Ngeow Y F, Hema V, Zakaria M, Lee C H, Ramachandran S
Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Malays J Pathol. 1997 Dec;19(2):127-32.
First-void urine samples collected from sexually transmitted diseases (STD) clinic patients were examined by a nested polymerase chain reaction (PCR) and a commercial enzyme immunoassay (IDEIA Chlamydia) for the diagnosis of Chlamydia trachomatis urethritis or cervicitis. The primers for the PCR amplified a target in the major outer membrane protein (MOMP) gene in C trachomatis while the IDEIA detected genus-specific chlamydial lipopolysaccharide. Discrepant results were resolved by retesting urine specimens with a second (plasmid-based) PCR and taking urethral or endocervical swab results into consideration. For 231 men (chlamydial prevalence 20.4%), the sensitivity, specificity, positive and negative predictive values were 59.6%, 99.5%, 96.6% and 90.6% for urine IDEIA, 68.1%, 99.5%, 97% and 92.4% for urethral swab IDEIA and 97.9%, 99.5%, 97.9% and 99.5% for urine PCR. The corresponding rates for 66 women (chlamydial prevalence 54.6%) were 19.4%, 100%, 100% and 50.8% for urine IDEIA, 86.1%, 96.7%, 96.9% and 85.3% for endocervical swab IDEIA and 91.7%, 93.3%, 94.3% and 90.3% for urine PCR. Hence, in a high prevalence population, the urine IDEIA was a suitable alternative to the male urethral swab IDEIA but significantly less sensitive than the endocervical swab IDEIA. The urine PCR was, however, much more sensitive than the urine IDEIA for both men and women and could replace the endocervical swab IDEIA for the diagnosis of chlamydial cervicitis.
对从性传播疾病（STD）门诊患者收集的首次晨尿样本，采用巢式聚合酶链反应（PCR）和商业酶免疫测定法（衣原体酶免疫测定法）检测沙眼衣原体尿道炎或宫颈炎。PCR引物扩增沙眼衣原体主要外膜蛋白（MOMP）基因中的一个靶点，而衣原体酶免疫测定法检测属特异性衣原体脂多糖。通过用第二种（基于质粒的）PCR重新检测尿液标本并考虑尿道或宫颈拭子结果来解决不一致的结果。对于231名男性（衣原体患病率20.4%），尿液衣原体酶免疫测定法的敏感性、特异性、阳性和阴性预测值分别为59.6%、99.5%、96.6%和90.6%，尿道拭子衣原体酶免疫测定法分别为68.1%、99.5%、97%和92.4%，尿液PCR分别为97.9%、99.5%、97.9%和99.5%。66名女性（衣原体患病率54.6%）的相应比率，尿液衣原体酶免疫测定法分别为19.4%、100%、100%和50.8%，宫颈拭子衣原体酶免疫测定法分别为86.1%、96.7%、96.9%和85.3%，尿液PCR分别为91.7%、93.3%、94.3%和90.3%。因此，在高患病率人群中，尿液衣原体酶免疫测定法是男性尿道拭子衣原体酶免疫测定法的合适替代方法，但敏感性明显低于宫颈拭子衣原体酶免疫测定法。然而，尿液PCR对男性和女性的敏感性均远高于尿液衣原体酶免疫测定法，可替代宫颈拭子衣原体酶免疫测定法用于诊断衣原体宫颈炎。
