1887

Abstract

(, CT) is an obligatory intracellular bacterium that causes urogenital tract infections and leads to severe reproductive consequences. Therefore, a rapid and accurate detection method with high sensitivity and specificity is an urgent requirement for the routine diagnosis of infections.

In this study, we aimed to develop a multiplex quantitative real-time PCR (qPCR) assay based on two target regions for accurate detection of in urogenital tract infections.

Primers and probes based on the conserved regions of the cryptic plasmid and gene were designed. Then, two qPCR assays were established to screen for the optimal probe and primers for each of the two target regions. Subsequently, the multiplex qPCR method was developed and optimized. For the diagnostic efficiency evaluation, 1284 urogenital specimens were tested by the newly developed multiplex qPCR method, an immunological assay and a singleplex qPCR assay widely used in hospitals.

The multiplex qPCR method could amplify both target regions in the range of 1.0×10–1.0×10 copies ml with a strong linear relationship, and lower limits of detection (LODs) for both targets reached 2 copies PCR. For the multiplex qPCR method, the diagnostic sensitivity and specificity was 100.0 % (134/134) and 99.3 % (1142/1150), respectively. For the singleplex qPCR assay, the diagnostic sensitivity and specificity was 88.8 % (119/134) and 100.0 % (1150/1150), respectively. For the immunological assay, the diagnostic sensitivity and specificity was 47.0 % (63/134) and 100.0 % (1150/1150), respectively.

In this study, a multiplex qPCR assay with high sensitivity and specificity for rapid (≤2.0 h) and accurate diagnosis of was developed. The qPCR assay has the potential to be used as a routine diagnostic method in clinical microbiology laboratories.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.001084
2019-10-15
2024-04-18
Loading full text...

Full text loading...

/deliver/fulltext/jmm/68/12/1732.html?itemId=/content/journal/jmm/10.1099/jmm.0.001084&mimeType=html&fmt=ahah

