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Confirming the Chlamydia trachomatis status of referred rectal specimens
  1. Sarah Alexander (sarah.alexander{at}hpa.org.uk)
  1. health protection agency, United Kingdom
    1. Iona M C Martin (iona.martin{at}hpa.org.uk)
    1. Health Protection Agency, United Kingdom
      1. Catherine A Ison (catherine.ison{at}hpa.org.uk)
      1. Health Protection Agency, United Kingdom

        Abstract

        Objectives: To assess the reliability of different laboratory methods for the detection of Chlamydia trachomatis in rectal specimens

        Methods: A total of 1782 rectal specimens confirmed as C. trachomatis positive using a standard laboratory method, were forwarded to the Sexually Transmitted Bacteria Reference Laboratory. All specimens were re-tested using an C. trachomatis specific independent in-house real-time PCR. In the event this test was negative, a second test (Artus Real-Art PCR Kit) was employed as a confirmation. A correlation between real-time PCR results obtained at the reference centre (Sexually Transmitted Bacterial Reference Laboratory, STBRL) and the method of C. trachomatis detection used in the primary laboratory was undertaken.

        Results: The percentage of specimens which could be confirmed as positive, compared with primary method of detection was as follows: C. trachomatis culture 87.5%, Strand Displacement Assay (SDA: Becton Dickinson) 93.4%, Cobas Amplicor (Roche) 89.2%, Aptima Combo Two assay (Genprobe) 83.3% and Enzyme immunoassays (EIA) 35.4%.

        Conclusions: High rates of confirmation can be achieved using an independent real-time PCR assay to examining rectal specimens which had initially tested C. trachomatis positive using nucleic acid amplification tests and Chlamydia tissue culture. This is not possible for specimens, which had been screened using EIA tests, which reflects the low specificity of this test when used for rectal specimens. Laboratories currently using EIA based assays to test rectal specimens should review this approach.

        • Chlamydia trachomatis
        • EIA
        • NAAT
        • rectal specimens

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