Recent developments in the laboratory diagnosis of chlamydial infections

There are two main approaches to diagnosing infections by Chlamydia and Chlamydophila spp. in mammals and birds. The first involves the direct detection of the agent in tissue or swab samples, while the second involves the serological screening of blood samples for the presence of anti-chlamydial antibodies. Ultimately, the test that is used is dependent on the types of samples that are submitted to the diagnostic laboratory for analysis. The present paper gives an overview on methodologies and technologies used currently in diagnosis of chlamydial infections with emphasis on recently developed tests. The performance characteristics of individual methods, such as the detection of antigen in smears and in pathological samples, the isolation of the pathogen, various antibody detection tests and DNA-based methods utilising conventional and real-time PCR, as well as DNA microarray technology are assessed, and specific advantages and drawbacks are discussed. Further, a combination of a specific real-time PCR assay and a microarray test for chlamydiae is proposed as an alternative reference standard to isolation by cell culture. (C) 2008 Elsevier B.V. All rights reserved.