What is the role of cell culture in the workup of chlamydial genitourinary infections (chlamydia)?

Updated: Sep 25, 2018
  • Author: Shahab Qureshi, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

C trachomatis grows well in a variety of cell lines (eg, McCoy and HeLa cells) that can be maintained in tissue culture. Incubation in tissue culture is 40-72 hours, depending on the cell type and specific biovar. Intracytoplasmic inclusions can be detected either by Giemsa stains or by immunofluorescent staining with monoclonal antibodies.

Cultures are difficult to obtain; many false-negative results are returned. They are also expensive to perform, because of the expertise and laboratory resources required. In addition, they are unsuitable for large numbers of patients (eg, in the emergency department [ED]). Nevertheless, in certain clinical situations, cultures are mandatory.

Because of its high specificity (100%) and sensitivity, cell culture is the only test that should be used to establish the presence or absence of infections in cases with legal implications, such as those involving rape or sexual abuse. Cell culture is also preferred for rectal specimens because nonculture test results are difficult to interpret in the presence of stool organisms.

This photomicrograph reveals McCoy cell monolayers This photomicrograph reveals McCoy cell monolayers with Chlamydia trachomatis inclusion bodies; magnified 200X. Image courtesy of the Centers for Disease Control and Prevention.

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