Test Id : SCLAM

Includes Chlamydophila pneumoniae, Chlamydophila psittaci, and Chlamydia trachomatis.

Container/Tube: 

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 0.2 mL

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

0.15 mL

Aiding in the clinical diagnosis of chlamydial infections

This test is not intended for medical-legal use.

Includes Chlamydophila pneumoniae, Chlamydophila psittaci, and Chlamydia trachomatis.

Members of the family Chlamydiaceae are small, nonmotile, gram-negative, obligate intracellular organisms that grow in the cytoplasm of host cells. Two genera of clinical importance are Chlamydia, which includes Chlamydia trachomatis, and Chlamydophila, which includes Chlamydophila pneumoniae and Chlamydophila psittaci. These organisms share many features of bacteria and are susceptible to antibiotic therapy. They are also similar to viruses, requiring living cells for multiplication.

The chlamydial life cycle can be divided into 2 distinct phases: an extracellular, nonreplicating, infectious stage and an obligate intracellular, replicating, noninfectious stage. The infectious form, or elementary body (EB), attaches to the target cell membrane and enters the cell via a phagosome. After cell entry, the EB reorganizes into reticulate particles (forming inclusion bodies) and binary fission begins. After 18 to 24 hours, reticulate particles condense to form EBs. These new EBs are released, beginning another infection cycle.

C psittaci is the causative agent of psittacosis, a disease characterized by pneumonia, headache, altered mentation, and hepatosplenomegaly. Psittacosis is acquired by airborne transmission from infected birds.

C pneumoniae (formerly known as Taiwan acute respiratory agent: TWAR and, more recently, as Chlamydia pneumoniae) causes pneumonia in humans. It is unique because it is a primary pathogen of humans, is spread from human to human, and apparently has no animal or bird host. Chlamydophila pneumoniae is responsible for approximately 10% of pneumonia cases.

C trachomatis has been implicated in a wide variety of infections in humans. It is a common cause of nongonococcal urethritis and cervicitis, and many systemic complications of chlamydial infections have been described. In females, this organism is a cause of pelvic inflammatory disease, salpingitis, and endometritis. In males, epididymitis and Reiter syndrome occur. Lymphogranuloma venereum is a sexually transmitted infection caused by C trachomatis. It presents with a transient primary genital lesion followed by suppurative regional lymphadenopathy. Occasionally, severe proctitis or proctocolitis may develop. C trachomatis also causes ophthalmologic infections, such as trachoma (rare in the United States), adult inclusion conjunctivitis and inclusion conjunctivitis in neonates. These disorders have traditionally been diagnosed by cytologic detection or culture. However, molecular detection methods (CTRNA / Chlamydia trachomatis by Nucleic Acid Amplification [HOLOGIC], Varies) may now represent a more sensitive diagnostic approach.

Fitz-Hugh-Curtis syndrome (perihepatitis) has been associated with chlamydiae.

Chlamydophila pneumoniae

IgG: <1:64

IgM: <1:10

Chlamydophila psittaci

IgG: <1:64

IgM: <1:10

Chlamydia trachomatis

IgG: <1:64

IgM: <1:10

IgG:

Chlamydophila pneumoniae

> or =1:512

IgG endpoint titers of 1:512 or more are considered presumptive evidence of current infection.

<1:512 and > or =1:64

A single specimen endpoint titer of  from 1:64 to 1:512 should be considered evidence of infection at an undetermined time. A second specimen drawn 10 to 21 days after the original draw should be tested in parallel with the first. If the second specimen exhibits a titer 1:512 or more or a 4-fold increase over that of the initial specimen, current (acute) infection is indicated. Unchanging titers from 1:64 to 1:512 suggest past infection.

<1:64

IgG endpoint titers below 1:64 suggest that the patient does not have a current infection. These antibody levels may be found in patients with either no history of chlamydial infection or those with past infection whose antibody levels have dropped below detectable levels.

Chlamydophila pneumoniae antibody is detectable in 25% to 45% of adults tested.

Chlamydophila psittaci and Chlamydia trachomatis

> or =1:64

IgG endpoint titers of 1:64 or more are considered presumptive evidence of current infection.

