Kissin D M, Holman S, Minkoff H L, DeMeo L, McCormack W M, DeHovitz J A
SUNY Albany School of Public Health, NY, USA.
Sex Transm Infect. 2002 Jun;78(3):208-9. doi: 10.1136/sti.78.3.208.
Ligase chain reaction (LCR) technology has dramatically increased the sensitivity of tests for sexually transmitted infections (STIs). It is unknown whether low copy infections (LCR positive, culture negative) have any clinical consequences. We assessed the clinical significance of untreated low copy Chlamydia trachomatis and Neisseria gonorrhoeae infections in a cohort of sexually active women.
We studied a cohort of sexually active women followed at 6 month intervals for up to 3 years. Frozen urine specimens from 181 women with negative cultures for C. trachomatis and N. gonorrhoeae who were 'high risk' (defined as being less than 40 years old at baseline, and having either Trichomonas vaginalis at baseline or a history of more than one sexual partner during the 12 months before baseline) were tested for C. trachomatis and N. gonorrhoeae by LCR (Abbott Laboratories, Abbott Park, IL, USA). The specimens from all visits for each person were pooled and LCR was performed on the pool. Laboratory results were linked to clinical information. We also tested all urine samples obtained from patients with a positive culture.
10 additional infections (nine C. trachomatis and one N. gonorrhoeae) were detected with LCR technique. None of the women with low copy infection had evidence of subsequent pelvic inflammatory disease or ectopic pregnancy. Pooling of urine samples resulted in a 47% decline in the number of tests performed.
Additional STIs can be identified when using LCR. Pooling of urine specimens is a cost saving technique for C. trachomatis and N. gonorrhoeae testing.
连接酶链反应（LCR）技术极大地提高了性传播感染（STIs）检测的灵敏度。低拷贝感染（LCR阳性，培养阴性）是否具有任何临床后果尚不清楚。我们评估了未治疗的低拷贝沙眼衣原体和淋病奈瑟菌感染在一群性活跃女性中的临床意义。
我们研究了一群性活跃女性，每隔6个月随访一次，为期3年。从181名沙眼衣原体和淋病奈瑟菌培养阴性的“高危”女性（定义为基线时年龄小于40岁，且基线时有阴道毛滴虫感染或在基线前12个月内有多个性伴侣史）的冷冻尿液标本中，通过LCR（美国伊利诺伊州雅培公园的雅培实验室）检测沙眼衣原体和淋病奈瑟菌。将每个人每次就诊的标本混合，并对混合标本进行LCR检测。实验室结果与临床信息相关联。我们还对培养阳性患者的所有尿液样本进行了检测。
通过LCR技术又检测到10例感染（9例沙眼衣原体和1例淋病奈瑟菌）。低拷贝感染的女性均无后续盆腔炎或异位妊娠的证据。尿液样本混合后，检测次数减少了47%。
使用LCR时可识别出更多的性传播感染。尿液标本混合是沙眼衣原体和淋病奈瑟菌检测的一种节省成本的技术。
