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Journal des Anti-Infectieux
Volume 16, n° 4
pages 185-191 (décembre 2014)
Doi : 10.1016/j.antinf.2014.08.002
Méthodes de diagnostic des infections à Chlamydiae : directes et/ou sérodiagnostic ? Que choisir ?
Diagnostic methods for Chlamydial infections: Direct and/or serology? What to choose?
 

B. de Barbeyrac a, , b , F. Obeniche b, O. Peuchant a, b, C. Bébéar a, b
a EA 3671, Inra, USC infections humaines à mycoplasmes et Chlamydiae, Centre national de référence des infections à Chlamydia, université de Bordeaux, campus Carreire, 146, rue Léo-Saignat, 33076 Bordeaux cedex, France 
b Laboratoire de bactériologie, CHU de Bordeaux, 33076 Bordeaux, cedex, France 

Auteur correspondant.
Résumé

Trois espèces sont responsables de chlamydioses chez l’homme : Chlamydia trachomatis , principal agent bactérien d’infection sexuellement transmissible, Chlamydia pneumoniae , responsable d’infection respiratoire communautaire et Chlamydia psittaci , d’origine aviaire, occasionnellement responsable de pneumopathie. Le diagnostic d’infection à C. trachomatis repose essentiellement sur la recherche directe par amplification génique avec des outils commercialisés, sensibles et spécifiques. Le sérodiagnostic a un intérêt dans l’évaluation de l’extension de la maladie. Le diagnostic d’infection à C. pneumoniae a beaucoup souffert du manque de spécificité des techniques utilisées après sa découverte. Il semble que l’incidence de l’infection respiratoire à C. pneumoniae ait été largement surestimée. Dans l’état actuel de nos connaissances, les techniques sérologiques pourraient être abandonnées au profit de techniques directes telles que l’amplification génique avec des trousses commercialisées, sensibles et spécifiques, en duplex avec Mycoplasma pneumoniae . Quant à C. psittaci , son diagnostic relève de laboratoire spécialisé, en raison de l’absence de techniques directes commercialisées disponibles et de l’expertise requise pour interpréter le sérodiagnostic.

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Summary

Three species are responsible for Chlamydia infections in men: Chlamydia trachomatis , a main bacterial agent of sexually transmitted infection, Chlamydia pneumoniae , responsible for community respiratory tract infection and Chlamydia psittaci from avian origin, occasionally responsible for pneumonia. The diagnosis of C. trachomatis infection is mainly based on direct detection by nucleic acid amplification gene tests (NAAT) with commercialized tools, sensitive and specific. Serodiagnosis has an interest in evaluating the extent of disease. The diagnosis of C. pneumoniae infection has suffered from the lack of specificity of the techniques used after its discovery. It seems that the incidence of respiratory C. pneumoniae infection has been largely overestimated. In the present state of our knowledge, serological techniques could be abandoned in favor of direct techniques such as NAATs with commercial kits, sensitive and specific, in duplex with Mycoplasma pneumoniae . For C. psittaci , diagnosis should be restricted to expert laboratories, due to the lack of available commercial direct techniques and the need of expertise required for interpreting the serodiagnosis results.

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Mots clés : Chlamydia trachomatis , Chlamydia pneumoniae , Chlamydia psittaci , TAAN (PCR), Sérologie

Keywords : Chlamydia trachomatis , Chlamydia pneumoniae , Chlamydia psittaci , NAAT (PCR), Serology




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