Chlamydia in women and men occurs not only as a lesion of the genitourinary system, but can also affect the eyes, lungs, and mucous membranes. To detect the pathogen, or the body's immune response to its introduction, systemic research methods are needed. One of them is a blood test for chlamydia.

Contrary to popular belief, chlamydial infection can be transmitted not only sexually, but also through household contact, within the family, especially in young children. The causative agent of chlamydia itself, Chlamydia trachomatis, is not even a bacterium, but an intermediate microorganism between bacteria and viruses.

Moreover, its extremely small size, constituting a fifth of a thousandth of a millimeter (0.2 microns), allows chlamydia in some cases to pass unhindered through the pores of mechanical contraceptive devices, which are made in violation of technical standards. To put it simply, chlamydia penetrates through intact condoms.

Quite often, after a short period of severe symptoms, or a manifest form of chlamydia, which is manifested by urethritis, conjunctivitis, proctitis, cervicitis, generalization of the infection occurs, and the nature of the lesion becomes systemic. The classic triad is Reiter's syndrome, or articular-oculo-genital syndrome, with damage to large joints, eyes and genitals. But in this case, it is still possible to determine the infection with a greater probability, since the patient has pronounced complaints that fit into a certain syndromic picture.

But with asymptomatic forms of chlamydia, great diagnostic difficulties arise. with chlamydia, it is uninformative, just like. In urine tests, everything is also within normal limits, if the secondary bacterial and pyogenic flora did not join. Therefore, very often, and especially women, are treated for a long time and unsuccessfully by gynecologists for chronic endometritis and salpingitis, with frequent forms of ectopic pregnancy, in case of recurrent miscarriage. Men often have chronic prostatitis and other complications.

Chlamydia blood tests: PCR and immunoglobulins

This can be important in the early stages of primary infection with chlamydia, when antibodies are absent at all, or have not reached diagnostically significant titers, or in the presence of severe forms of immunodeficiency, for example, while taking hormonal drugs, immunosuppressive drugs, or during the course of HIV infection.

In addition to a blood test for chlamydia, it can determine the presence of the pathogen in any biological fluid and substrate, from discharge from the genital tract to cerebrospinal fluid. But still, before donating blood right away, you need to take care of identifying this microorganism in the intended place of initial penetration, most often by examining the discharge from the genital tract. In women, this can be a normal smear, and in men, the most informative is either urethral scraping, or PCR - an analysis taken from the seminal fluid, from the ejaculate.

It is possible to determine in a blood test not only the pathogens themselves, but also to identify the body's immune response to chlamydia using or. With a picture of primary and acute chlamydia, for example, with acute urethritis in men against the background of normal tension of immunity, antibodies of the acute phase are most often detected, or already 3-5 days after the alleged infection.

Also, for an acute infection, after two to three weeks, the titer rises, usually 4 times the norm. These two tests (PCR and immunoglobulins) must be done together. In the event that you donate blood for chlamydia, but mean only donating antibodies, then when they are detected, this does not mean at all that you are sick. You could have suffered chlamydia for a long time, defeat it and recover. In this case, the circulation of antibodies of class G in an increased titer remains for life.

Indications: when to donate blood for chlamydia?

Since chlamydial infection is very diverse, it is difficult to find two or three general criteria for prescribing tests. But, nevertheless, it is possible to identify the main symptoms in which people who have an active sex life need to pass blood tests for chlamydia with their subsequent decoding. These are conditions and diseases such as:

• pain and burning when urinating, dysuric disorders and symptoms of urethritis;
• inflammation of the rectal mucosa, pain and burning, pain in the anus, signs of proctitis;
• chronic and difficult to treat sore throats, sore throat, symptoms of pharyngitis, especially in people who practice non-traditional forms of sexual intercourse;
• cervicitis and inflammatory diseases of the female genital organs, including those arising during pregnancy;
• for prevention, blood tests for chlamydia can be performed with frequent and unprotected sexual intercourse, as well as with frequent change of sexual partners.

