Abstract
The availability of a low cost, rapid method to detect C.t. antigen would encourage diagnostic testing for this important genital pathogen. We compared the efficacy of C.t. EIA to tissue culture isolation in 95 sexually active female adolescents. An endocervical swab specimen was tested for C.t. antigen and a second swab processed for culture in cycloheximide-treated McCoy cells using both iodine and a fluorescein-conjugated C.t. monoclonal antibody (FA) for detection of chlamydial inclusions. 24 subjects (25%) were C.t. culture (+). 23 specimens were positive by both iodine and FA; 1 was (+) by FA only. C.t. (+) and (-) subjects did not differ in regards to presence of symptoms or signs of genital tract infection. 18 of the 24 culture (+) subjects were EIA (+) (sensitivity 75%). C.t. inclusion counts in 4 of the 6 culture (+) EIA (-) specimens were low. 69 of 71 C.t. culture (-) specimens were EIA (-) (specificity 97%). In view of the high prevalence of C.t. in our population and its non-specific presentation, diagnostic testing for this pathogen is essential. In our study, EIA performed well as a diagnostic test with a (+) predictive value of 90% and a (-) predictive value of 92%. Potentially, EIA offers a cost-effective rapid screen which could expand testing of groups at high risk for C.t. infection.
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