Sensitive immune dot blot test for diagnosis of Chlamydia trachomatis infection.

The sensitivity and specificity of an immune dot blot test (IDBT), which relies on a 125I-labeled genus-specific monoclonal antibody to detect the Chlamydia lipopolysaccharide (LPS) antigen, were improved by pretreatment of specimens with proteinase K. This enzyme destroys protein A and therefore eliminates false-positive reactions caused by the presence of Staphylococcus aureus. Proteinase K treatment also improved the ability of the assay to detect the Chlamydia LPS antigen. When the improved IDBT was compared with culture for detection of C. trachomatis in 1,394 urogenital specimens obtained from a genitourinary medicine clinic, the overall sensitivity was 96%, and LPS antigen was detected in 76 of 83 (92%) specimens that yielded less than 10 inclusions in culture. The specificity and positive and negative predictive values of the test were 97, 81.5, and 99%, respectively. Of 123 conjunctival swabs, 7 were positive by both tests and 4 swabs were positive only by IDBT. This improved IDBT provides a simple, reliable alternative to culture for the detection of C. trachomatis in urogenital and conjunctival specimens.