to cell culture and are considered the method of choice for CT detection. […] In the case of lower genital tract infections, first void urine and vaginal swabs are the recommended specimens for testing males and females, respectively. Infections of anorectal, oropharyngeal and ocular epithelia should also be tested by NAAT analysis of corresponding mucosal swabs. […] Detection of CT antigens by enzyme immunoassay (EIAs) or rapid diagnostic tests (RDTs) are unsuitable due to insufficient sensitivity and specificity. Recent PCR-based RDTs, however, are non-inferior to standard NAATs, and might be used at the point-of-care.

• #17 Recommendations for the Laboratory-Based Detection of Chlamydia trachomatis and Neisseria gonorrhoeae — 2014

  https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6302a1.htm

  For sexually active women, including those who are pregnant, the U.S. Preventive Services Task Force (USPSTF) recommends that clinicians provide gonorrhea screening only to those at increased risk for infection. […] For female screening, specimens obtained with a vaginal swab are the preferred specimen type. […] Overwhelming evidence described the performance of male first catch urine samples as equivalent to, and in some situations superior to, urethral swabs. […] Infections with C. trachomatis and N. gonorrhoeae are common in extragenital sites in certain populations such as MSM. […] Because extragenital infections are common in MSM, and most infections are asymptomatic, routine annual screening of extragenital sites in MSM is recommended. […] NAATs for C. trachomatis and N. gonorrhoeae are preferred for the diagnostic evaluation of adult sexual assault victims, from any sites of penetration or attempted penetration.

• #18 Systematic reviews of point-of-care tests for the diagnosis of urogenital Chlamydia trachomatis infections | Sexually Transmitted Infections

  https://sti.bmj.com/content/93/S4/S22

  The systematic reviews showed that antigen detection POCTs for CT, although easy to use, lacked sufficient sensitivity to be recommended as a screening test. […] A near-patient NAAT shows acceptable performance as a screening or diagnostic test but requires electricity, takes 90min and is costly. […] The two systematic reviews described the evaluation of nine brands of antigen detection POCTs and one NAAT that can be labelled as near patient as it is an automated sample-in answer-out assay that requires 2min of hands-on time and is designed for both laboratories and clinic settings. […] Antigen detection rapid POCTs exhibited high specificity across all specimen types (range 97%100%), the pooled sensitivity was 37% for vaginal swabs (95% CI 22.9% to 52.9%; range 17.1%74.2%), 53% for endocervical swabs (95% CI 34.7% to 70.8%; range 22.7%87%) and 63% for urine (95% CI 43.2% to 78.5%; range 49.7%88.2%).

• #19 Systematic reviews of point-of-care tests for the diagnosis of urogenital Chlamydia trachomatis infections | Sexually Transmitted Infections

  https://sti.bmj.com/content/93/S4/S22

  The best performing test overall was the Xpert CT/NG, a Food and Drug Administration-approved real-time PCR assay. […] The quality of the studies included in these systematic reviews is generally satisfactory. […] In selecting a test for screening of asymptomatic populations or diagnosis of symptomatic patients, health providers and control programmes need to consider the trade-off between accuracy and affordability for their epidemiological setting and what patients are willing to pay and whether they are willing to wait for 90min versus 1530min. […] The systematic reviews showed that antigen detection POCTs for CT, although easy to use, lacked sufficient sensitivity to be recommended as screening tests. Currently available near-POC NAATs have acceptable performance characteristics to be used as screening and diagnostic tests but need a source of electricity, have a relatively long turnaround time of approximately 90min and are too costly for widespread use, especially in low resource settings.