If you suspect the systemic spread of chlamydia and lesions of the bronchopulmonary system, it is necessary to conduct a study with:

• the appearance of a prolonged and persistent cough against the background of a slight increase in temperature, or subfebrile condition;
• the presence of pneumonia, which stubbornly does not want to be treated with antibiotics;
• just in the presence of prolonged and persistent fever at subfebrile numbers.

In children, the suspicion of chlamydia can be confirmed when symptoms of bronchiolitis appear. Bronchiolitis is a bronchitis with damage to the deeply located smallest bronchi, which have a large area, are the terminal section of the bronchial tree, and are directly adjacent to the alveolar section, in which gas exchange occurs. It is also important to identify possible chlamydial infection with eye damage in newborns, along with symptoms of treatment-resistant childhood pneumonia.

Delivery of analyzes and interpretation of results

How to donate blood for chlamydia? And in the case of PCR, and in the study of various immunoglobulins, no special conditions for delivery need not be met. The main condition is at least 4 hours of fasting after meals. Therefore, blood tests for chlamydia can be taken in the morning on an empty stomach, after a night's sleep, under normal conditions.

What test results can be obtained normally, and what is their interpretation in case of illness with various forms of chlamydia?

PCR

When performing a polymerase chain reaction in real time, a qualitative response is given, which indicates whether the pathogen is found in the blood plasma or there are no traces of it. Accordingly, in the first case, it is definitely possible to diagnose chlamydia infection, and in the second, it may be both the absence of chlamydia and the presence of an extremely small number of pathogens, which is below the capabilities of the method, but this is an unlikely result.

With positive PCR values, a diagnostic search is carried out in the future to determine the primary localization of the pathogen. Since the presence of chlamydia in the blood means only the fact that they have overcome the histohematological barrier, they could get into the blood from anywhere: from the oropharynx, from the urethra, from the anus, or from the lungs, depending on where the primary focus of the pathogen was introduced into organism.

Antibodies - immunoglobulins of classes M, G, A

In an acute process, antibodies of class M appear first in the body. This indicates an early period, or a case of exacerbation of chronic chlamydial infection. How can these two states be distinguished?

• If a high titer is combined with low titers, then this indicates primary infection and the freshness of the infectious process;
• If a high titer of immunoglobulin M coincides with an increased titer of immunoglobulins G, then this indicates chronicity.

In some cases, a secretory blood test is performed. Their task is to protect various mucous membranes from deeper penetration of chlamydia so that they do not appear in the blood. These antibodies are also a marker of acute infection, or exacerbation of a chronic process. The term of their appearance is a few days from the moment of primary infection with chlamydia. Of course, it is best to take class A immunoglobulins directly from the mucous membranes, since it is there that their concentration is highest, but they are completely determined by their peripheral blood.

After infection, the maximum value of immunoglobulins A appears within a month, and after three months their titer decreases. Facts such as reinfection and exacerbation of the chronic process again cause an increase in the titer of these antibodies. If chlamydia enters the bloodstream, the titer of these antibodies decreases, since the immune defense of the mucous membranes is broken, and in superficial forms of the disease, when the histohematogenous barrier has not yet been broken, these class A secretory immunoglobulins are produced throughout the entire period of the disease, which can be distinguished in the test results.

"Long-term" immunoglobulins of class G are called a marker of a long-term, or already transferred infection. Given the previous data, you yourself can easily decipher the various options for their interpretation. On average, Ig G appears in the blood 2.5 weeks after the pathogen enters the body. But the activity of the immunity caused by these antibodies is unstable.

After recovery, antibodies can circulate in the blood, sometimes for years, and sometimes for life. If the chronic process proceeds with very low activity, or the patient has recovered, then their titer decreases. With exacerbations of the process, the titer increases again, and in the case of a fourfold increase in the values, we can confidently speak of the reactivation of the process.

