Chernesky M, Jang D, Portillo E, Chong S, Smieja M, Luinstra K, Petrich A, Macritchie C, Ewert R, Hayhoe B, Sarabia A, Thompson F
St. Joseph's Healthcare/McMaster University, Toronto, Ontario, Canada.
J Clin Microbiol. 2007 Aug;45(8):2355-8. doi: 10.1128/JCM.00405-07. Epub 2007 May 30.
Infections with Chlamydia trachomatis and Neisseria gonorrhoeae are often asymptomatic. Liquid-based Pap (L-Pap) screening may provide samples for testing by commercial assays. Women attending a health clinic or a street youth clinic had a PreservCyt ThinPrep sample and a cervical swab (CS) collected. The L-Pap sample was tested for cytopathology; then 1 ml was transferred to an L-Pap specimen transfer tube for testing by the Gen-Probe APTIMA assays (APTIMA Combo 2 [AC2], APTIMA C. trachomatis [ACT], and APTIMA N. gonorrhoeae [AGC]). The residual L-Pap sample was tested for C. trachomatis and N. gonorrhoeae using Roche AMPLICOR (AMP) and Becton Dickinson ProbeTec (PT). The CS was tested by AC2. A patient was considered infected if two specimens were positive or if a single specimen was positive in two tests. The prevalence of infection was 10% (29/290) for C. trachomatis and 2.4% (7/290) for N. gonorrhoeae. Most of the positive patients had specimens that were reactive in all assays (20/29 for C. trachomatis; 6/7 for N. gonorrhoeae). Four patients had double infections. The sensitivities and specificities of the various tests for the specimens tested were as follows. For C. trachomatis on L-Pap, sensitivity and specificity were 100 and 98.1%, respectively, for ACT, 93.1 and 98.8% for AC2, 86.2 and 91.2% for AMP, and 72.4 and 92.7% for PT. For N. gonorrhoeae on L-Pap, sensitivity and specificity were 100% for both AGC and AC2, 85.7 and 100% for AMP, and 85.7 and 100% for PT. For AC2 with CSs, sensitivity and specificity were 93.1 and 98.5%, respectively, for C. trachomatis, and both were 100% for N. gonorrhoeae. There were significant differences in sensitivity and specificity (P < 0.001). The APTIMA assays were more sensitive and specific than AMP or PT for detecting women's C. trachomatis and/or N. gonorrhoeae infections by testing ThinPrep samples.
沙眼衣原体和淋病奈瑟菌感染通常无症状。液基巴氏涂片（L-Pap）筛查可为商业检测提供样本。在健康诊所或街头青年诊所就诊的女性接受了PreservCyt ThinPrep样本和宫颈拭子（CS）采集。L-Pap样本进行了细胞病理学检测；然后将1毫升样本转移至L-Pap样本转移管，用于Gen-Probe APTIMA检测（APTIMA Combo 2 [AC2]、APTIMA沙眼衣原体检测[ACT]和APTIMA淋病奈瑟菌检测[AGC]）。剩余的L-Pap样本使用罗氏AMPLICOR（AMP）和贝克曼库尔特ProbeTec（PT）检测沙眼衣原体和淋病奈瑟菌。CS样本通过AC2检测。如果两份样本呈阳性或一份样本在两次检测中呈阳性，则该患者被视为感染。沙眼衣原体感染率为10%（29/290），淋病奈瑟菌感染率为2.4%（7/290）。大多数阳性患者的样本在所有检测中均呈反应性（沙眼衣原体20/29；淋病奈瑟菌6/7）。4名患者为双重感染。对所检测样本进行的各种检测的敏感性和特异性如下。对于L-Pap样本中的沙眼衣原体，ACT的敏感性和特异性分别为100%和98.1%，AC2为93.1%和98.8%，AMP为86.2%和91.2%，PT为72.4%和92.7%。对于L-Pap样本中的淋病奈瑟菌，AGC和AC2的敏感性和特异性均为100%，AMP为85.7%和100%，PT为85.7%和100%。对于CS样本中的AC2，沙眼衣原体的敏感性和特异性分别为93.1%和98.5%，淋病奈瑟菌的敏感性和特异性均为100%。敏感性和特异性存在显著差异（P<0.001）。通过检测ThinPrep样本，APTIMA检测在检测女性沙眼衣原体和/或淋病奈瑟菌感染方面比AMP或PT更敏感、更特异。