• #20 MCTGC – Overview: Chlamydia trachomatis and Neisseria gonorrhoeae, Miscellaneous Sites, Nucleic Acid Amplification, Varies

  https://www.mayocliniclabs.com/test-catalog/overview/43721

  Detecting Chlamydia trachomatis and Neisseria gonorrhoeae in non-US Food and Drug Administration-approved specimen types. […] This test is not intended for use in medico-legal applications. […] This test is not useful for the detection of Chlamydia pneumoniae or other Chlamydia species. […] Culture was previously considered to be the gold standard test for diagnosis of C trachomatis and N gonorrhoeae infections. However, these organisms are labile in vitro, therefore, precise specimen collection, transportation, and processing conditions are required to maintain organism viability, which is necessary for successful culturing. In comparison, nucleic acid amplification testing (NAAT) provides superior sensitivity and specificity and is now considered the reference standard method for diagnosis in most cases.

• #21 008565: Chlamydia trachomatis Culture | Labcorp

  https://www.labcorp.com/tests/008565/chlamydia-trachomatis-culture

  Cell culture and subsequent detection of Chlamydia by fluorescent antibody […] Cell culture and subsequent detection of Chlamydia trachomatis by fluorescent antibody staining. […] Aid in the diagnosis of infections, including medical/legal cases caused by Chlamydia trachomatis (eg, cervicitis, trachoma, conjunctivitis, PID, pneumonia, urethritis, nongonococcal urethritis, pneumonitis, and sexually-transmitted diseases) […] Culture may be negative in the presence of Chlamydia infection. Although culture is the legal standard, it is not the gold standard for the detection of C trachomatis. The sensitivity of culture is only 70% to 90% because C trachomatis may not survive transit to the laboratory, inadequate sampling, or low numbers of organisms in asymptomatic infection. […] Direct immunofluorescence techniques and nucleic acid amplification assays are available to detect Chlamydia in clinical specimens. These methods usually provide reliable results in high- and low-prevalence populations and detect both viable and nonviable organisms.

• #22 The laboratory diagnosis of Chlamydia trachomatis infections

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2095010/

  The purpose of the present document is to provide guidance for the clinician and laboratory worker and enable the most appropriate specimen collection, testing and reporting of C trachomatis infections, thus enabling effective patient treatment and management. […] For successful culture of chlamydiae, swabs, scrapings and small tissue samples should be forwarded to the laboratory in a special chlamydial transport medium such as 2SP. […] Currently, culture is the only assay that provides acceptable results for C trachomatis in legal abuse cases, but collection of specimens for nucleic acid amplification (NAA) tests at the same time may enhance an investigation. […] The sensitivity profiles of the commercially available C trachomatis EIAs range from 65% to 75% compared with NAA assays.

• #23 008565: Chlamydia trachomatis Culture | Labcorp

  https://www.labcorp.com/tests/008565/chlamydia-trachomatis-culture

  Culture should be the test-of-choice in cases of child abuse, rectal and throat infections, and when a test for cure is desired. […] The incidence of cervical infection with Chlamydia trachomatis is two to three times that of gonorrhea: 4% to 9% in private office settings, 6% to 23% in family planning clinics, and 20% to 30% in sexually-transmitted diseases clinics.

• #24 Recommendations for the Laboratory-Based Detection of Chlamydia trachomatis and Neisseria gonorrhoeae — 2014

  https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6302a1.htm

  This changed with the introduction of NAATs that amplify and detect C. trachomatis specific or N. gonorrhoeae specific DNA or RNA sequences. […] These tests are approximately 20%35% more sensitive than the earlier nonculture tests. […] This report emphasizes the importance of maintaining the capability to culture for both N. gonorrhoeae and C. trachomatis in laboratories throughout the country because there are insufficient data to recommend nonculture tests in cases of sexual assault in boys and extragenital site exposure in girls. […] N. gonorrhoeae culture is required as a test of cure to evaluate suspected cases of gonorrhea treatment failure and to monitor developing resistance to current treatment regimens. […] Test of cure should be done when clinically indicated only (i.e., not part of routine care).

