Test ID: SCLAM Chlamydia Serology, Serum
Reporting Name
Chlamydia Serology, SUseful For
Aiding in the clinical diagnosis of chlamydial infections
This test is not intended for medical-legal use.
Clinical Information
Members of the family Chlamydiaceae are small, nonmotile, gram-negative, obligate intracellular organisms that grow in the cytoplasm of host cells. Two genera of clinical importance are Chlamydia, which includes Chlamydia trachomatis, and Chlamydophila, which includes Chlamydophila pneumoniae and Chlamydophila psittaci. These organisms share many features of bacteria and are susceptible to antibiotic therapy. They are also similar to viruses, requiring living cells for multiplication.
The chlamydial life cycle can be divided into 2 distinct phases: an extracellular, nonreplicating, infectious stage and an obligate intracellular, replicating, noninfectious stage. The infectious form, or elementary body (EB), attaches to the target cell membrane and enters the cell via a phagosome. After cell entry, the EB reorganizes into reticulate particles (forming inclusion bodies) and binary fission begins. After 18 to 24 hours, reticulate particles condense to form EBs. These new EBs are released, beginning another infection cycle.
C psittaci is the causative agent of psittacosis, a disease characterized by pneumonia, headache, altered mentation, and hepatosplenomegaly. Psittacosis is acquired by airborne transmission from infected birds.
C pneumoniae (formerly known as Taiwan acute respiratory agent and, more recently, as Chlamydia pneumoniae) causes pneumonia in humans. It is unique because it is a primary pathogen of humans, is spread from human to human, and apparently has no animal or bird host. Chlamydophila pneumoniae is responsible for approximately 10% of pneumonia cases.
C trachomatis has been implicated in a wide variety of infections in humans. It is a common cause of nongonococcal urethritis and cervicitis, and many systemic complications of chlamydial infections have been described. In female patients, this organism is a cause of pelvic inflammatory disease, salpingitis, and endometritis. In male patients, epididymitis and Reiter syndrome occur. Lymphogranuloma venereum is a sexually transmitted infection caused by C trachomatis. It presents with a transient primary genital lesion followed by suppurative regional lymphadenopathy. Occasionally, severe proctitis or proctocolitis may develop. C trachomatis also causes ophthalmologic infections, such as trachoma (rare in the United States), adult inclusion conjunctivitis and inclusion conjunctivitis in neonates. These disorders have traditionally been diagnosed by cytologic detection or culture. However, molecular detection methods (CTRNA / Chlamydia trachomatis by Nucleic Acid Amplification, Varies) may now represent a more sensitive diagnostic approach.
Fitz-Hugh-Curtis syndrome (perihepatitis) has been associated with chlamydiae.
Interpretation
IgG:
Chlamydophila pneumoniae
≥1:512
IgG endpoint titer results of 1:512 or more are considered presumptive evidence of current infection.
<1:512 and ≥1:64
A single specimen endpoint titer result of 1:64 to 1:512 should be considered evidence of infection at an undetermined time. A second specimen collected 10 to 21 days after the original collection should be tested in parallel with the first. If the second specimen exhibits a titer 1:512 or more or a 4-fold increase over that of the initial specimen, current (acute) infection is indicated. Unchanging titers from 1:64 to 1:512 suggest past infection.
<1:64
IgG endpoint titer results below 1:64 suggest that the patient does not have a current infection. These antibody levels may be found in patients with either no history of chlamydial infection or those with past infection whose antibody levels have dropped below detectable levels.
Chlamydophila pneumoniae antibody is detectable in 25% to 45% of adults tested.
Chlamydophila psittaci and Chlamydia trachomatis
≥1:64
IgG endpoint titer results of 1:64 or more are considered presumptive evidence of current infection.
<1:64
IgG endpoint titer results below 1:64 suggest that the patient does not have a current infection. These antibody levels may be found in patients with either no history of chlamydial infection or those with past infection whose antibody levels have dropped below detectable levels.
IgM
Chlamydophila pneumoniae, Chlamydophila psittaci, and Chlamydia trachomatis
≥1:10
IgM endpoint titer results of 1:10 or more are considered presumptive evidence of infection.
<1:10
IgM endpoint titer results below 1:10 suggest that the patient does not have a current infection. These antibody levels may be found in patients with either no history of chlamydial infection or those with past infection whose antibody levels have dropped below detectable levels.
Report Available
Same day/1 to 4 daysDay(s) Performed
Monday through Friday
Clinical Reference
1. Movahed MR: Infection with Chlamydia pneumoniae and atherosclerosis: a review. J South Carolina Med Assoc. 1999;95:303-308
2. Smith T: Chlamydia. In: Schmidt N, Emmons R, eds. Diagnostic procedures for viral, rickettsial and chlamydial infections. 6th ed. APHA; 1989: 1165-1198
3. Sheffield PA, Moore DE, Voigt LF, et al: The association between Chlamydia trachomatis serology and pelvic damage in women with tubal ectopic gestations. Fertil Steril. 1993;60:970-975
4. Batteiger BE, Tang M: Chlamydia trachomatis (trachoma and urogenital infections). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:2301-2319
5. Schlossberg D: Psittacosis (due to Chlamydia psittaci). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:2320-2322
6. Hammerschlag MR, Kohlhoff SA, Gaydos CA: Chlamydia pneumoniae. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:2323-2331
Method Name
Micro-Immunofluorescent Antibody (MIF) Assay
Specimen Type
SerumOrdering Guidance
Specimen Required
Supplies: Sarstedt 5 mL Aliquot Tube (T914)
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 0.2 mL
Collection Instructions: Centrifuge and aliquot serum into plastic vial.
Specimen Minimum Volume
0.15 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 30 days | |
Frozen | 30 days |
Reference Values
Chlamydophila pneumoniae
IgG: <1:64
IgM: <1:10
Chlamydophila psittaci
IgG: <1:64
IgM: <1:10
Chlamydia trachomatis
IgG: <1:64
IgM: <1:10
Test Classification
This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
86631 x 3
86632 x 3
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
SCLAM | Chlamydia Serology, S | 77166-7 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
185 | C. pneumoniae IgG | 6913-8 |
186 | C. pneumoniae IgM | 6914-6 |
190 | C. trachomatis IgG | 6919-5 |
191 | C. trachomatis IgM | 6920-3 |
187 | C. psittaci IgG | 6916-1 |
188 | C. psittaci IgM | 6917-9 |
Testing Algorithm
This test includes Chlamydophila pneumoniae, Chlamydophila psittaci, and Chlamydia trachomatis.
Forms
If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.
mml-gisti, mml-respiratoryinfections