Article

Chlamydia trachomatis (CT)

Leading the charge against “silent” CT infections

With 127 million new infections per year, Chlamydia trachomatis (CT) is one of the most common sexually transmitted infections (STIs).1

The majority of CT cases do not present with symptoms, making management of these bacterial infections a challenge. Undiagnosed and untreated, CT may result in complications that affect the urethra, cervix, uterus, and prostate. CT is also a known cause of tubal factor infertility.2

Chlamydia is generally curable with existing, effective single-dose regimens of antibiotics, but has shown early signs of resistance.3 Diagnostic testing is an important strategic tool to help mitigate the impact of the disease, and stave off the potential consequences from a drug-resistant form of the bacteria.

laboratory worker using cobas 6800 system
See through the noise on silent infection detection

While a number of diagnostic options are available for screening CT, not all tests and technologies are appropriate.

The replication of CT in infected host cells is varied (often low), requiring a high sensitivity approach to obtain a reliable result. Rapid antigen-based tests are no longer recommended due to low sensitivity, and serology tests would be more appropriate for diagnosing chronic versus acute infections.4,5

Nucleic acid amplification tests (NAAT) using molecular polymerase chain reaction (PCR) technology has replaced culture as the diagnostic gold standard for chlamydia detection. The enhanced sensitivity provides better accuracy which not only helps to reduce the prevalence but also improves understanding of the infection.

A well-designed CT assay should have no need for confirmatory testing, resulting in higher clinician confidence in NAAT generated results.

Robust testing and technology

Roche introduced the first-ever FDA-cleared PCR test for CT in 1993. Since then, the assay has been continually developed, along with the respective analytical solutions—gaining significant advances in and accuracy, plus the ability to test for multiple sexually transmitted infections on one platform using a single sample.

This enhanced diagnostic sensitivity, improved flexibility, and reduced human error due to automation will enable technicians to work more efficiently while empowering clinicians to make CT testing a more routine part of patient care.

 

  1. World Health Organization. Sexually transmitted infections. https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis). Accessed August 17, 2020.
  2. Centers for Disease Control and Prevention. Chlamydia – CDC Fact Sheet (Detailed). https://www.cdc.gov/std/chlamydia/stdfact-chlamydia-detailed.htm. Accessed August 17, 2020.
  3. Sandoz KM, Rockey DD. Antibiotic resistance in Chlamydiae. Future Microbiol. 2010;5(9):1427-1442. doi:10.2217/fmb.10.96
  4. Abbai-Shaik NS, Reddy T, Govender S, Ramjee G. Poor Performance of the Chlamydia Rapid Test Device for the Detection of Asymptomatic Infections in South African Men: A Pilot Study. J Sex Transm Dis. 2016;2016:8695146. doi:10.1155/2016/8695146
  5. Centers for Disease Control and Prevention. Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae—2014. MMWR Recomm Rep. 2014;63(RR-02):1-19.