In conclusion, it should be said about the form of issuing the test results. Many patients are accustomed to the fact that the pathology, and the interpretation of the norm, is issued in the form of a table - numerical values. This is not the case with chlamydia. PCR is a qualitative reaction that gives the answer "yes, detected" or "no, not detected." For antibodies, there are three options: the result is negative, doubtful and positive.

This is quite enough for diagnosis, but also in the test results a special value can be given, which is called the "positivity coefficient". This factor shows how close the patient sample results are to the thresholds at which antibodies can be detected at all. The further this coefficient is from the threshold value, the greater the reliability of the study. This coefficient can only confirm the doctor's confidence that the patient does not have a false positive reaction, since the positivity rate is quite high.

Currently, chlamydial infections are considered not only a medical, but also a social problem. This is due to the negative influence of bacteria on the reproductive system of women. Lack of the required treatment or the use of inadequate therapy can lead to complications during pregnancy and childbirth, as well as have a detrimental effect on the intrauterine formation of the fetus. Analysis for the prevailing strains of chlamydia in women is a prerequisite during pregnancy. Timely treatment will avoid many problems and prevent the harmful effects of infection on the body.

Timely tests for chlamydia will prevent the development of the disease and complications

What are the tests for?

Laboratory studies are the only medically reliable method for detecting chlamydia. At the early stages of development, chlamydia proceeds against the background of an almost complete absence of a clinical picture, but minor manifestations of the disease are not excluded, which can disturb a woman both constantly and systematically.

They are an integral part of pregnancy planning and preparation for childbirth. This is due to the risk of the detrimental effect of chlamydial infections on the condition of women and the formation of the fetus. In addition, the development of concomitant infectious diseases against the background of chlamydia is not excluded.

During pregnancy, women are tested for chlamydia, regardless of whether there is a suspicion of chlamydia

Important! In order to obtain the most reliable research results, some women take several types of tests. The combination of two or more research methods allows you to get a more complete picture regarding the presence of chlamydial infection and the virus strain.

Types of laboratory research

Often, chlamydia occurs against the background of the absence of disturbing symptoms, which complicates timely diagnosis. But despite the absence of signs, chlamydia in women, especially, can lead to serious consequences. That is, research is recommended as a preventive measure. Among the most reliable and frequently used are the following types of research:

• Smear. This method is one of the most frequently used methods for diagnosing chlamydia. Samples of biological fluids taken from the surface of the genitals are used as research subjects. A significant disadvantage of this method is a large number of false results.

If chlamydia is suspected, smear analysis is performed

• Polymerase chain reaction. One of the most reliable methods for diagnosing chlamydia in the laboratory. Allows you to get positive results even in the early stages of infection. A significant disadvantage of this method is the pain and trauma of the procedure.
• Bacteriological research method. Due to the specificity of the analysis, not only the detection of chlamydia is available, but also the determination of the sensitivity of the bacterial strain to antibiotic drugs, which greatly simplifies the process of choosing a drug.
• Linked immunosorbent assay. Most accurate research method, categorized as newest methods. ELISA allows not only to determine the presence or absence of chlamydial infection, but also to identify the degree of infection and the category of the bacterial strain.
• Mini test. Such testing can also be done at home. However, it is possible to obtain a false negative or, on the contrary, a false positive result. The method is the least reliable of the others.

Sowing can accurately tell about the presence of chlamydia

• Culture analysis or inoculation method. Differs in high reliability and is carried out exclusively in laboratory conditions.

Analysis for chlamydia as part of a preventive examination plays an important role. This is due to the fact that chlamydia is often asymptomatic. Tissue samples, blood, urine and other biological fluids can serve as research material.

Chlamydial infections are a group of infectious diseases caused by chlamydia. Bacteria of this kind affect the organs of the genitourinary, respiratory, cardiovascular, visual, musculoskeletal systems.

A blood test for chlamydia is performed using venous blood, which is taken in the morning on an empty stomach.

Indications for analysis for chlamydia

Examination for chlamydia is indicated in the following cases:

• preventive examination;
• signs of a genital infection;
• planning pregnancy;
• a history of complicated pregnancy;
• obstetric registration;
• inflammatory diseases of the genitourinary organs;
• absence of pregnancy for 2-3 years of regular sex life;
• monitoring the effectiveness of therapy for chlamydia;
• persons whose sexual partners have chlamydia.

