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Clinical and Diagnostic Laboratory Immunology, July 2002, p. 833-839, Vol. 9, No. 4
1071-412X/02/$04.00+0     DOI: 10.1128/CDLI.9.4.833-839.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Performance of Three Microimmunofluorescence Assays for Detection of Chlamydia pneumoniae Immunoglobulin M, G, and A Antibodies

Mette Bennedsen,^1* Lene Berthelsen,¹ Inga Lind,^1,2 and the Infection, Atherosclerosis and Macrolide Antibiotics Group

Neisseria Unit, Statens Serum Institut,¹ Copenhagen Hospital Corporation, Copenhagen University Hospital, Copenhagen, Denmark²

Received 2 November 2001/ Returned for modification 15 February 2002/ Accepted 11 April 2002

The microimmunofluorescence (MIF) test is considered the "gold standard" for laboratory diagnosis of acute and chronic Chlamydia pneumoniae infection. The performance of a MIF test based on C. pneumoniae antigen from Washington Research Foundation (WRF) was compared with those of assays from Labsystems (LAB) and MRL Diagnostics (MRL) by investigation of sera from three groups of patients: group I, 83 sera from 28 patients with atypical pneumonia; group II, 37 sera from 16 patients with acute C. pneumoniae or Chlamydia psittaci respiratory tract infection confirmed by PCR or culture; group III, 100 sera from 100 persons enrolled in the Copenhagen City Heart Study. The accordance among the results of the WRF assay and the two commercial assays was excellent for the immunoglobulin M (IgM) antibody detection rate (98%). The accordance in detection rates for IgG and IgA antibodies in sera from patients with acute infections was acceptable (87 and 88%), and in sera from group III, it was excellent (95 and 97%). The determinations of endpoint titers were reproducible with <1 dilution step difference for all three methods, except that the mean IgM antibody titer found by the LAB assay was almost 2 dilution steps higher than that found by the other two methods. Although the three assays use different C. pneumoniae strains as antigens, the detection rates and IgG and IgA endpoint titers were similar. The difference in endpoint titers of IgM antibodies is of no major concern, as the diagnosis of acute C. pneumoniae infection rests on the presence of IgM antibodies, not on their level.

The Infection, Atherosclerosis and Macrolide Antibiotics Group includes the following persons: Christian Gluud, Copenhagen Trial Unit, Copenhagen University Hospital, Copenhagen, Denmark; Jørgen Fischer Hansen, Bispebjerg Hospital, Copenhagen, Denmark; Stig Haunsø, Rigshospitalet, Copenhagen, Denmark; Per Hildebrandt, Frederiksberg Hospital, Copenhagen, Denmark; Gorm Jensen, Hvidovre Hospital, Copenhagen, Denmark; Christian Jespersen, Bispebjerg Hospital, Copenhagen, Denmark; Jens Kastrup, Rigshospitalet, Copenhagen, Denmark; Erik Kjøller, KAS Herlev, Copenhagen, Denmark; Hans Jørn Kolmos, Odense Universitets Hospital, Denmark; Beata B. Malmquist, Hvidovre Hospital, Copenhagen, Denmark; Henrik Nielsen, Amager Hospital, Copenhagen, Denmark; Rolf Steffensen, Hillerød Hospital, Hillerød, Denmark. Coauthor Inga Lind is also a member of the group.

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