Abstract
Chlamydiazyme developed by Abbott laboratories, U. S. A., is an enzyme immunoassay kit to detect chlamydial antigen. The usefulness of Chlamydiazyme for the diagnosis of Chlamydiatrachomatis infection in the genitourinary tract was investigated by comparison with cell culutre method. Urethral (male) and cervical swab specimens obtained from patients attending urological, and obstetric and gynecological clinics were tested according to the manual enclosed in Chlamydiazyme kit. A net absorbance value of 1.00 or greater was determined as a positive reaction. Among 486 untreated cases (323males and 163 females), Chlamydiazyme was positive in 132 (96.4%) of 137 culture-positive specimens and negative in 322 (92.3%) of 349 culture-negative specimens. For male patients, 102 (99.0%) of 103 culture-positive specimens were Chlamydiazyme-positive and 201 (91.4%) of 220 culture-negative specimens were Chlamydiazyme-negative. In female cases the positive-coincidnece ratio (sensitivity) of the Chlamydiazyme test to cell culture was 88%(30/34) and the negative-coincidence ratio (specificity) of Chlamydiazyme was 93.8%(121/129). The positive-coincidence ratio in female cases was slightly lower than that in male cases. High net absorbances, 2.00 or greater, were observed in 50.9% of 157 positive specimens. In 62 cases which had been culture-and Chlamydiazyme-positive before treatment, 16 (73%) of 22 culture-negative specimens were Chlamydiazyme-negative during treatment, although 39 (98%) of 40 culture-positive specimens were Chlamydiazyme-positive. The low positive coincidence ratio during treatment might be due to chlamydial antigen persisting in the infected focus for one to two weeks after the onset of treatment, even if the C. trachomatis was not alive. No influence was also observed on the results of Chlamydiazyme by storage of specimens up to 4 weeks at 4°C. The Chlamydiazyme kit will provide a rapid, rather simpler than cell culture, sensitive and specific tool for the diagnosis of C. trachomatis infection in the genitourinary tract.
