Chlamydia trachomatis – Culture
Conformément au Règlement de l’Ontario 671/92 de la Loi sur les services en français, les renseignements d’analyses de laboratoire liés à la présente page ne sont offerts qu’en anglais parce qu’ils sont de nature scientifique ou technique et destinés uniquement à l’usage des fournisseurs de soins de santé qualifiés et non aux membres du public.
Specimen Requirements
| Test Requested | Required Requisition(s) | Specimen Type | Minimum Volume | Collection Kit |
Chlamydia trachomatis / CT culture |
Genital, non-genital swabs (rectal, throat/ pharyngeal, conjunctival scrapings/swabs) |
1.0 mL of fluid |
PHO CHL(C) kit / Chlamydia trachomatis culture kit order # 390083 or 390084 or a universal transport medium (UTM) for swabs or a sterile container for fluids/tissue. |
|
Chlamydia trachomatis / CT culture |
Tissue |
Available tissue |
PHO CHL(C) kit / Chlamydia trachomatis culture kit order # 390083 or 390084 or a universal transport medium (UTM) for swabs or a sterile container for fluids/tissue. |
|
Chlamydia trachomatis / CT culture |
Neonatal – fluid from auger suction, transtracheal / nasopharyngeal aspirates, conjunctival swabs |
1.0 mL of fluid |
PHO CHL(C) kit / Chlamydia trachomatis culture kit order # 390083 or 390084 or a universal transport medium (UTM) for swabs or a sterile container for fluids/tissue. |
|
Chlamydia trachomatis / CT culture |
Sexual abuse and/or sexual assault cases in peri-pubertal and pre-pubertal children, including rectal, throat/pharyngeal, vaginal, and urethral swabs |
1.0 mL of fluid |
PHO CHL(C) kit / Chlamydia trachomatis culture kit order # 390083 or 390084 or a universal transport medium (UTM) for swabs or a sterile container for fluids/tissue. |
Submission and Collection Notes
Unsuitable specimens: Urine and seminal fluid are not acceptable specimen sites for Chlamydia trachomatis culture. Dry swabs and swabs in bacteriological transport media (gel) are not acceptable collection kits for Chlamydia trachomatis culture and testing will not be performed.
Do not use expired kits.
Storage and Transport
Label the specimen container with the patient’s full name, date of collection, and one other unique identifier such as the patient’s date of birth or Health Card Number. Failure to provide this information may result in rejection or testing delay.
Special Instructions
Specimens should be stored at 2-8°C after collection and shipped on ice. Transport to the laboratory as soon as possible.
Specimens should be received at the testing laboratory within 48 hours of collection; this is especially important for neonatal and paediatric specimens. In situations of delayed transportation, specimens should be frozen at -70°C and transported on dry ice. Do not freeze sample at -20°C.
Test Frequency and Turnaround Time (TAT)
Chlamydia trachomatis specimens are tested 3 times per week.
Turnaround time is up to 7 days from receipt by PHO laboratory.
Specimens are tested using standard cell culture technique.
Interpretation
Results may be interpreted as positive, negative or toxic.
Toxicity may occur for various reasons including antibiotic therapy or high specimen pH and retesting may be required.
Reporting
Results are reported to the ordering physician or health care provider as indicated on the requisition.
Critical positive reports (results from body fluids/aspirates, tissues, CSF or specimens from pregnant patients, infants, pre-pubertal children, i.e. ≤ 12 years and medico-legal specimens, i.e. pre-pubertal children, sexual abuse in peri-pubertal and pre-pubertal children, sexual assault and legal cases) are phoned and faxed if the client is registered for auto fax.
Other positives are only faxed if client is registered for auto fax.
Specimens that are positive for Chlamydia trachomatis are reported to the Medical Officer of Health as per the Health Protection and Promotion Act.
Additional Information
Medico-legal specimens
Culture is the specimen of choice for all potentially medico-legal specimens, i.e. pre-pubertal children, sexual abuse in peri-pubertal and pre-pubertal children, sexual assault and legal cases. Legal specimens should be transported to the laboratory under legal seal; contact the Medical Microbiologist prior to specimen collection.
Test of Cure (TOC)
General guidelines for Chlamydia trachomatis (CT) Test of Cure (TOC) are described below. Refer to the PHAC Canadian Guidelines on Sexually Transmitted Infections for detailed information.
TOC by NAAT is recommended 3-4 weeks after completion of treatment when compliance to treatment is suboptimal, an alternative treatment regimen is used, for those with persisting signs or symptoms post-treatment, or the individual is prepubertal or pregnant.
For Lymphogranuloma venereum (LGV), TOC is recommended 3 weeks after completion of treatment. Follow LGV-infected individuals until CT is negative and symptoms have resolved.
In rare circumstances, CT DNA may persist for longer than 4 weeks and therefore must be considered when interpreting positive TOC results. Repeat screening is recommended 3 months post-treatment for all individuals with CT infection.
LGV testing
Male rectal specimens positive for Chlamydia trachomatis will be routinely forwarded to the National Microbiology Laboratory (NML) in Winnipeg for Lymphogranuloma venereum (LGV) testing. Specimens positive for Chlamydia trachomatis from other sources will only be sent if LGV testing is specifically requested.
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