Types of tests for chlamydia

Chlamydia diagnosis is carried out in several directions.

Culture analysis

Study of the biomaterial using inoculation, isolation of the culture of the pathogen and determination of its sensitivity to antibiotics. During the analysis, the chlamydial isolate is used to infect sensitive cells. Then a growth medium is added to them, which contains an antibiotic. Infected cell cultures are incubated at +36 ° C for five days. Antibiotic sensitivity is determined depending on the suppression of infection. Sowing on chlamydia is used to assess the effectiveness of antibacterial treatment; the disadvantages of the method include the laboriousness of the process and the duration of preparation.

Cytological examination of a smear

The method is informative only in acute forms of the disease. Epithelial scrapings serve as clinical material for research. In the course of the study, the biomaterial is exposed to fixing agents and staining. Under the influence of reagents, drugs are detected under a light microscope.

The results of the study are individual for different types of infection; only a doctor should deal with their interpretation and determination of the nature of the treatment.

Immunofluorescence reaction (RIF)

Identification of chlamydial antigens using a fluorescent microscope. The method is based on the property of antibodies to differ from each other by the brightness of the luminescence, while the inclusions of chlamydia stand out against the background of the cytoplasm of the cells. This method is not sensitive enough in the asymptomatic course of the disease.

Immunoassay (ELISA)

A method based on the detection of specific antibodies to chlamydia in the test samples. Allows you to determine the phase of the disease, to evaluate the effectiveness of antibacterial treatment. Thus, the production of IgM antibodies to Chlamydia trachomatis is a marker of the acute stage of the process. With the progression of the disease and its transition to a chronic form, IgA antibodies appear, then IgG.

The decoding of the enzyme immunoassay is presented in the table.

Polymerase chain reaction (PCR)

A method for identifying DNA fragments of the pathogen, which allows you to confirm the presence of a foreign microorganism in the body with an accuracy of 90-95% and determine what kind of microorganism it is. Samples of tissue, blood, urine and other biological fluids can be taken for analysis. In women, epithelial scrapings are taken from the vagina, urethra, cervix. In men, a smear from the urethra, prostate secretions, ejaculate are used. If the eyes are affected, scraping from the conjunctiva is examined. To exclude rheumatic lesions of the osteoarticular system, the articular fluid is examined.

Special devices are used - amplifiers for DNA multiplication. When the amount of DNA is sufficient, it is determined whether the sample contains DNA fragments characteristic of the infectious agent. Evaluation is carried out by electrophoresis or using labeled DNA fragments. Normally, the genetic material of chlamydia is not found.

Chlamydiae are intermediate between viruses and bacteria.

The PCR result can be positive or negative. A quantitative assessment in dynamics allows you to determine the activity of the pathogen and the effectiveness of the therapy.

Express diagnostics

For express diagnostics, immunochromatographic tests are used, the action of which is based on the use of fluorescent markers, while the presence of chlamydia DNA in the sample is determined already in the reaction tube.

To identify chlamydia allows an integrated approach. It is important to consider how much analysis is done. As a rule, after receiving the results of PCR (usually ready 4 days after delivery), additional studies are prescribed - culture culture and enzyme immunoassay. The results of the study are individual for different types of infection; only a doctor should deal with their interpretation and determination of the nature of the treatment.

Preparation for analysis for chlamydia

How is the material taken for research and how to pass it correctly?

A blood test for chlamydia is performed using venous blood, which is taken in the morning on an empty stomach.

Preparation for the study includes abstaining from alcohol, fatty and salty foods, smoking for a day. It is recommended not to urinate for several hours before taking a biological sample from the urethra.

Before the culture study, it is necessary to stop taking antibiotics and uroseptic drugs for 30 days. In immunocytological studies, antibacterial drugs are canceled in 14 days.

