Laboratory Testing for Chlamydia pneumoniae

Key points

  • Clinical laboratories can provide diagnostic testing for Chlamydia pneumoniae infections.
  • There are multiple Food and Drug Administration (FDA)-cleared laboratory tests for the detection of C. pneumoniae infection.
  • Nucleic acid amplification tests (NAAT), including real-time polymerase chain reaction (PCR), are the preferred method of diagnostic testing for acute C. pneumoniae infection.
  • Learn about the different laboratory methods to test for C. pneumoniae infection.
A laboratorian prepares to conduct real-time polymerase chain reaction (PCR) testing.

Lab methods

Clinical laboratories can provide diagnostic testing for C. pneumoniae infections using molecular methods, serology, or culture.

There are multiple FDA-cleared tests for the detection of C. pneumoniae infection. Respiratory pathogen panels are the most common test method performed in clinical laboratories.

Molecular tests, including NAATs, offer high sensitivity and specificity and provide timely results for treatment decisions. These tests can also determine antibiotic susceptibilities.

Serological testing is performed in some clinical laboratories but lacks specificity. It often requires multiple patient visits to collect acute and convalescent paired sera specimens (time-sensitive sampling).

Culture of C. pneumoniae is performed by specialized reference laboratories, but it's time-consuming and not optimal for treatment decisions.

Additional or specialized testing

Public health laboratories can provide diagnostic support or forward specimens to CDC.

Laboratory guidelines

CDC recommendations by method

Molecular

  • Best method for the diagnosis of an acute C. pneumoniae infection
  • Preferred method: NAAT, such as real-time PCR, or respiratory pathogen panel
Serology

  • Don't diagnose an acute infection based on single IgG titers
  • Preferred method: Microimmunofluorescence
  • Non-endorsed methods: Complement fixation, EIA, and whole-inclusion fluorescence

Culture

  • Confirm positive results by an additional test, such as NAAT

Additional information on non-endorsed methods

The following tests aren't recommended for diagnosis of C. pneumoniae because of low sensitivity and insufficient evaluation:

  • Complement fixation
  • EIA
  • Whole-inclusion fluorescence tests

Additional information about microimmunofluorescence

Microimmunofluorescence is the only species-specific antibody test available that can measure isotype-specific antibody titers to all Chlamydia species simultaneously. However, this testing is technically complex and interpretation is subjective.

Submitting specimens

Public health department laboratory staff can forward approved specimens to CDC for specialized testing.

Keep Reading Submitting Specimens

Resources

Standardizing Chlamydia pneumoniae Assays: Recommendations from CDC (USA) and the Laboratory Centre for Disease Control (Canada)

Print
Content Source:
National Center for Immunization and Respiratory Diseases; Division of Bacterial Diseases