• #25

  https://www.aaem.pl/The-role-of-serological-testing-for-Chlamydia-trachomatis-in-differential-diagnosis,72459,0,2.html

  Pelvic pain is typically associated with pelvic inflammatory disease (PID). The most common cause of PID is Chlamydia trachomatis. The aim of this study was to verify the role of serological testing for Chlamydia trachomatis in patients with suspected PID. […] Serological examination for Chlamydia trachomatis is helpful in evaluation of patients with suspected PID. Elevated titers of anti-Chlamydia trachomatis antibodies are frequently associated with laparoscopic evidence of pelvic adhesions and inflammation.

• #26 Chlamydia Serology, IgM & IgG (Sendout) | Laboratory Test Guide | Dept. of Laboratory Medicine & Pathology | UW Medicine

  https://dlmp.uw.edu/test-guide/view/RCLAMS

  Useful For: Aiding in the diagnosis of Chlamydia pneumoniae or Chlamydia psittaci infection. […] Interpretation: […] Chlamydia pneumoniae IgM: 1:10 IgM endpoint titers below 1:10 suggest that the patient does not have a current infection. […] 1:10 IgM endpoint titers of 1:10 or more are considered presumptive evidence of infection. […] Chlamydia pneumoniae IgG: 1:64 IgG endpoint titers below 1:64 suggest that the patient does not have a current infection. […] A single specimen endpoint titer of 1:64 to 1:512 should be considered evidence of infection at an undetermined time. […] If the second specimen exhibits a titer 1:512 or more or a 4-fold increase over that of the initial specimen, current (acute) infection is indicated.

• #27 Recommendations for the Laboratory-Based Detection of Chlamydia trachomatis and Neisseria gonorrhoeae — 2014

  https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6302a1.htm

  Using highly specific tests is critical with prepubescent children for whom the diagnosis of a sexually transmitted infection might lead to initiation of an investigation for child abuse. […] Only standard culture systems for the isolation of C. trachomatis should be used. […] The isolation of C. trachomatis should be confirmed by microscopic identification of inclusions by staining with fluorescein-conjugated monoclonal antibody MOMP specific for C. trachomatis. […] Nonculture tests for C. trachomatis such as EIAs and DFA are not sufficiently specific for use in circumstances involving possible child abuse or sexual assault.

• #28 A challenging future in the sexually transmitted infection diagnostics landscape: Chlamydia trachomatis as model | Enfermedades Infecciosas y Microbiología Clínica (English Edition)

  https://www.elsevier.es/en-revista-enfermedades-infecciosas-microbiologia-clinica-english-428-articulo-a-challenging-future-in-sexually-S2529993X22002015

  A correct diagnosis of LGV is important because of the distressing morbidities, such as perirectal abscesses severe proctitis, proctocolitis, rectal bleeding, etc. […] For this reason, the detection and treatment of C. trachomatis infections will prevent or interrupt reproductive tract morbidity, but unfortunately, many times, the persistent infections are asymptomatic. […] The point-of-care (PoC) for detection of C. trachomatis and N. gonorrhoeae in PID cases concluded that the presence of CT/NG was not a risk factor for a complicated clinical course, and the PID management should be based on clinical features, irrespectively of the presence or absence of C. trachomatis or N. gonorrhoeae. […] We agree that the clinical and molecular PID diagnosis should be improved. […] The health system in general needs to integrate all STIs together with these new approaches to increase access and effectiveness in diagnosing and treating STIs as soon as possible.

• #29 Chlamydia and LGV guide: Screening and diagnostic testing – Canada.ca

  https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/chlamydia-lgv/screening-diagnostic-testing.html

  Screen neonates exposed to chlamydia during pregnancy, labour, or delivery. […] Nucleic acid amplification tests (NAAT) are the most sensitive test for C. trachomatis. […] Culture for C. trachomatis is no longer routinely available in Canada. […] NAAT does not differentiate between LGV and non-LGV genotypes. […] Identification of C. trachomatis in bubo fluid is highly suggestive of LGV, even prior to or without identification of LGV genotypes. […] Genotyping of positive specimens for C. trachomatis is necessary for a definitive diagnosis of LGV. […] C. trachomatis-positive specimens from people with symptoms compatible with LGV and from sexual partners of people diagnosed with LGV should be forwarded to a provincial/territorial laboratory or the National Microbiology Laboratory (NML) for LGV genotyping.