On the eve of PCR, women are advised to abandon douching, hygiene procedures with antibacterial soap, and the use of vaginal suppositories. Before collecting material, men need to stop using medicines to increase potency.

Tissue samples, blood, urine and other biological fluids can serve as material for research on chlamydia.

Chlamydia and chlamydia

Three types of chlamydia infect humans - C. trachomatis, C. Psittaci and C. pneumoniae. The localization of the pathological process depends on the type of bacteria. Chlamydia trachomatis causes the urogenital form of chlamydia.

According to the characteristics of the genetic material, there is a similarity with mycoplasma, ureaplasma and Haemophilus influenzae.

Infection routes:

• sexual - with unprotected sexual intercourse;
• vertical (from mother to newborn baby) - infection of the fetus through the placenta during pregnancy or during childbirth;
• contact-household - through common household items, kisses.

The significant prevalence of chlamydial infection is explained by the asymptomatic nature of the course of the disease. The appearance of the first clinical signs and the development of symptoms (vitreous discharge from the urethra, itching, pain and stinging during urination, temperature drops, signs of intoxication) depends on the state of immunity. After a while, the symptoms of chlamydia usually disappear, the disease goes into a chronic stage with periods of exacerbation. This form of infection is called persistent.

Today, there are many methods aimed at detecting chlamydia. Each of them has its positive and negative sides. The main disadvantage of most of these methods is the lack of 100% accuracy in the results obtained. Although this disadvantage can be compensated for by passing several types of tests.

The gold standard for testing for chlamydia is cultural method. It takes about 7 days to complete and is relatively expensive. However, thanks to this diagnosis, the doctor can accurately determine the type of genital infection, its concentration in the body and the list of antimicrobial drugs to which this infection is sensitive.

When should you get a blood test for chlamydia?

The considered analysis is relevant to hand over in the presence of the following pathological conditions:

1. Pain in the lower abdomen and / or lower back; mucopurulent discharge; burning of the mucous membrane of the labia. These violations can be combined with an increase in body temperature, frequent urge to urinate.
2. Inflammation in the organs of the reproductive system: urethritis, epididymitis, prostatitis, cervicitis (including during childbearing), etc.
3. Frequent inflammation of internal organs and systems, joints: conjunctivitis, arthritis, pneumonia, encephalopathy.
4. Inability to conceive / carry a child.
5. Ectopic pregnancy.

Checking for chlamydia is also shown in the following cases:

• Upon completion of treatment measures aimed at eliminating sexual infection.
• At the planning stage of pregnancy.
• During the preparation of the patient for surgical intervention on the organs of the genitourinary system.
• With unprotected / accidental intercourse.

How to prepare for the test for chlamydia?

If at the time of preparation for checking the body for chlamydia, the patient is taking any medications, he should notify your doctor about it.

Biomaterial of the patient is examined in special laboratories, and its delivery takes place directly in medical institutions.

To make the research results as accurate as possible, you must adhere to the following rules:

1. 48 hours before the test you need to minimize the amount of spicy and fatty foods, exclude alcohol. You should also refrain from sexual intercourse.
2. With antibiotic treatment this analysis is not performed.
3. If the studied biomaterial is blood , the patient should stop smoking on the day of sample collection. Another important point is the elimination of stressful situations before diagnosis.
4. When passing urine it is important for patients to remember several nuances: the test portion should be in the morning; collect the "average urine" in the container; for diagnostics, 50 ml is required. urine. Before taking the biomaterial, it is necessary to rinse the external genitals with warm water, without resorting to any detergents.
5. Give a smear to women need at least 5 days after the end of menstruation. Men should not urinate at least 60 minutes before taking a smear.

How is material submitted for research?

