Microimmunofluorescence (MIF)

Microimmunofluorescence (MIF) serology to test for infection by strains of Chlamydia trachomatis that cause lymphogranuloma venereum (LGV).

Serum, or paired sera (preferred) – acute and convalescent. Minimum serum sample is 0.5 mL.

Submit serum in a sterile 1.5 - 2 mL microcentrifuge tube.

Store samples in a refrigerator or frozen until shipped for testing. Ship frozen on dry ice, or on wet ice.

Shipping of specimens shall be done by a TDG certified individual in accordance with TDG regulations. For additional information regarding classification of specimens for the purposes of shipping, consult either Part 2 Appendix 3 of the TDG Regulations or section 3.6.2 of the IATA Dangerous Goods Regulations as applicable.

Patient must have one or more of the following and must be stated on the requisition form:

- Patient is immunocompromised (eg. HIV+);

- Symptoms consistent with LGV (eg. inguinal lymphadenopathy, proctitis);

- Clinical history includes lymphoma;

- Risk of infection is the result of sexual assault;

- Contact with a confimed case of LGV

- Ocular Chlamydia trachomatis infection suspected;

- Patient history includes sexual contact during travel to an endemic area;

- Male patient who is, or has had contact with, a member of the high risk patient population (eg. MSM, other STI's);

- Female patient experiencing infertility;

- Neonate patient.

Please note that to date there are no cases of LGV occurring in females who lack prior contact with LGV cases, do not present with LGV type symptoms and/or are immunocompetent, described in the literature. Therefore sera from asymptomatic, immunocompetent females will not be accepted for LGV testing.

Completed Special Bacteriology requisition form detailing all patient information and relevant clinical information. If possible, attach lab results that have already been done at local or provincial laboratories.

All patient history must be included. Samples without adequate patient history to justify testing are subject to rejection.

Serology is performed using a commercial MIF kit (Focus Diagnostics Inc./Bio Nuclear Diagnostics Inc., Toronto ON) and supplemented by an in-house assay using purified L2 antigen. An IgG reciprocal titre greater than or equal to 256 and/or an IgM reciprocal titre greater than or equal to 16 are suggestive of acute infection. However, serology results should be confirmed by PCR and sequencing or RFLP. Please note that PHAC guidelines (2006) do not recommend serology for diagnostic purposes in the absence of culture or NAAT due to issues of cross-reactivity and difficulty with interpretation of test results.

15 calendar days. Please note that during times when large numbers of samples are received or if tests must be repeated, the turnaround time may be longer.

1. Kropp, R. Y., T. Wong, and Canadian LGV Working Group. 2005. Emergence of lymphogranuloma venereum in Canada. CMAJ 172:1674-1676.
2. Mabey, D., and Peeling R. W. 2002. Lymphogranuloma venereum. Sex. Transm. Infect. 78:90-92.