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The contain the known human pathogens , , and as well as organisms such as and that have been associated only rarely with human infections. An overview about ranges of sensitivity and specificity for common diagnostic tests for in urogenital specimens is provided in this chapter. Problems associated with cell culture isolation of chlamydiae, including technical complexity and long turnaround time, and stringent requirements related to collection, transport, and storage of specimens have driven the development of commercially available nonculture methods that have found widespread application in many routine laboratories. The basic procedure for detection of isolated chlamydiae involves demonstration of intracytoplasmic inclusions by fluorescent-antibody staining that provides both morphological and immunological identification of chlamydiae. Serologic testing may be helpful in the diagnosis of human ornithosis, LGV, neonatal pneumonia caused by , and respiratory infections. The most commonly used serological assay formats include the complement fixation (CF) test, the MIF test, and the EIA to detect immunoglobulin M (IgM), IgA, IgG, or total classes of antibodies, with either family, species, or serotype specificity. Evaluation of antimicrobial resistance and potential clinical treatment failure in chlamydial infection is hampered by the lack of standardized antimicrobial susceptibility tests and the fact that in vitro resistance does not correlate with the patient’s clinical outcome.

Citation: Gaydos C, Essig A. 2011. , p 986-1000. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch60
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Image of FIGURE 1

Identification of by staining intracytoplasmic inclusions with iodine (A) and an FITC-conjugated monoclonal antibody directed at the MOMP (B). Transmission electron microscopy of a infected cell shows an intracytoplasmic inclusion impressing the cell nucleus (C) and filled with EBs and RBs (D) at 60 h postinfection; the arrowhead shows a dividing RB. Identification of culture-grown by fluorescence in situ hybridization using rRNA targeted oligonucleotide probes (E). Simultaneous use of a Cy5-labeled probe that targets a chlamydial 16S rRNA sequence common to all members of the (blue) and a Cy3-labeled probe specific for (red). Due to the overlap of colors, appears purple in the composite image; host cells are counterstained by a 5( )-carboxyfluorescein--hydroxysuccinimide ester (FLUOS)-labeled eukaryotic probe (green). IgG-MIF image (magnification, ×400) showing bright homogeneous fluorescence of EBs at a serum dilution of 1:512 (F). (Photographs courtesy of Sonja Maier, Sven Poppert, and Ulrike Simnacher, Department of Medical Microbiology and Hygiene, University of Ulm; and Matthias Horn, Division of Microbial Ecology, University of Vienna.)

Citation: Gaydos C, Essig A. 2011. , p 986-1000. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch60
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Table 1

Ranges of sensitivity and specificity for diagnostic tests for in urogenital specimens

Sensitivities and specificities are adapted from clinical trial data and are published in package inserts.

Citation: Gaydos C, Essig A. 2011. , p 986-1000. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch60

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