To date, there are several methods for determining chlamydia:

• Common smear from the urethra or female genital tract . The sampling of biomaterial is carried out, respectively, by a urologist or a gynecologist. The main instrument is a small medical brush, through which secretions are extracted from the prostate / urethra in men, or from the genital tract / cervix in women. It takes 2 days to get the result, and due to its painlessness, simplicity and accessibility, this analysis is very popular. Although it is not considered reliable: its accuracy is limited to 20%.
• Immunofluorescence reaction (RIF) provides for the collection of secretions from the urethra, which are further stained and examined under a special microscope. When carrying out this diagnosis, a lot of biomaterial is required, and the accuracy of the result obtained is limited to 70%. In general, if the sampling of the material and the decoding of the result are entrusted to professionals, RIF can be attributed to one of the best ways to detect chlamydia.
• Immunoassay (ELISA) ... Using the method under consideration, it is possible to clarify the presence and stage of the disease. The test material can be venous blood or a scraping smear from the urethra, cervix. When taking epithelial cells from the urethra, the patient should refrain from urinating at least an hour before the analysis. The accuracy of this test is relatively high (more than 60%), but ELISA is often combined with other methods for diagnosing chlamydia.
• The most informative method that allows you to identify the disease even if there are several chlamydia in the sample taken. The main disadvantage of PCR is the high cost and laboriousness of the analysis. Not every clinic can afford to buy the equipment necessary for research. As a biomaterial, secretions from the genital tract, the first portion of urine, endometrial tissue or ovum can be used.
• Cultural method ... In the diagnosis of the ailment in question, this method is a kind of gold standard. Thanks to him, you can confirm or deny the diagnosis, as well as determine the tactics of treatment. This analysis can take up to 7 days: the removed cells are placed in a special growth medium, after which they are incubated for several days.

Deciphering the results - norms and deviations

On average, the interpretation of analyzes takes 2-3 days. Some medical institutions, for a fee, can provide the results of the examination several hours after the sampling of the biomaterial.

An exception is the culture method.: Diagnosis in this case takes several days.

Let's consider in more detail the interpretation of analyzes for each method:

• ELISA

Depending on the amount of IgG, IgM, IgA antigens, the doctor can diagnose four stages of chlamydia:

1. Sharp... The IgG indicator will vary within 100-6400, IgA - 50-1600, IgM - 50-3200.
2. Chronic... In this case, IgG titers will be 100-1600, IgA - 0-50, IgM - 50-200.
3. Acute stage of chronic chlamydia... IgG titers can reach 51200 (but not less than 100), IgA - 50-400, IgM - up to 50.
4. Recovery... The IgG indicator will vary within 100-400, IgA and IgM - no more than 50.

• PCR

In the form with the results of studies of biomaterials for chlamydia by means of the specified method, only “found” or “not found” will appear.

• Interpretation of analyzes by means of the culture method

Will include the following information:

1. The exact name of the pathogen.
2. Concentration of microorganisms in a milliliter of blood (CFU / ml). With results over 103 CFU / ml, the doctor states the development of an inflammatory process in the body, which is caused by chlamydia.
3. The list of antibiotics that will be effective in the treatment of the ailment in question. Next to the name of antibiotics to which chlamydia is sensitive will be the letter S. Drugs to which chlamydia has "immunity" will be designated by the letter R.

In cases where a short period of time has passed after the positive effect of antibiotic therapy, false positive diagnostic results may occur.

This is due to the fact that the body contains single cells of pathogenic microorganisms.

In addition, the presence of IgA, IgM, IgG titers in the blood serum may indicate the development of other genital infection (for example, staphylococcus).

To obtain more reliable information, it is better to pass several types of tests for chlamydia.

False negative results can be obtained in the following cases:

1. A short period passed after infection: the body did not have time to develop antibodies against the introduced bacteria.
2. The terms and conditions of storage of the samples taken for research were not observed.

Everyone knows what flu is. Everyone more or less knows how to behave if an infection occurs, and what drugs can help. Only a few will be able to tell about what chlamydia is. And even about what symptoms this disease has and how dangerous it is - and even less. Meanwhile, chlamydia is the second most common infectious disease after influenza. If you ignore its manifestations, you can cause serious and even irreparable harm to health.