• #30 Chlamydial Infections – STI Treatment GuidelinesMinusSASstats

  https://www.cdc.gov/std/treatment-guidelines/chlamydia.htm

  Sensitive and specific methods for diagnosing chlamydial ophthalmia in the neonate include both tissue culture and nonculture tests (e.g., DFA tests and NAATs). DFA is the only nonculture FDA-cleared test for detecting chlamydia from conjunctival swabs. NAATs are not cleared by FDA for detecting chlamydia from conjunctival swabs, and clinical laboratories should verify the procedure according to CLIA regulations. […] Specimens for chlamydial testing should be collected from the nasopharynx. Tissue culture is the definitive standard diagnostic test for chlamydial pneumonia. Nonculture tests (e.g., DFA and NAAT) can be used.

• #31 Chlamydia Testing – Testing.com

  https://www.testing.com/tests/chlamydia-test/

  NAAT is the preferred method for detecting a chlamydia infection. […] Diagnostic chlamydia testing is recommended for anyone with signs or symptoms of this infection. […] If you’re diagnosed with chlamydia, retesting for this infection is often performed after treatment is complete. […] Chlamydia testing is usually ordered by a doctor. […] If you have symptoms of this infection, a doctor will order testing to diagnose or rule out chlamydia. […] Chlamydia test results are typically reported as positive or negative, indicating whether there was evidence of an infection caused by the bacteria Chlamydia trachomatis. […] A positive test indicates that you have a current chlamydia infection that requires treatment with antibiotics. […] A negative chlamydia test means that there is no evidence of a chlamydia infection at the time the test sample was collected.

• #32 Chlamydia Trachomatis (CT) & Neisseria Gonorrhoeae (NG) PCR – Radiance Diagnostics – Fast, Accurate Results

  https://theradiancediagnostics.com/order-test/chlamydia-trachomatis-ct-and-neisseria-gonorrhoeae-ng-pcr/

  Regular chlamydia testing at least once a year is also recommended if you: Have HIV. […] Your provider will order a test if your sex partner has been diagnosed with chlamydia or if you have symptoms. Symptoms of chlamydia may include: An unusual discharge (fluid) from your genitals (penis or vagina) or rectum, Irritation or itching around your genitals, Pain or burning when you urinate (pee), Rectal pain or bleeding if chlamydia infects the rectum. […] To do a chlamydia test, you will need to provide a sample of fluid from the part of your body that may be infected. […] Test results are usually ready in a day. There are some rapid chlamydia tests that can provide results in 90 minutes or less. […] A negative test result means that you did not have a chlamydia infection when the sample was collected. A positive test result means you have been infected with chlamydia. […] If your test result is positive, you will need antibiotics to treat your infection. […] Chlamydia testing can help you avoid lasting health problems and stop the spread of this disease.

• #33 Chlamydia trachomatis and Neisseria gonorrhoeae, Nucleic Acid Amplification, Varies – Mayo Clinic Laboratories | Microbiology and Infectious Disease Catalog

  https://microbiology.testcatalog.org/show/CGRNA

  Improved screening rates and increased sensitivity of NAAT have resulted in an increased number of accurately diagnosed cases. Improved detection rates result from improved performance characteristics of the assays and patients’ easy acceptance of urine testing. Early identification of infection enables sexual partners to seek testing and/or treatment as soon as possible and reduces the risk of disease spread. […] A positive result indicates the presence of nucleic acid from Chlamydia trachomatis or Neisseria gonorrhoeae and strongly supports a diagnosis of chlamydial or gonorrheal infection. […] A negative result indicates that nucleic acid from C trachomatis or N gonorrhoeae was not detected in the specimen. A negative result does not exclude the possibility of infection. If clinical indications strongly suggest gonococcal or chlamydial infection, additional specimens should be collected for testing.

