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The Molecular Diagnosis of Lymphogranuloma Venereum: Evaluation of a Real-Time Multiplex Polymerase Chain Reaction Test Using Rectal and Urethral Specimens

Chen, Cheng-Yen*; Chi, Kai-Hua*; Alexander, Sarah; Martin, Iona M. C.; Liu, Hsi*; Ison, Cathy A.; Ballard, Ronald C.*

Sexually Transmitted Diseases: July 2007 - Volume 34 - Issue 7 - p 451-455
doi: 10.1097/01.olq.0000245957.02939.ea

Objectives: The objectives of this study were to evaluate the use of a real-time multiplex polymerase chain reaction (M-PCR) assay to differentiate between trachoma and lymphogranuloma venereum (LGV) biovars of Chlamydia trachomatis and to validate its performance with the conventional genotyping method.

Study: Swab specimens from 115 patients with anorectal symptoms or syndromes associated with LGV were tested by a real-time M-PCR assay and the results compared with the PCR-based restriction fragment length polymorphism analysis of the major outer membrane protein gene (omp1).

Results: A high agreement of 96.5% (111 of 115 specimens) was found between the real-time M-PCR testing and the standard genotyping method for the detection of C. trachomatis DNA (κ value, 0.945, P <0.00001). Both methods identified 53 LGV, 32 non-LGV C. trachomatis, and 26 negative specimens.

Conclusions: The real-time M-PCR assay simultaneously detects and differentiates LGV from non-LGV strains using swab specimens. This assay offers a relatively rapid and sensitive alternative for the diagnosis of LGV infection and is a useful tool for screening and for outbreak investigations.

A real-time multiplex PCR assay was developed for the diagnosis of chlamydial infection and for the differentiation of LGV from non-LGV infection. The performance of the real-time multiplex PCR assay for the identification of LGV infection is highly comparable with that of the conventional genotyping method using rectal and urethral DNA specimens.

From the *Division of STD Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; and the †Sexually Transmitted Bacteria Reference Laboratory, Health Protection Agency Centre for Infections, London, U.K.

The authors thank John Papp of the Division of STD Prevention (DSTDP), CDC, for his critical review of the manuscript and Akbar Zaidi of DSTDP for his assistance in statistical analysis.

Correspondence: Cheng-Yen Chen, PhD, Division of STD Prevention, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Mail Stop: G-39, 1600 Clifton Road, Atlanta, GA 30333. E-mail:

Received for publication August 24, 2006, and accepted September 5, 2006.

© Copyright 2007 American Sexually Transmitted Diseases Association