<1:64

IgG endpoint titers below 1:64 suggest that the patient does not have a current infection. These antibody levels may be found in patients with either no history of chlamydial infection or those with past infection whose antibody levels have dropped below detectable levels.

IgM

Chlamydophila pneumoniae, Chlamydophila psittaci, and Chlamydia trachomatis

> or =1:10

IgM endpoint titers of 1:10 or more are considered presumptive evidence of infection.

<1:10

IgM endpoint titers below 1:10 suggest that the patient does not have a current infection. These antibody levels may be found in patients with either no history of chlamydial infection or those with past infection whose antibody levels have dropped below detectable levels.

Antichlamydial IgG can persist for years. All results from chlamydial serologies must correlate with clinical history and other data available to the physician.

Specimens collected too early during primary infection may not contain detectable antibodies. If chlamydial infection is suspected, a second specimen should be collected 10 to 21 days later and tested in parallel with the original specimen.

During a primary Chlamydia infection, the early antibody response may be cross-reactive with multiple Chlamydia species.

The Chlamydia microimmunofluorescent antibody assay utilizes serotypes D-K of Chlamydia trachomatis. Sera from suspected cases of lymphogranuloma venereum (LGV) should be tested by a Lymphogranuloma Venereum Differentiation Antibody Panel. LGV testing is not performed by Mayo Clinic Laboratories; call 800-533-1710 for further assistance.

Due to the limited sensitivity and specificity of Chlamydia serologic tests, patients with suspected C trachomatis infection should be tested by a molecular method (eg, CTRNA / Chlamydia trachomatis by Nucleic Acid Amplification [HOLOGIC], Varies) when clinical manifestations are present.

1. Movahed MR: Infection with Chlamydia pneumoniae and atherosclerosis: a review. J South Carolina Med Assoc. 1999;95:303-308

2. Smith T: Chlamydia. In: Schmidt N, Emmons R, eds. Diagnostic procedures for viral, rickettsial and chlamydial infections. 6th ed. APHA; 1989: 1165-1198

3. Sheffield PA, Moore DE, Voigt LF, et al: The association between Chlamydia trachomatis serology and pelvic damage in women with tubal ectopic gestations. Fertil Steril. 1993;60:970-975

4. Batteiger BE, Tang M: Chlamydia trachomatis (trachoma and urogenital infections). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:2301-2319

5. Schlossberg D: Psittacosis (due to Chlamydia psittaci). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:2320-2322

6. Hammerschlag MR, Kohlhoff SA, Gaydos CA: Chlamydia pneumoniae. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020:2323-2331

The microimmunofluorescent antibody assay is a 2-stage "sandwich" procedure. In the first stage, the patient serum is diluted in phosphate-buffered saline, added to appropriate slide wells in contact with the substrate, and incubated. After incubation, the slide is washed in buffered saline to remove unbound serum antibodies. In the second stage, each antigen well is overlaid with fluorescein-labeled antibody to IgG or IgM. The slide is incubated, allowing antigen-antibody complexes to react with the fluorescein-labeled anti-IgG. After the slide is washed, dried, and mounted, it is examined using fluorescence microscopy. Positive reactions appear as bright apple-green fluorescent elementary bodies with a background matrix of yolk sac. Semiquantitative endpoint titers are obtained by testing serial dilutions of positive specimens.(Schachter J: Chlamydiae [Psittacosis-Lymphogranuloma Venereum-Trachome Group]. In: Lennette E, Balows A, Hausler W, Shadomy H, eds. Manual of Clinical Microbiology. 4th ed. ASM Press; 1985: 856-861; Smith T: Chlamydia. In: Schmidt N, Emmons R, eds. Diagnostic procedures for viral, rickettsial and chlamydial infections. 6th ed. APHA; 1989: 1165-1198; package insert: Anti-Chlamydia MIF [IgA, IgG or IgM]. Euroimmun Medizinische Labordiadnostika AG; Version 12/16/2019)

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This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

86631 x 3-IgG

86632 x 3-IgM

Sample Reports

Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports

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