• #34 Chlamydia trachomatis, Nucleic Acid Amplification, Varies – Mayo Clinic Laboratories | Microbiology and Infectious Disease Catalog

  https://microbiology.testcatalog.org/show/CTRNA

  Chlamydia trachomatis, Nucleic Acid Amplification, Varies […] Detecting Chlamydia trachomatis […] This test is not useful for the detection of other Chlamydia species. […] A positive result indicates the presence of nucleic acid from Chlamydia trachomatis and strongly supports the diagnosis of chlamydial infection. […] A negative result indicates that nucleic acid from C trachomatis was not detected in the specimen. A negative result does not exclude the possibility of infection. If clinical indications strongly suggest chlamydial infection, additional specimens should be collected for testing. […] The predictive value of an assay depends on the prevalence of the disease in any specific population. In settings with a high prevalence of sexually transmitted infections, positive assay results have a high likelihood of being true-positive results. In settings with a low prevalence of sexually transmitted infections, or in any setting in which a patient’s clinical signs and symptoms or risk factors are inconsistent with chlamydial urogenital infection, positive results should be carefully assessed, and the patient retested by other methods, if appropriate. […] This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer’s instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

• #35 Chlamydia Trachomatis Infections: Screening, Diagnosis, and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/1215/p1127.html/amp/

  Make diagnosis via specimen collection (i.e., urine, urethra, endocervix, pharynx, rectum, or vagina), using a nucleic acid amplification test. All pregnant women infected with chlamydia should be retested three to four weeks after completing treatment. Test of cure is not advised for nonpregnant patients who finished one of the recommended courses of treatment. Repeat testing for reinfection of men and women who were recently infected is recommended at three months after completion of treatment, or within the first year following treatment. Sex partners should be referred for evaluation, testing, and treatment if they engaged in sexual contact within 60 days before a diagnosis was made or at the onset of symptoms. Advise patients to abstain from sexual contact until they and their sex partners have finished one of the recommended treatments, and for seven days afterward.

• #36 Chlamydia Infections | Chlamydia | Chlamydia Symptoms | MedlinePlus

  https://medlineplus.gov/chlamydiainfections.html

  Chlamydia is a common sexually transmitted infection (STI). It is caused by bacteria called Chlamydia trachomatis. […] There are lab tests to diagnose chlamydia. Your health care provider may ask you to provide a urine sample. Or your provider may use (or ask you to use) a cotton swab to get a sample from your vagina to test for chlamydia. […] You should go to your provider for a test if you have symptoms of chlamydia or if you have a partner who has an STI. If you are pregnant, you should get a test when you go to your first prenatal visit. […] People at higher risk should get checked for chlamydia every year: Sexually active women 25 and younger, Older women who have new or multiple sex partners or a sex partner who has an STI, Men who have sex with men (MSM). […] Antibiotics will cure the infection. You may get a one-time dose of the antibiotics, or you may need to take medicine every day for 7 days. It is important to take all the medicine that your provider prescribed for you. […] It is common to get a repeat infection, so you need to get tested again about three months after treatment.

• #37 Chlamydia trachomatis/Neisseria gonorrhoeae (CT/NG) – Nucleic Acid Amplification Testing (NAAT) | Public Health Ontario

  https://www.publichealthontario.ca/en/Laboratory-Services/Test-Information-Index/Chlamydia-trachomatis-NAAT-Swabs

  For CT: TOC by NAAT is recommended 3 weeks after completion of treatment when compliance to treatment is suboptimal, an alternative treatment regimen is used, for those with persisting signs or symptoms post-treatment, or the individual is pre-pubertal or pregnant. […] Chlamydia trachomatis (CT)/Neisseria gonorrhoeae (NG) NAAT is performed using the Roche cobas CT/NG Assay, a duplex real-time PCR assay for the qualitative detection of CT and NG. […] Confirmatory testing for NG is performed using the Roche cobas omni Utility Channel with the PivNG Assay V2 (IDT). […] CT confirmatory testing is performed using the Cepheid Xpert CT assay.

