Clinical reference laboratories can provide diagnostic testing for Chlamydia pneumoniae infections using culture, serology, or molecular methods (see chart below). Currently, there are multiple commercially available systems for the detection of C. pneumoniae infection, including several Food and Drug Administration (FDA)-cleared tests. Real-time Polymerase Chain Reaction (PCR) is the preferred method of diagnostic testing for acute C. pneumoniae infection, assuming the availability of an appropriate specimen type. When additional or specialized testing is necessary, local or state public health laboratories can provide either diagnostic support or forward specimens to CDC.
Advantages, Disadvantages, and Availability of Select C. pneumoniae Diagnostic Methods
|Method||Advantages||Disadvantages||Test Setting||Recommendations 7|
- Combined nasopharyngeal (NP) and oropharyngeal (OP) swabs in viral transfer media (VTM) or universal transfer media (UTM)
- NP swab in VTM/UTM
- OP swab in VTM/UTM
- NP aspirates
- Bronchial lavage (BAL) fluid
- Bronchial washings
- Cerebrospinal fluid
3 CF is not recommended for diagnosis of acute C. pneumoniae infection because of cross-reactivity with other Chlamydia species and other enteric bacteria. Also, the sensitivity for detecting reinfection is low. Whole-inclusion fluorescence tests are also not species-specific and have not been widely evaluated. EIA is not a recommended diagnostic method because of low sensitivity and specificity.
4 MIF is the only species-specific antibody test available that can measure isotype-specific antibody titers to all Chlamydia species simultaneously. However, MIF testing is technically complex and interpretation is subjective.
7 Refer to Standardizing Chlamydia pneumoniae assays: Recommendations from the Centers for Disease Control and Prevention (USA) and the Laboratory Centre for Disease Control (Canada)external icon for further recommendations.
CF – Complement fixation, EIA – enzyme immunoassay, MIF – microimmunofluorescence, qPCR – quantitative polymerase chain reaction, NP – nasopharyngeal, OP – oropharyngeal, CSF – cerebrospinal fluid
- Benitez AJ, Thurman KA, Diaz MH, Conklin L, Kendig NE, Winchell JM. Comparison of real-time PCR and a microimmunofluorescence serological assay for the detection of Chlamydophila pneumoniae infection in an outbreak investigation. J Clin Micro. 2012;50(1):151–3.
- Kumar S, Hammerschlag MR. Acute respiratory infection due to Chlamydia pneumoniae: Current status of diagnostic methods. Clin Infect Dis.2007;44:568–76.
- Dowell SF, Peeling RW, Boman J, et al. Standardizing Chlamydia pneumoniae assays: Recommendations from the Centers for Disease Control and Prevention (USA) and the Laboratory Centre for Disease Control (Canada). Clin Infect Dis. 2001;33:492–502.