The molecular epidemiology of genital Chlamydia trachomatis in the greater Reykjavik area, Iceland.

BACKGROUND: The diversity in MOMP (major outer membrane protein) of Chlamydia trachomatis is thought to be necessary for the bacteria to survive in its environment. The rate of change in the omp1 gene (coding for MOMP) is not known. Iceland offers a good opportunity to study the epidemiology of chlamydial infections because the population is small (280,000) and geographically well defined. GOAL: The goal was to determine the number and distribution of genotypes in a population attending the STD clinic in Reykjavík and to assess changes in omp1 sequences over a period of 2 years. STUDY DESIGN: Three-hundred thirty isolates of C trachomatis collected periodically from January 1999 to January 2001 were omp1 genotyped with nested PCR and sequencing. RESULTS: The serotypes found, in descending order of prevalence, were E, D, J, F, K, G, H, and I. Eighteen distinctive genotypes were found. During the study period no significant changes in frequency of genotypes were noted, and introduction of new or changed genotypes was not observed. CONCLUSION: The results indicate a relatively stable situation of genotypes and suggest an ecological advantage of serotype E.

Multicenter comparative evaluation of two rapid immunoassay methods for the detection of Chlamydia trachomatis antigen in endocervical specimens.

OBJECTIVE: To evaluate two rapid immunoassay methods, QuickVue-Chlamydia (Quidel Corp., San Diego California) and Kodak SureCell (Kodak Corp., Rochester, NY) for the detection of Chlamydia trachomatis antigen in endocervical swabs from high- and low-risk females. METHODS: Seven hundred and twenty-four females attending three clinics were enrolled in the study. The results were compared to McCoy's or BGMK cell culture and discrepancies resolved with polymerase chain reaction and direct fluorescent antibody tests performed on left-over culture specimens. RESULTS: The sensitivity, specificity, predictive value of a positive and predictive value of a negative of the QuickVue Chlamydia assay were 92.0%, 99.1%, 92.0% and 99.1%, respectively. The sensitivity, specificity, predictive value of a positive and predictive value of a negative of the SureCell assay were 90.0%, 99.8%, 98.6% and 98.8%, respectively. CONCLUSIONS: The performances of the two immunoassay methods were similar, and slight differences in sensitivity and specificity were not statistically significant. Both immunoassay methods performed well in high- and low-risk patient groups, both for symptomatic and for asymptomatic patients.