• #38 Chlamydia | STI Guidelines Australia

  https://sti.guidelines.org.au/sexually-transmissible-infections/chlamydia/

  Chlamydia trachomatis is the most reported communicable disease in Australia. […] Simple to test and treat. […] NAATs are highly sensitive, can be used in non-clinical settings and are the only recommended test for chlamydia. […] For asymptomatic testing or where an examination is unable to be performed, encourage patient self-collection of vaginal swabs and anorectal swabs. […] Concurrent gonorrhoea testing should accompany chlamydia testing. […] Test of cure by nucleic acid amplification test (NAAT) in these situations should be performed no earlier than 4 weeks after treatment is completed to prevent false positive result due to persistent chlamydia DNA. […] Retesting at 3 months is recommended to detect re-infection.

• #39 Chlamydia: Diagnosis, Tests, Treatment, Medication

  https://www.webmd.com/sexual-conditions/understanding-chlamydia-treatment

  If you’re pregnant, you may get tested for chlamydia at your first prenatal visit. […] Chlamydia can be well treated with antibiotics and is cured in 95% of uncomplicated cases. […] Get tested for chlamydia 3 months after treating your initial infection, whether or not you or your partner got full treatment. […] Chlamydia is an STD that can only be cured with treatment. It won’t go away on its own. […] If you are diagnosed with chlamydia, your doctor will prescribe antibiotics that you take by mouth. […] Chlamydia is well treated with antibiotics. […] Chlamydia cannot go away on its own, but treatment with antibiotics can cure it. […] If you take a chlamydia test and your results show you have it, it’s important that you tell your partners. […] The only way to know for sure that you or a sex partner has chlamydia is by taking a test.

• #40

  https://link.springer.com/article/10.1007/s42770-021-00533-z

  Chlamydial genital infections constitute significant sexually transmitted infections worldwide. […] Early detection and management of these infections could play a decisive role in controlling this public health burden. […] The objective of this review is to provide an insight into the evolution of diagnostic methods for CT infections through the development of new molecular technologies, emphasizing on -omics technologies and their significance as diagnostic tools both for effective patient management and control of disease transmission. […] Implementing the most accurate methods in diagnosis is highlighted as the cornerstone in managing CT infections. […] Diagnostics based on -omics technologies are considered to be the most pertinent modalities in CT testing when compared to other available methods.

• #41

  https://link.springer.com/article/10.1007/s42770-021-00533-z

  There is a need to modify these effective and accurate diagnostic tools in order to render them more available and feasible in all settings, especially aiming on turning them to rapid point-of-care tests for effective patient management and disease control. […] This review focusses on the currently available diagnostic approaches in detecting chlamydial infections, with special emphasis on the significance of -omics technologies in molecular testing. […] The testing for extra-genital CT infections requires sampling from rectal and pharyngeal sites. […] The major role of NAAT technologies in chlamydial diagnostics was appreciated with the development of polymerase chain reaction (PCR) and ligase chain reaction (LCR) techniques. […] The introduction of these methods led to a drastic leap in CT diagnosis, enabling better identification of cases and management.

• #42

  https://link.springer.com/article/10.1007/s42770-021-00533-z

  NAATs have been the most competent methods devised for CT diagnosis with high sensitivity and specificity values. […] The fact that non-invasive samples are accepted for testing has favored the use of these methodologies in screening asymptomatic population. […] Rapid and accurate POC tests are necessary in order to enable diagnosis and treatment on a single clinical visit. […] The diagnosis of CT genital infections has come a long way, from the less-sensitive culture techniques to the non-culture methods, to the advent of highly accurate molecular technologies. […] -omics technologies, especially when used in an integrated manner, can be very promising solutions.

