邮寄的家庭采集尿液标本：一种检测无症状沙眼衣原体感染的可靠筛查方法。
Mailed, home-obtained urine specimens: a reliable screening approach for detecting asymptomatic Chlamydia trachomatis infections.
作者信息
Morré S A, van Valkengoed I G, de Jong A, Boeke A J, van Eijk J T, Meijer C J, van den Brule A J
机构信息
Department of Pathology, Section of Molecular Pathology, University Hospital Vrije Universiteit, 1081 HV Amsterdam, The Netherlands.
出版信息
J Clin Microbiol. 1999 Apr;37(4):976-80. doi: 10.1128/JCM.37.4.976-980.1999.
The use of mailed, home-obtained urine specimens could facilitate screening programs for the detection of asymptomatic Chlamydia trachomatis infections. Since transport time could have an adverse effect on the sensitivity of C. trachomatis detection by PCR, the influence of DNA degradation on amplification was monitored over the course of 1 week. Therefore, urine specimens were aliquoted on the day of collection or arrival. Two groups of urine specimens were investigated. Group I contains first-void C. trachomatis-positive and -negative urine samples. DNA degradation was monitored in group I samples for 7 days at room temperature (RT) and at 4 degrees C by amplifying different lengths of the human beta-globin gene and the C. trachomatis plasmid target. DNA degradation was observed only for the larger human beta-globin fragments at days 5 to 7 at RT. In contrast, at 4 degrees C all targets could be amplified. Urine specimens were also frozen and thawed before aliquoting to mimic freezing during transport. This resulted in a lower sensitivity for the detection of C. trachomatis after thawing and 3 to 4 days at RT. In addition, mailed, home-obtained C. trachomatis-positive urine specimens (group II) were analyzed for 7 days after arrival by two commercially available C. trachomatis detection systems (PCR and ligase chain reaction [LCR]). The C. trachomatis plasmid target in mailed, home-obtained urine specimens could be amplified by both PCR and LCR after 1 week of storage and/or transport at RT. In conclusion, our findings indicate that mailed, home-obtained urine specimens are suitable for the sensitive detection of asymptomatic C. trachomatis infections by amplification methods, even if the transport time is up to 1 week at RT. These findings support the feasibility and validity of screening programs based on mailed, home-obtained urine specimens. Larger studies should be initiated to confirm our results.
使用邮寄的、在家中采集的尿液标本有助于开展筛查项目，以检测无症状沙眼衣原体感染。由于运输时间可能会对通过聚合酶链反应（PCR）检测沙眼衣原体的敏感性产生不利影响，因此在1周的时间内监测了DNA降解对扩增的影响。因此，尿液标本在采集当天或送达当天进行分装。对两组尿液标本进行了研究。第一组包含首次晨尿沙眼衣原体阳性和阴性的尿液样本。通过扩增不同长度的人β-珠蛋白基因和沙眼衣原体质粒靶标，在室温（RT）和4℃下对第一组样本中的DNA降解情况进行了7天的监测。仅在室温下第5至7天观察到较大的人β-珠蛋白片段出现DNA降解。相比之下，在4℃时所有靶标均可扩增。尿液标本在分装前还进行了冻融处理，以模拟运输过程中的冷冻情况。这导致解冻后以及在室温下放置3至4天后沙眼衣原体检测的敏感性降低。此外，对邮寄的、在家中采集的沙眼衣原体阳性尿液标本（第二组）在送达后7天内，使用两种市售的沙眼衣原体检测系统（PCR和连接酶链反应[LCR]）进行了分析。在室温下储存和/或运输1周后，邮寄的、在家中采集的尿液标本中的沙眼衣原体质粒靶标可通过PCR和LCR进行扩增。总之，我们的研究结果表明，即使在室温下运输时间长达1周，邮寄的、在家中采集的尿液标本也适用于通过扩增方法敏感地检测无症状沙眼衣原体感染。这些发现支持了基于邮寄的、在家中采集的尿液标本开展筛查项目的可行性和有效性。应开展更大规模的研究以证实我们的结果。
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