A Chlamydia trachomatis Strain With a 377-bp Deletion in the Cryptic Plasmid Causing False-Negative Nucleic Acid Amplification Tests

TL;DRAbstract

AFTER AN ALMOST STEADY increase for 10 years in reported Chlamydia trachomatis (Ct) genital infections in Sweden, there was a leveling out in 2005 to 2006. In some areas of the country, like the county of Halland (290,000 inhabitants), we noted a decrease in diagnosed infections of 25% in the beginning of 2006. In Halland we have used nucleic acid amplification tests (NAAT) to diagnose Ct infections since 1995, beginning with Abbott LCx (Abbott Laboratories, Abbott Park, IL), October 2002 to March 2006, Roche Amplicor PCR (Roche Molecular Systems, Branchburg, NJ), and then Abbott m200 real-time PCR, all with target areas on the cryptic plasmid. The unexplained decrease raised a suspicion of impairment of kit quality or a change in the target area in the microbe. By using ARTUS C. trachomatis (Hamburg, Germany) kit targeting the genomic ompA gene and not the cryptic plasmid, we found positive samples that had tested negative in Abbott's test. DNA sequencing of the area in the cryptic pl

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