Chlamydia pneumoniae – Respiratory PCR

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Background
This page provides testing information for Chlamydia pneumoniae from respiratory specimens using the Chlamydia pneumoniae - Respiratory PCR assay at Public Health Ontario (PHO).

Chlamydia pneumoniae is a causative agent of community-acquired pneumonia.

The following testing options are available for Chlamydia pneumoniae: PCR.

This page provides information specific to PCR Testing

Updates
Cerebrospinal Fluid (CSF) is added under specimen type. Prior to submission of CSF to PHO, contact PHO’s Laboratory Customer Service Centre for a Microbiologist’s approval to avoid rejection or delay in testing.

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Testing Indications

Chlamydia pneumoniae testing is indicated when there is a clinical suspicion of Chlamydia pneumoniae infection, particularly in cases of atypical pneumonia, bronchitis, or sinusitis, and when other respiratory pathogens have been ruled out.

Acceptance/Rejection Criteria

Acceptable:

Use the recommended specimen collection kit (below)
Neat specimens acceptable (>=0.5ml)
Swab specimens must be collected with nylon flocculated swabs or on swabs with Dacron tips and aluminum or plastic shafts.

Unacceptable:

Swabs with calcium alginate or cotton tips and wooden sticks are not acceptable, as they have been shown to inhibit PCR.
Chemically fixed or preserved specimens are not acceptable for PCR testing and will be rejected upon receipt at PHO-Laboratory
Cobas PCR media is unacceptable as a transport media for Chlamydia pneumoniae. Specimens sent in this media will be rejected.

For outbreaks contact Medical/Clinical Microbiologist at PHOL (Customer Service Center 1-877 604 4567).

Specimen Collection and Handling

Specimen Requirements

Test Requested

Required Requisition(s)

Specimen Type

Minimum Volume

Collection Kit

Chlamydia pneumoniae

General Test Requisition Requisition for Specimen Containers and Supplies

Bronchoalveolar lavage

Nasopharyngeal Swab (NPS)

Throat swab

Tracheal aspirates

Respiratory tract specimens

Cerebrospinal Fluid (see note 3)

Swab in universal transport media provided in kit
Neat (minimum volume 0.5mL)

Mycoplasma pneumoniae / Chlamydia pneumoniae PCR Kit; Kit Order# 390085

Requisition for Specimen Containers and Supplies

Submission and Collection Notes

Complete all fields of the requisition form, including:

Test(s) requests and indications for testing
Patient setting/population/source
Symptoms
Onset date

For clinical specimens, label the specimen container(s) with the patient’s first and last name, date of collection, and one other unique identifier such as the patient’s date of birth or Health Card Number. For additional information see: Criteria for Acceptance of Patient Specimens. Failure to provide this information may result in rejection or testing delay.

Before submitting CSF specimen to PHO, contact PHO’s Laboratory Customer Service Centre first for Microbiologist’s approval. Note that CSF is not a validated specimen type.

Timing of Specimen Collection

Specimens should be collected as soon as possible during the acute phase of the illness.

Storage and Transport

Specimens placed inside and biohazard bag and sealed should be stored at 2-8°C following collection and shipped to Public Health Ontario on ice packs. All clinical specimens must be shipped in accordance to the Transportation of Dangerous Good Act.

Requisitions and Kit Ordering

Test Frequency and Turnaround Time (TAT)

Chlamydia pneumoniae PCR testing is performed at PHO, Toronto and Kingston locations.

TAT is up to 5 business days from receipt at PHO’s Laboratory.

STAT and Critical Specimens Testing

Contact PHO’s Laboratory Customer Service Centre when submitting critical specimen so it will be prioritized and included in the next available testing run.

Test Methods

The method is a laboratory-developed multiplex real-time polymerase chain reaction (PCR)which detects the Outer Membrane Protein (OmpA) gene (Gullsby et. al) in Chlamydia pneumoniae.

Only respiratory tract specimens such as bronchoalveolar lavage (BAL), nasopharyngeal swab (NPS), throat swab, and tracheal aspirates were validated for use with this assay at PHO. Cerebrospinal fluid (CSF) is not a validated specimen type but can be tested when approved by a PHO microbiologist.

Interpretation

The following table provides possible test results with associated interpretations:

Result	Interpretation	Comments
Not Detected	Chlamydia pneumoniae Not Detected	Note: This specimen was tested using a laboratory test developed by Public Health Ontario Laboratory for the purpose of clinical testing. Results should be interpreted in the context of the clinical situation.
Detected	Chlamydia pneumoniae Detected	Note: This specimen was tested using a laboratory test developed by Public Health Ontario Laboratory for the purpose of clinical testing. Results should be interpreted in the context of the clinical situation.
Invalid	Chlamydia pneumoniae Invalid	Note: Nucleic Acid extraction and/or amplification could not be successfully completed. This may be caused by inhibitory substances or improper sample collection. Please resubmit if clinically relevant. This specimen was tested using a laboratory test developed by Public Health Ontario Laboratory for the purpose of clinical testing. Results should be interpreted in the context of the clinical situation.
Indeterminate	Chlamydia pneumoniae Indeterminate	Note: An indeterminate PCR test result may be due to a low level of target genetic material in the specimen content or a non-specific signal. Please resubmit another specimen for testing if clinically indicated. This specimen was tested using a laboratory test developed by Public Health Ontario Laboratory for the purpose of clinical testing. Results should be interpreted in the context of the clinical situation.
Inconclusive	Chlamydia pneumoniae Inconclusive	Note: PCR results are inconclusive. Consider collecting another specimen for repeat PCR testing. This specimen was tested using a laboratory test developed by Public Health Ontario Laboratory for the purpose of clinical testing. Results should be interpreted in the context of the clinical situation.

Reporting

Results are reported to the physician, authorized health care provider (General O. Reg 45/22, s.18) or submitter as indicated on the requisition.