References

  1. Zhong G, Pathogenicity CP-D. Chlamydial Plasmid-Dependent pathogenicity. Trends Microbiol 2017; 25:págs141–152 [View Article]
    [Google Scholar]
  2. Redgrove KA, McLaughlin EA. The role of the immune response in Chlamydia trachomatis infection of the male genital tract: a double-edged sword. Front Immunol 2014; 5:534 [View Article]
    [Google Scholar]
  3. Safarkar R, Mehrabadi JF, Noormohammadi Z, Mirnejad R. Development a rapid and accurate multiplex real time PCR method for the detection Chlamydia trachomatis and Mycoplasma hominis . J Clin Lab Anal 2017; 31:e22126 [View Article]
    [Google Scholar]
  4. Lanjouw E, Ouburg S, de Vries HJ, Stary A, Radcliffe K et al. 2015 European guideline on the management of Chlamydia trachomatis infections. Int J STD AIDS 2016; 27:333–348 [View Article]
    [Google Scholar]
  5. Darville T, Hiltke TJ. Pathogenesis of genital tract disease due to Chlamydia trachomatis. J Infect Dis 2010; 201:S114125 [View Article]
    [Google Scholar]
  6. Black CM, Marrazzo J, Johnson RE, Hook EW, Jones RB et al. Head-To-Head multicenter comparison of DNA probe and nucleic acid amplification tests for Chlamydia trachomatis infection in women performed with an improved reference standard. J Clin Microbiol 2002; 40:3757–3763 [View Article]
    [Google Scholar]
  7. Haggerty CL, Gottlieb SL, Taylor BD, Low N, Xu F et al. Risk of sequelae after Chlamydia trachomatis genital infection in women. J Infect Dis 2010; 201:S134–155 [View Article]
    [Google Scholar]
  8. Buckner LR, Amedee AM, Albritton HL, Kozlowski PA, Lacour N et al. Chlamydia trachomatis infection of endocervical epithelial cells enhances early HIV transmission events. PLoS One 2016; 11:e0146663 [View Article]
    [Google Scholar]
  9. Gottlieb SL, Newman LM, Amin A, Temmerman M, Broutet N. Sexually transmitted infections and women's sexual and reproductive health. Int J Gynaecol Obstet 2013; 123:183–184 [View Article]
    [Google Scholar]
  10. Silins I, Ryd W, Strand A, Wadell G, Törnberg S et al. Chlamydia trachomatis infection and persistence of human papillomavirus. Int J Cancer 2005; 116:110–115 [View Article]
    [Google Scholar]
  11. Quinónez-Calvache EM, Ríos-Chaparro DI, Ramírez JD, Soto-De León SC, Camargo M et al. Chlamydia trachomatis frequency in a cohort of HPV-Infected Colombian women. PLoS One 2016; 11:e0147504 [View Article]
    [Google Scholar]
  12. Peipert JF. Clinical practice. genital chlamydial infections. N Engl J Med 2003; 349:2424–2430 [View Article]
    [Google Scholar]
  13. Watson EJ, Templeton A, Russell I, Paavonen J, Mardh PA et al. The accuracy and efficacy of screening tests for Chlamydia trachomatis: a systematic review. J Med Microbiol 2002; 51:1021–1031 [View Article]
    [Google Scholar]
  14. Black CM. Current methods of laboratory diagnosis of Chlamydia trachomatis infections. Clin Microbiol Rev 1997; 10:160–184 [View Article]
    [Google Scholar]
  15. Jespersen DJ, Flatten KS, Jones MF, Smith TF. Prospective comparison of cell cultures and nucleic acid amplification tests for laboratory diagnosis of Chlamydia trachomatis infections. J Clin Microbiol 2005; 43:5324–5326 [View Article]
    [Google Scholar]
  16. Meyer T. Diagnostic procedures to detect Chlamydia trachomatis infections. Microorganisms 2016; 4:25 [View Article]
    [Google Scholar]
  17. Haralambieva I, Iankov I, Petrov D, Ivanova R, Kamarinchev B et al. Cross-Reaction between the genus-specific lipopolysaccharide antigen of Chlamydia spp. and the lipopolysaccharides of Porphyromonas gingivalis, Escherichia coli O119 and Salmonella newington: implications for diagnosis. Diagn Microbiol Infect Dis 2001; 41:99–106 [View Article]
    [Google Scholar]
  18. Papp JR, Schachter J, Gaydos CA. Pol BVD Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae-2014. MMWR Recomm Rep 2014; 63:1–19
    [Google Scholar]
  19. Nwokolo NC, Dragovic B, Patel S, Tong CYW, Barker G et al. 2015 UK national guideline for the management of infection with Chlamydia trachomatis . Int J STD AIDS 2016; 27:251–267 [View Article]
    [Google Scholar]
  20. Bébéar C, de Barbeyrac B. Genital Chlamydia trachomatis infections. Clin Microbiol Infect 2009; 15:4–10 [View Article]
    [Google Scholar]
  21. Wei H-bo, Zou S-xiao, Yang X-lin, Yang D-qin, Chen X-dong. Development of multiplex real-time quantitative PCR for simultaneous detection of Chlamydia trachomatis and Ureaplasma parvum. Clin Biochem 2012; 45:663–667 [View Article]
    [Google Scholar]
  22. Møller JK, Pedersen LN, Persson K. Comparison of the Abbott RealTime CT new formulation assay with two other commercial assays for detection of wild-type and new variant strains of Chlamydia trachomatis. J Clin Microbiol 2010; 48:440–443 [View Article]
    [Google Scholar]
  23. Mahony JB, Luinstra KE, Sellors JW, Chernesky MA. Comparison of plasmid- and chromosome-based polymerase chain reaction assays for detecting Chlamydia trachomatis nucleic acids. J Clin Microbiol 1993; 31:1753–1758
    [Google Scholar]
