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Test ID: SCLAM Chlamydia Serology, Serum

Reporting Name

Chlamydia Serology, S

Useful 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: TWAR 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 females, this organism is a cause of pelvic inflammatory disease, salpingitis, and endometritis. In males, 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 [HOLOGIC], 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 titers of 1:512 or more are considered presumptive evidence of current infection.

 

<1:512 and ≥1:64

A single specimen endpoint titer of  from 1:64 to 1:512 should be considered evidence of infection at an undetermined time. A second specimen drawn 10 to 21 days after the original draw 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 titers 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 titers of 1:64 or more are considered presumptive evidence of current infection.

 

<1:64

IgG endpoint titers 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 titers of 1:10 or more are considered presumptive evidence of infection.

 

<1:10

IgM endpoint titers 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 days

Day(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

Serum


Ordering Guidance


 



Specimen Required


Container/Tube: 

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 0.2 mL


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 U.S. Food and Drug Administration.

CPT Code Information

86631 x 3-IgG

86632 x 3-IgM

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

Includes Chlamydophila pneumoniae, Chlamydophila psittaci, and Chlamydia trachomatis.

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Mayo Clinic Laboratories | Microbiology and Infectious Disease Catalog Additional Information:

mml-gisti, mml-respiratoryinfections