Standardizing Chlamydia pneumoniae assays:: Recommendations from the Centers for Disease Control and Prevention (USA) and the Laboratory Centre for Disease Control (Canada)
Standardizing Chlamydia pneumoniae assays:: Recommendations from the Centers for Disease Control and Prevention (USA) and the Laboratory Centre for Disease Control (Canada)
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DOI：
10.1086/322632
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发表时间：
2001-08-15
影响因子：
11.8
通讯作者：
Apfalter, P
中科院分区：
文献类型：
--
作者：
Dowell, SF;Peeling, RW;Apfalter, P
肺炎衣原体与动脉粥样硬化和其他几种慢性疾病有关，但不同实验室的报告差异很大，缺乏“金标准”，这导致人们呼吁采用更标准化的诊断检测方法。利用该领域的领先研究人员，我们回顾了血清学检测、培养、DNA扩增和组织诊断的可用方法，以提出具体建议。关于血清学检测，建议仅使用微量免疫荧光法，提出了“急性感染”和“既往暴露”的标准化定义，不鼓励使用单一免疫球蛋白（IG）G滴度确定急性感染，使用伊加确定慢性感染。阳性培养结果的确认需要分离株的繁殖或使用聚合酶链反应（PCR）进行确认。已发表报告中描述的18种PCR检测中有4种符合拟定验证标准。为了避免免疫组化染色的假阳性结果，需要更一致地使用对照抗体和组织，并提高识别染色伪影的技能。这些标准应适用于今后的调查，并按规定定期修改。
Chlamydia pneumoniae has been associated with atherosclerosis and several other chronic diseases, but reports from different laboratories are highly variable and "gold standards" are lacking, which has led to calls for more standardized approaches to diagnostic testing. Using leading researchers in the field, we reviewed the available approaches to serological testing, culture, DNA amplification, and tissue diagnostics to make specific recommendations. With regard to serological testing, only use of microimmunofluorescence is recommended, standardized definitions for "acute infection" and "past exposure" are proposed, and the use of single immunoglobulin (Ig) G titers for determining acute infection and IgA for determining chronic infection are discouraged. Confirmation of a positive culture result requires propagation of the isolate or confirmation by use of polymerase chain reaction (PCR). Four of 18 PCR assays described in published reports met the proposed validation criteria. More consistent use of control antibodies and tissues and improvement in skill at identifying staining artifacts are necessary to avoid false-positive results of immunohistochemical staining. These standards should be applied in future investigations and periodically modified as indicated.