  24. Parra-Sánchez M, Palomares JC, Bernal S, González MT, Sivianes N et al. Evaluation of the COBAS 4800 CT/NG test for detecting Chlamydia trachomatis and Neisseria gonorrhoeae DNA in urogenital swabs and urine specimens. Diagn Microbiol Infect Dis 2012; 74:338–342 [View Article]
    [Google Scholar]
  25. Baczynska A, Hvid M, Lamy P, Birkelund S, Christiansen G et al. Prevalence of Mycoplasma genitalium, Mycoplasma hominis and Chlamydia trachomatis among Danish patients requesting abortion. Syst Biol Reprod Med 2008; 54:127–134 [View Article]
    [Google Scholar]
  26. Michel CEC, Saison FG, Joshi H, Mahilum-Tapay LM, Lee HH. Pitfalls of internet-accessible diagnostic tests: inadequate performance of a CE-marked Chlamydia test for home use. Sex Transm Infect 2009; 85:187–189 [View Article]
    [Google Scholar]
  27. Last AR, Roberts Ch, Cassama E, Nabicassa M, Molina-Gonzalez S et al. Plasmid copy number and disease severity in naturally occurring ocular Chlamydia trachomatis infection. J Clin Microbiol 2014; 52:324–327 [View Article]
    [Google Scholar]
  28. Møller JK, Pedersen LN, Persson K. Comparison of Gen-Probe transcription-mediated amplification, Abbott PCR, and Roche PCR assays for detection of wild-type and mutant plasmid strains of Chlamydia trachomatis in Sweden. J Clin Microbiol 2008; 46:3892–3895 [View Article]
    [Google Scholar]
  29. Ripa T, Nilsson P. A variant of Chlamydia trachomatis with deletion in cryptic plasmid: implications for use of PCR diagnostic tests. Euro Surveill 2006; 11:E061109.2 [View Article]
    [Google Scholar]
  30. An Q, Radcliffe G, Vassallo R, Buxton D, O'Brien WJ et al. Infection with a plasmid-free variant Chlamydia related to Chlamydia trachomatis identified by using multiple assays for nucleic acid detection. J Clin Microbiol 1992; 30:2814–2821
    [Google Scholar]
  31. Magbanua JPV, Goh BT, Michel C-E, Aguirre-Andreasen A, Alexander S et al. Chlamydia trachomatis variant not detected by plasmid based nucleic acid amplification tests: molecular characterisation and failure of single dose azithromycin. Sex Transm Infect 2007; 83:339–343 [View Article]
    [Google Scholar]
  32. Stothard DR, Williams JA, Van Der Pol B, Jones RB. Identification of a Chlamydia trachomatis serovar E urogenital isolate which lacks the cryptic plasmid. Infect Immun 1998; 66:6010–6013
    [Google Scholar]
  33. Ripa T, Nilsson PA. A Chlamydia trachomatis strain with a 377-bp deletion in the cryptic plasmid causing false-negative nucleic acid amplification tests. Sex Transm Dis 2007; 34:255–256 [View Article]
    [Google Scholar]
  34. Yeow TC, Wong WF, Sabet NS, Sulaiman S, Shahhosseini F et al. Prevalence of plasmid-bearing and plasmid-free Chlamydia trachomatis infection among women who visited obstetrics and gynecology clinics in Malaysia. BMC Microbiol 2016; 16:45 [View Article]
    [Google Scholar]
  35. Sachse K, Hotzel H, Slickers P, Ellinger T, Ehricht R. DNA microarray-based detection and identification of Chlamydia and Chlamydophila spp. Mol Cell Probes 2005; 19:41–50 [View Article]
    [Google Scholar]
  36. Melendez JH, Huppert JS, Jett-Goheen M, Hesse EA, Quinn N et al. Blind evaluation of the microwave-accelerated metal-enhanced fluorescence ultrarapid and sensitive Chlamydia trachomatis test by use of clinical samples. J Clin Microbiol 2013; 51:2913–2920 [View Article]
    [Google Scholar]
  37. Gottlieb SL, Berman SM, Low N. Screening and Treatment to Prevent Sequelae in Women with Chlamydia trachomatis Genital Infection: How Much Do We Know?. J Infect Dis 2010; 201:156–167 [View Article]
    [Google Scholar]
  38. Schachter J, Stamm WE, Quinn TC. Discrepant analysis and screening for Chlamydia trachomatis. The Lancet 1996; 348:1308–1309 [View Article]
    [Google Scholar]
  39. Dou Y, Li L, Du J, He Y, Chen R et al. Development of a multiplex two-gene real-time PCR assay for accurate detection of Klebsiella pneumoniae . Br J Biomed Sci 2019; 76:42–45 [View Article]
    [Google Scholar]
  40. Gaydos CA, Quinn TC, Willis D, Weissfeld A, Hook EW et al. Performance of the APTIMA Combo 2 assay for detection of Chlamydia trachomatis and Neisseria gonorrhoeae in female urine and endocervical swab specimens. J Clin Microbiol 2003; 41:304–309 [View Article]
    [Google Scholar]
  41. Gaydos CA, Cartwright CP, Colaninno P, Welsch J, Holden J et al. Performance of the Abbott RealTime CT/NG for detection of Chlamydia trachomatis and Neisseria gonorrhoeae. J Clin Microbiol 2010; 48:3236–3243 [View Article]
    [Google Scholar]
  42. Van Der Pol B, Liesenfeld O, Williams JA, Taylor SN, Lillis RA et al. Performance of the COBAS CT/NG test compared to the Aptima AC2 and viper CTQ/GCQ assays for detection of Chlamydia trachomatis and Neisseria gonorrhoeae. J Clin Microbiol 2012; 50:2244–2249 [View Article]
    [Google Scholar]
  43. Jaton K, Bille J, Greub G. A novel real-time PCR to detect Chlamydia trachomatis in first-void urine or genital swabs. J Med Microbiol 2006; 55:1667–1674 [View Article]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.001084
Loading
/content/journal/jmm/10.1099/jmm.0.001084
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error