Standardizing Chlamydia pneumoniae assays: recommendations from the Centers for Disease Control and Prevention (USA) and the Laboratory Centre for Disease Control (Canada)

Clin Infect Dis. 2001 Aug 15;33(4):492-503. doi: 10.1086/322632. Epub 2001 Jul 20.


Chlamydia pneumoniae has been associated with atherosclerosis and several other chronic diseases, but reports from different laboratories are highly variable and "gold standards" are lacking, which has led to calls for more standardized approaches to diagnostic testing. Using leading researchers in the field, we reviewed the available approaches to serological testing, culture, DNA amplification, and tissue diagnostics to make specific recommendations. With regard to serological testing, only use of microimmunofluorescence is recommended, standardized definitions for "acute infection" and "past exposure" are proposed, and the use of single immunoglobulin (Ig) G titers for determining acute infection and IgA for determining chronic infection are discouraged. Confirmation of a positive culture result requires propagation of the isolate or confirmation by use of polymerase chain reaction (PCR). Four of 18 PCR assays described in published reports met the proposed validation criteria. More consistent use of control antibodies and tissues and improvement in skill at identifying staining artifacts are necessary to avoid false-positive results of immunohistochemical staining. These standards should be applied in future investigations and periodically modified as indicated.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Bacteriological Techniques / methods
  • Bacteriological Techniques / standards
  • Centers for Disease Control and Prevention, U.S.*
  • Chlamydophila Infections / diagnosis*
  • Chlamydophila Infections / microbiology
  • Chlamydophila pneumoniae / genetics
  • Chlamydophila pneumoniae / isolation & purification*
  • Clinical Laboratory Techniques / methods
  • Clinical Laboratory Techniques / standards*
  • Culture Media
  • DNA, Bacterial / analysis
  • Health Planning Guidelines
  • Humans
  • Immunohistochemistry / methods
  • Immunohistochemistry / standards
  • Polymerase Chain Reaction / methods
  • Polymerase Chain Reaction / standards
  • Serologic Tests / methods
  • Serologic Tests / standards
  • United States


  • Culture Media
  • DNA, Bacterial