What is chlamydia and when is it worth getting tested

Chlamydia is a sexually transmitted disease caused by chlamydia - Chlamydia trachomatis ... The infection affects the urethra, rectum, vagina, cervix, and even the eyes (with orogenital contact or through household items). In most cases, infection occurs during sexual intercourse, less often in a household way. A vertical mode of transmission of infection (from mother to child), including transplacental, is also likely.

The incubation period lasts about two weeks. At this time, infectious agents are incorporated into healthy cells and begin to multiply actively. Symptoms of infection appear at 2-3 weeks, they are expressed in the discharge from the urethra in men and from the vagina in women, there is pain when urinating. In addition, women feel a pulling pain in the lower abdomen and may experience intermenstrual bleeding.

note
In 50–70% of cases, chlamydia is asymptomatic and is diagnosed only when a couple comes to the doctor with a complaint of inability to conceive a child.

If the symptoms of the disease did not arise or if they were ignored, then the disease becomes chronic. In women, chlamydia causes inflammatory processes in the pelvic organs and abdominal cavity, adhesions form in the fallopian tubes, which subsequently become the cause of female infertility. In men, chlamydiae cause inflammation of the epididymis - epididymitis, which threatens infertility and impotence.

An analysis for chlamydia must be passed if the symptoms described above appear, as well as if there was sexual contact, unprotected by a barrier method of contraception, with a person whose health condition is unknown.

What tests to take to determine chlamydia

For analysis, take blood, urine or a smear - it depends on the type of study. What they are and what are the features of each - we will consider further.

• Express test
  You can buy such a test at a pharmacy and do it yourself at home. The material for the study is urine; in women, a smear is also acceptable. The biomaterial is placed on a cassette and observed - one or two red-violet stripes will appear. The test is based on the detection of lipopolysaccharide antigen (LPS). The accuracy of the express test does not exceed 20%, therefore it is recommended to contact the clinic to obtain a reliable result.
• Cytoscopic method
  For the analysis, a urethral smear is taken from men and a cervical smear from women. The biomaterial is distributed on a glass slide, dried and immersed in methanol or acetone, and then examined under a microscope. Thus, in the smear, they are trying to identify cytoplasmic cells-inclusions of Halberstedter-Provachek, indicating chlamydia. This method is reliable, but it is effective only for detecting infection in the acute stage. In a chronic form, the disease can proceed without the presence of inclusion cells, which means that it will not be fixed.
• ELISA
  The enzyme-linked immunosorbent assay assumes a search for chlamydia antigens (IgG, IgA, IgM) in the venous blood. With the help of ELISA, you can diagnose a disease, identify its pathogen, and also determine at what stage the disease is. The accuracy of the method is 60%. A blood test for chlamydia can be prescribed not only if the disease is suspected, but also in case of infertility of unknown origin or during pregnancy, if there are cases of miscarriage in the anamnesis.
• PCR
  The essence of the method is to decipher a small piece of DNA, the analysis of a fragment of which helps to identify chlamydia. The material for the study by the PCR method is a urogenital smear. The advantages of the method are its high sensitivity and accuracy. The infection can be detected not only in the acute stage, but also in the latent or sluggish. The analysis is prescribed for infertility of unknown genesis and during pregnancy with complications. In addition, the study is prescribed to monitor the effectiveness of the course of antibiotic therapy. It should be borne in mind that after a course of chemotherapy, a false-positive test result for chlamydia is possible. In this case, re-examination is required in a different way. Also, the analysis is assigned to persons with tuberculosis, viral hepatitis, HIV-infected.

By the way
In 1993, the American scientist Carrie Mullis was awarded the Nobel Prize for the discovery of the PCR method.

• Sowing on chlamydia
  This method is also called cultural, it is the "gold standard", since it is the most accurate (100% sensitivity) and allows not only to identify the pathogen, but its response to various antibiotics. This is necessary for the appointment of therapy for the disease. Also, bacterial culture is prescribed to patients after undergoing a course of antibiotic therapy - to assess its results. The essence of bakseeding is that the biomaterial is "sown" in a favorable environment and grown. After a few days, the nature and size of the colony determine which infection is present in the material.

