Knud-Hansen C R, Dallabetta G A, Reichart C, Pabst K M, Hook E W, Wasserheit J N
Calbot County Health Department, Easton, Maryland.
Sex Transm Dis. 1991 Oct-Dec;18(4):211-6. doi: 10.1097/00007435-199110000-00003.
This study compared leukocyte esterase dipsticks (LED) and endocervical Gram stains (EGS) as surrogates for culture diagnosis of gonococcal and chlamydial cervicitis in 495 STD clinic patients. Overall, gonorrhea prevalence was 15.7%; chlamydia prevalence (in the subgroup that was tested) was 17.8%. In diagnosing gonorrhea, LED and EGS performed similarly, with sensitivities of 68% and 76%, respectively, and identical specificities of 44%. In diagnosing gonococcal or chlamydial cervicitis, LED and EGS sensitivities fell to 48% and 47%, respectively, whereas specificities increased to 55% and 75%. These data suggest that, although both tests are imperfect surrogates for gonococcal and chlamydial culture, LED sacrifices little in sensitivity compared with EGS. Because LED does not require ancillary supplies, equipment, electricity, or trained personnel, its use may be feasible when Gram-stain diagnosis is impossible. Modifications of LED technology and specimen preparation should be sought to improve LED performance.
本研究比较了白细胞酯酶试纸（LED）和宫颈内膜革兰氏染色（EGS）作为495例性病门诊患者淋菌性和衣原体性宫颈炎培养诊断替代方法的情况。总体而言，淋病患病率为15.7%；衣原体患病率（在接受检测的亚组中）为17.8%。在诊断淋病时，LED和EGS表现相似，敏感性分别为68%和76%，特异性均为44%。在诊断淋菌性或衣原体性宫颈炎时，LED和EGS的敏感性分别降至48%和47%，而特异性则升至55%和75%。这些数据表明，尽管这两种检测方法都是淋病和衣原体培养的不完美替代方法，但与EGS相比，LED在敏感性方面牺牲较小。由于LED不需要辅助耗材、设备、电力或经过培训的人员，在无法进行革兰氏染色诊断时，使用LED可能是可行的。应寻求改进LED技术和标本制备方法以提高其性能。
