Morse Stephen A
Science Bioterrorism Preparedness and Response Program, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Salud Publica Mex. 2003;45 Supp 5:S698-708. doi: 10.1590/s0036-36342003001100017.
Because of their asymptomatic nature and nonspecific symptoms, laboratory tests are often required to diagnose a sexually transmitted infection. Over the past few years, there have been advances in technology, such as the development of nucleic acid amplification assays, which have improved our ability to diagnose infections caused by Chlamydia trachomatis. The finding that nucleic acid amplification tests can detect more infected individuals and are useful in screening low prevalence populations, has led to the development of strategies designed to reduce the cost of these assays without significantly impacting their sensitivity. The development of new tests for the diagnosis of syphilis has gained momentum from the report of a synthetic VDRL antigen, which will result in better nontreponemal antibody tests for syphilis. In spite of the completion of the genome sequence of Treponema pallidum and its annotation, we are still unable to cultivate this microorganism in vitro. However, the molecular revolution has resulted in the development of PCR assays for detecting Treponema pallidum in various types of clinical specimens, and to the production of recombinant antigens for use in tests that detect treponemal-specific antibodies. Further research will improve the availability of low cost, sensitive tests for the diagnosis of sexually transmitted infections. The English version of this paper is available too at:http://www.insp.mx/salud/index.html.
由于性传播感染无症状且症状不具特异性，通常需要实验室检测来进行诊断。在过去几年里，技术取得了进步，例如核酸扩增检测方法的开发，这提高了我们诊断沙眼衣原体感染的能力。核酸扩增检测能够检测出更多感染者且对低流行率人群筛查有用这一发现，促使人们制定策略以降低这些检测方法的成本，同时又不会显著影响其敏感性。梅毒诊断新检测方法的开发因一种合成性病研究实验室（VDRL）抗原的报告而得到推动，这将带来更好的梅毒非梅毒螺旋体抗体检测方法。尽管梅毒螺旋体的基因组序列已完成测序及注释，但我们仍无法在体外培养这种微生物。然而，分子革命带来了用于在各类临床标本中检测梅毒螺旋体的聚合酶链反应（PCR）检测方法的开发，以及用于检测梅毒螺旋体特异性抗体检测的重组抗原的生产。进一步的研究将提高低成本、高敏感性的性传播感染诊断检测方法的可得性。本文的英文版也可在以下网址获取：http://www.insp.mx/salud/index.html 。
