b. Nonculture tests listed below, such as direct immunofluorescence, enzyme-linked immunosorbent

assay, and polymerase chain reaction (PCR), all perform well for ocular specimens and provide a result

more rapidly. (20–24). PCR is the most sensitive

nonculture test for Chlamydia, with the advantage of

increased detection in mild disease (20–24). If PCR

is not readily available, direct immunoflourescent

monoclonal antibody stain antibody may be the

most sensitive and rapid option (25).

(1) For chlamydial direct fluorescence antibody stain:

MicroTrak Chlamydia trachomatis specimen collection kit (Trinity Biotech, Bray, County Wicklow,

Ireland)

(2) For chlamydial enzyme-linked immunosorbent

assay: Place specimen in media advised by the

laboratory performing the study.

Table 24.1 Analysis of Conjunctival Scrapings

Test Organisms Identified Finding

Stain

Gram stain Neisseria gonorrhea Gram-negative diplococci

Giemsa stain Chlamydia trachomatis Intraepithelial intracytoplasmic inclusions

Papanicolaou stain Herpes simplex virus Multinucleate giant cells and inclusionbearing cells

Direct antigen detection techniques

Immunofluorescent indicator system Chlamydia trachomatis

Immunosorbent assay (ELISA) Chlamydia trachomatis

Herpes simplex virus

Fluorescein-labeled monoclonal

antibodies (MicroTrack)

Chlamydia trachomatis

Indirect fluorescence Herpes simplex virus

Culture

Thayer–Martin Neisseria gonorrhea

Aerobic Gram-positive and gramnegative bacteria

Anaerobic Anaerobic bacteria

Viral transport Herpes simplex virus

Chlamydia culture (McCoy

 culture)

Chlamydia trachomatis

ELISA, enzyme-linked immunosorbent assay.