So, to date, the most accurate are PCR and bacterial culture. The rest of the methods for diagnosing chlamydia are usually used as an additional method of research, allowing to confirm the diagnosis or to question it.

How to prepare and how to donate biomaterial for detection of chlamydia

In order to obtain a reliable result, the biomaterial should be handed over to a medical institution, and subsequent processing and analysis should be carried out in a specialized laboratory.

On the eve of sampling the biomaterial, you should stop drinking alcohol, spicy and fatty foods. For 1-2 days before visiting a doctor, you should refrain from sexual intercourse. You cannot be tested for chlamydia while taking antibiotics.

An hour before donating blood you need to quit smoking. It is important not to be nervous, not to experience emotional overload before the study.

If you want to take a smear , then men are advised not to urinate for 1–2 hours before sampling. Women should take the material on the 5-7th day of the menstrual cycle. In girls, the biomaterial is taken from the mucous membrane of the vestibule of the vagina.

Urine for analysis collected in the morning, an average portion of urine is required. That is, the first drops are lowered into the toilet, and the next ones are collected in a sterile container. The study requires approximately 50 ml of liquid. Before collecting the material, it is worth rinsing the external genitals with warm water, while using soap, gels and other hygiene products is prohibited.

If the patient at the time of the analysis is undergoing a medication course of treatment of any disease, it is imperative to inform a specialist about this.

Interpretation of test results for chlamydia

The results of tests for chlamydia are usually prepared within 1-3 working days, some paid institutions provide an urgent analysis service, then the patient can receive a conclusion within a few hours after taking the material. The exception is bacteriological culture, this study takes several days, usually 5–7.

Linked immunosorbent assay

When analyzing biomaterial for chlamydia by the ELISA method, the term "titer" is used. Titers of IgG, IgA, IgM antigens are considered. The table below shows the meanings and explanations.

Stage of the disease	IgG titers	Titles IgA	Titles IgM
Sharp	>100–6400	> 50–1600	> 50–3200
Chronic	>100–1600	<50	>50–200
Exacerbation of a chronic illness or reinfection	>100–51200	>50–400	<50
Convalescence	> 100–400	<50	<50

In the body of a healthy person, antigens are not detected. IgM antigens appear 5 days after infection. IgG - after 10 days. IgA - in 2-3 weeks. Borderline values: titers of IgM and IgA - up to 50, IgG - up to 100 - require re-examination of the patient after 10-14 days.

PCR

It is a qualitative analysis, therefore, the form with the results may say: "found" or "not found".

Sowing

In the laboratory report, the first item will be the name of the infection found in the biomaterial. Further - its concentration, indicated in colony-forming units per milliliter (CFU / ml). One cell gives rise to the growth of a whole colony. The result of over 103 CFU / ml indicates an inflammatory process in the body caused by this pathogen. Also, the result will be a list of antibiotics that fight chlamydia. If the letter "R" stands next to the antibiotic, it means that the bacterium is resistant (resistant) to it, the antibiotic will not work on it. And if there is the letter "S", it means that chlamydia is sensitive to this antibiotic, it can be prescribed as a therapy for the disease.

The clinical picture of chlamydia is characterized by a latent course, absolutely asymptomatic or oligosymptomatic. The disease is dangerous because of complications leading to infertility, miscarriage, and genital lesions. Today, there are several ways to diagnose chlamydia, but none of them gives a 100% answer. If one of the tests is positive, then additional studies are required. Only a specialist can interpret the results and prescribe treatment.

Wednesday, 28.03.2018

Editorial opinion

If you have found a bacterium, it is imperative that your sexual partner be examined as well. Even if nothing seems to bother him. It happens that symptoms of the disease appear in only one partner, while the other continues to feel good. But the asymptomatic course of the disease does not reduce the risk of complications. It makes no sense for one partner to be treated - in this case, the disease will constantly "wander" from one to another and can lead to serious consequences.