• #43 Exploring Bioinformatics-Driven Approaches for Enhanced Diagnosis of Chlamydia trachomatis Infections: Analysis of Target Proteins – European Medical Journal

  https://www.emjreviews.com/innovations/article/exploring-bioinformatics-driven-approaches-for-enhanced-diagnosis-of-chlamydia-trachomatis-infections-analysis-of-target-proteins/

  The urgent need for rapid and accurate diagnostic methods is emphasised by the high incidence rates in regions like Sub-Saharan Africa. […] This study presents an innovative bioinformatics-driven approach aimed at enhancing the diagnosis of Chlamydia trachomatis infections. […] The designed chimeric construct demonstrated promising antigenic properties, stability, and non-allergenicity, making it a strong candidate for the development of an affordable and rapid diagnostic tool, potentially transforming the landscape of chlamydia screening and control. […] Early screening and diagnosis remain the most important preventive measures. […] The most sensitive assays, nucleic acid amplification tests, are thought to be the best technique for CT detection because of their cell culture-like specificity.

• #44 Exploring Bioinformatics-Driven Approaches for Enhanced Diagnosis of Chlamydia trachomatis Infections: Analysis of Target Proteins – European Medical Journal

  https://www.emjreviews.com/innovations/article/exploring-bioinformatics-driven-approaches-for-enhanced-diagnosis-of-chlamydia-trachomatis-infections-analysis-of-target-proteins/

  Chlamydia trachomatis, a major cause of sexually transmitted infection, poses a range of symptoms including genital discharge, pain during urination, and abdominal pains in women, and can lead to serious health complications such as pelvic inflammatory diseases, infertility, and ectopic pregnancy if left untreated. The need for rapid and accurate detection is imperative so prompt treatment and control of the disease can be achieved. […] This study conducted an immunoinformatic analysis of proteins of Chlamydia trachomatis (incA, hctA, ompA, omcB, rpoB, and HSP60) for the development of a lateral flow assay-based diagnostic test. […] With a Ramachandras score of 95.4% and Z-score of -5.1, results indicate that the construct efficacy is high in potential to provide extreme specificity and sensitivity for the detection of Chlamydia trachomatis in clinical samples as compared to traditional culture-based methods using nucleic acid amplification, hereby providing a quicker and more accurate diagnostic tool for Chlamydia trachomatis infection.

• #45 Exploring Bioinformatics-Driven Approaches for Enhanced Diagnosis of Chlamydia trachomatis Infections: Analysis of Target Proteins – European Medical Journal

  https://www.emjreviews.com/innovations/article/exploring-bioinformatics-driven-approaches-for-enhanced-diagnosis-of-chlamydia-trachomatis-infections-analysis-of-target-proteins/

  Despite the overall accuracy, these systems have several shortcomings, such as limited turnaround times, high costs, labour-intensive tasks, and the need for sophisticated equipment and highly skilled personnel. […] The constructs potential efficacy and safety in therapeutic applications is highlighted by the clinical significance of its high antigenicity and non-allergenicity. […] The development of this lateral flow test kit represents a significant advancement in infectious disease diagnostics considering the speed and convenience, cost effectiveness, and portability supporting the privilege for onsite testing including remote and underserved areas where laboratory facilities are not available.

• #46 Chlamydia: Diagnosis, Tests, Treatment, Medication

  https://www.webmd.com/sexual-conditions/understanding-chlamydia-treatment

  The only way to know for sure that you have chlamydia is through a chlamydia test. If you think you have chlamydia, your doctor may test your discharge, urine, or other body fluids for the bacteria that causes chlamydia, Chlamydia trachomatis. […] Results often come quickly, usually in a day. […] Chlamydia home tests can be more convenient and save you time and money going to the doctor. […] You can also get free and low-cost chlamydia testing from health centers at colleges or universities, local health departments, and nonprofit organizations like Planned Parenthood that offer HIV/STI testing. […] Chlamydia is a serious but preventable and curable sexually transmitted disease (STD). […] If you’re sexually active and under age 25 or at higher risk, it’s a good idea to test for chlamydia once a year, even if you don’t have symptoms.

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