Lab

Chlamydia Antigen

Chlamydia Antigen, Chlamydia Trachomatis Antigen, Chlamydia Polymerase Chain Reaction, Chlamydia Trachomatis PCR, Chlamydia PCR, Chlamydia Nucleic Acid Amplification Test, Chlamydia Trachomatis NAAT, Chlamydia DNA Probe, Chlamydia Rapid Point-Of-Care Test

See Also

Chlamydia trachomatis

Indication

Chlamydia screening in symptomatic and asymptomatic patients

Background

Chlamydia Antigen testing has replaced Chlamydia culture
Nucleic Acid Amplification Tests (NAAT, PCR) are the primary tests used in the U.S. for Chlamydia detection

Precautions

Avoid rapid point-of-care Chlamydia tests (very low accuracy, see below)

Labs

Chlamydia Nucleic Acid Amplification Test (NAAT, PCR)
1. Preferred method
Older Methods
1. Direct Fluorescent Antibody (DFA)
2. Enzyme Immunoassay (EIA)
Mechanism
1. Detects both live and dead organisms
2. Positive test may be seen in recent treatment

Technique

Same swab is used to detect both Gonorrhea and Chlamydia
Eye Sample
1. Topical Eye Anesthetic applied
2. Swab lower and upper lids (inner surface)
Urethral Samples (Males)
1. Patient should not urinate within 1 hour before test
2. Insert small Dacron swab 2-4 cm into Urethra
Cervical Samples
1. Wipe Cervix to remove excess mucus
2. Insert Dacron swab into endocervix
3. Rotate swab for 5 to 10 seconds
4. Withdraw swabs without touching any vaginal surface
Rectal Samples (symptomatic patients)
1. Insert Dacron swab 3 cm into anal canal
2. Withdraw swab
3. Fecal contaminated samples should be redone

Efficacy

Chlamydia Nucleic Acid Amplification Tests (NAAT, PCR)
Chlamydia DFA, EIA (older methods, replaced by PCR)
1. Test Sensitivity: 88-91%
2. Test Specificity: 97-99%
Chlamydia Rapid Point-Of-Care Tests (avoid, very high False Negative Rate)