Lister N A, Tabrizi S N, Fairley C K, Garland S
Department of Public Health, The University of Melbourne, Royal Women's Hospital, Women's and Children's Health, Melbourne, Australia.
J Clin Microbiol. 2004 Jan;42(1):239-41. doi: 10.1128/JCM.42.1.239-241.2004.
Screening guidelines for men who have sex with men (MSM) recommend testing of extragenital sites (pharyngeal and rectal) for gonorrhoea and chlamydia. Testing of specimens from these sites is not validated by most commercial nucleic amplification tests, such as the COBAS Amplicor assay. To investigate the utility of the COBAS Amplicor assay for detection of Chlamydia trachomatis in extragenital specimens, this study developed and evaluated confirmatory tests using the omp1 gene as an alternative target for amplification by PCR. Of anal and throat swabs collected from men in male-only saunas, 52 swabs that tested C. trachomatis positive by COBAS Amplicor and 30 swabs that tested as negative were included for confirmatory omp1 PCR testing. A total of 49 (94%) COBAS Amplicor-positive samples were confirmed by the omp1 PCR. A substantial proportion of specimens were confirmed by using a nested omp1 PCR (27%). Not confirmed by any omp1 PCR were three anal swabs (6%). It is most probable that these samples contained lower bacterial levels that were near or below the detection level of the omp1 PCR assays. The findings of this study support the confident reporting of C. trachomatis detected by COBAS Amplicor in extragenital specimens and support the utility of this assay as a screening test for MSM.
男男性行为者（MSM）的筛查指南建议对其生殖器外部位（咽部和直肠）进行淋病和衣原体检测。大多数商业核酸扩增检测方法，如COBAS Amplicor检测法，并未验证过对这些部位标本的检测。为了研究COBAS Amplicor检测法在检测生殖器外标本中沙眼衣原体的实用性，本研究开发并评估了以omp1基因为PCR扩增替代靶点的验证性检测方法。从仅对男性开放的桑拿浴室中的男性采集的肛门和咽喉拭子中，选取了52份经COBAS Amplicor检测沙眼衣原体呈阳性的拭子以及30份检测为阴性的拭子，用于omp1 PCR验证性检测。共有49份（94%）COBAS Amplicor检测阳性的样本经omp1 PCR得到确认。相当一部分标本通过巢式omp1 PCR得到确认（27%）。有三份肛门拭子（6%）未被任何omp1 PCR方法确认。很可能这些样本中的细菌水平较低，接近或低于omp1 PCR检测法的检测水平。本研究结果支持对COBAS Amplicor在生殖器外标本中检测出的沙眼衣原体进行可靠报告，并支持该检测法作为MSM筛查检测方法的实用性。
