The investigations described in this thesis had several alms. As discussed in the diagnostics section, the detection of antibodies directed against C. trachomatis using the MIF is not only laborious, but the interpretation of the results is also subjective. The main objection against using an ELISA or an IPA in which serovar LGV2 is used as the sole antigen is that antibodies directed against other serovars are either not detected at all or detected unsatisfactorily (34). In the literature too, there is no general consensus on the sensitivity and the specificity of serology as compared with that of the tissue culture for detecting acute C. trachomatis infections. In order to overcome these objections, we developed a sensitive enzyme linked immunofluorescent assay (ELFA). Antibodies directed against 6 different antigens of C. trachoma/is can be detected using the ELFA. The antigens are chosen in such a way that antibodies against all C. trachomatis serovars can be detected. The contribution made by serology in the diagnostics of acute Chlamydia infection was investigated in two groups of patients. Initially, a group of men and women with uncomplicated infections who visited the outpatient department of the clinic for sexually transmitted diseases in Rotterdam was investigated in order to determine whether there was any correlation between the results of serology and those of the tissue culture. Later, a group of patients with complicated infections was also investigated. This group consisted of patients suffering from pelvic inflammatory disease who had been admitted to the department of Gynecology of the Dijkzigt Hospital in Rotterdam. It was also determined whether there was any correlation between the results of serology and those of the tissue culture and the polymerase chain reaction (PCRI. Little is known on the manner in which C. pneumoniae is transmitted from one host to another. A possible clue for transmission occurring via aerosols was reported by Hyman et al (42). He deduced this from the C. pneumoniae infections acquired by the laboratory personnel after an accident involving a centrifuge. Undoubtedly, an aqueous intermediate also influences the survival of C. pneumoniae during transmission. The spread of the organism must occur very efficiently as illustrated by the fact that about 50% of the population in the industrialized world has already acquired C.pneumoniae infection between the age of 5 and 15 years (39). Therefore, the aim of the subsequent studies was to investigate the influence of pH, ion concentrations and temperature on the survival of C. pneumoniae. The survival of C. pneumoniae in aerosols under various conditions was also investigated using a 114.5 L stainless steel aerosol chamber in which both the relative humidity and the temperature could be carefully controlled. The survival of other microorganisms including C. trachoma tis in aerosols was also investigated in order to determine whether there was any correlation with the survival of C. pneumoniae under the same conditions. C. trachomatis can be stored best for prolonged periods in SPG medium at a minimum temperature of -70°C 143). Optimum survival of C. pneumoniae can be achieved by cooling it at 4°C for 4 h prior to freezing 144). However, this method is cumbersome and expensive for transport and culture collections. A large number of pathogenic bacteria can be stored for a long time with a negligible loss in viability by lyophilization in a suitable medium (45,46). Consequently, investigations into the optimum media for lyophilization and different methods of freezing that may be suitable for the transport and storage of Chlamydia (chapter 61 were also pursued.

antibodies, chlamidia, chlamidia trachomatis, dermatology, diagnostics
M.F. Michel , E. Stolz (Ernst)
Erasmus University Rotterdam
Erasmus MC: University Medical Center Rotterdam

Theunissen, J.J.H. (1993, November 17). Chlamydia, physical characteristics and diagnostic aspects. Erasmus University Rotterdam. Retrieved from