Chlamydia Testing in Singapore: Chlamydia testing allows you to check for a chlamydia infection after unprotected sex: condom break, slip, or no condom. The urethra, vagina, anus, and throat can be tested in our private & confidential STD clinic.
Chlamydia trachomatis is an intracellular organism, specimens must include epithelial cells and not exudates alone.
Nucleic acid-based amplification tests (NAAT): most sensitive 90–95%, highly specific, new gold standard; polymerase chain reaction (PCR) can be used to test a range of specimens (urine, urethral, cervical, rectal, pharyngeal).
Females – cervical or vulvo-vaginal swabs are specimens of choice, followed by first void urine (FVU); males – FVU is as sensitive as urethral swabs; care with inhibitors with urine specimens; storing urine overnight at 40C or freeze-thawing may enhance sensitivity of urine specimens.
NAATs may be used for conjunctival, pharyngeal and rectal specimens, although currently unlicensed for these sites; rectal swabs should be obtained via proctoscopy.
Medico legal cases – samples for NAAT should be taken from all the sites where penetration has occurred, a reactive NAAT result must be confirmed using a different NAAT.
Antigen detection methods – Direct Florescent Antigen (DFA) sensitivity 50–90%; enzyme immunoassay (EIA) poor sensitivity 50–70%, specificity >95%, inexpensive, can be used for large numbers of specimens. FVU or urethral swabs can be used for males, endocervical swabs are preferred for women.
Cell culture for chlamydia in McCoy cell monolayers, used to be the gold-standard, it is fairly sensitive (70–80%) and 100% specific, requires stringent cold-chain, costly, very expensive, not readily available anymore.
Giemsa-stained direct smear for the inclusion bodies within infected cells is useful only for ocular infections.
Serological tests are not useful to diagnose acute chlamydial infections because of cross-reactivity between chlamydial species, high prevalence of chlamydia antibodies in high risk populations, and the unpredictability of serological response and changes in titres of IgM and IgG antibodies in acute uncomplicated infections.
Chlamydia antibodies in the blood suggest on ongoing or previous chronic chlamydia infection.
“[Chlamydia] IgG serology should not be routinely performed to diagnose acute [Chlamydia] STIs.”
“Most of the patients that evidenced CT [Chlamydia trachomatis] infection also evidenced CT[Chlamydia trachomatis]-specific antibodies either in semen or in serum.”
“Our results support the potential role of CT [Chlamydia trachomatis] in chronic prostatitis, its importance in diagnosis”
Rubén Darío Motrich, Cecilia Cuffinib, Juan Pablo Mackern Obertia, Mariana Maccionia, Virginia Elena Riveroa. Chlamydia trachomatis occurrence and its impact on sperm quality in chronic prostatitis patients. Journal of Infection Volume 53, Issue 3, September 2006, Pages 175–183
“The presence of serum anti-chlamydial IgG antibodies was demonstrated in 13/42 (30.9%) patients with prostatitis and in 3/36 (8.3%) patients with prostatodynia ( P 0.01). The results suggest that chlamydia may be one of the causative agents of chronic prostatitis.”
Iwona Ostaszewska, Bozena Zdrodowska-Stefanow, Jerzy Badyda, Katarzyna Pucilo, Jadwiga Trybula and Violetta Bulhak. Chlamydia trachomatis : probable cause of prostatitis. Int J STD AIDS 1 June 1998 vol. 9 no. 6 350-353
“Pelvic inflammatory disease (PID) and its chronic sequelae are associated with chlamydial IgG antibody formation in serum, and a correlation between the height of antibody titres and the presence of tubal factor subfertility has been established.”
Land JA, Evers JL. Chlamydia infection and subfertility. Best Practice & Research Clinical Obstetrics & Gynaecology Volume 16, Issue 6 , Pages 901-912, December 2002