Vázquez Fernando, Lepe José Antonio, Otero Luis, Blanco María Antonia, Aznar Javier
Servicio de Microbiología, Hospital Monte Naranco, Area de Microbiología, Facultad de Medicina de Oviedo, Oviedo, España.
Enferm Infecc Microbiol Clin. 2008 Jan;26(1):32-7. doi: 10.1157/13114393.
Sexually transmitted infections (STIs) constitute an important world-wide public health problem. The use of sensitive and specific laboratory methods for diagnosing this condition is crucial to reduce the transmission and sequelae of STI. The present review describes current microbiological methods for the diagnosis of STIs. Neisseria gonorrhoeae and Chlamydia trachomatis are the pathogens most frequently involved in urethral and cervical infection. Culture continues to be the gold standard for diagnosing gonorrhea. Nucleic acid amplification assays are considered the new gold standard for C. trachomatis, although culture is till the most specific technique. Genital ulcers due to Treponema pallidum, Haemophilus ducreyi, or herpes simplex virus have little clinical and bacteriological correlation; therefore, it is essential to establish the microbiological diagnosis. Lesions present in the primary or secondary period of syphilis can be diagnosed by dark field microscopy. Serologic diagnosis for the remaining periods is based on non-treponemal tests associated with confirmatory treponemal tests. Cell culture is considered the gold standard for herpes simplex virus although molecular methods also have a sensitivity and specificity near 100%. Currently, microbiologic diagnosis of H. ducreyi and venereal lymphogranuloma is achieved with the use of molecular methods on samples obtained from the ulceration or lymph adenopathy. The diagnosis of genital warts in immunocompetent patients is based on clinical findings in most cases because the lesions are sufficiently characteristic. Culture is considered the reference method in Trichomonas vaginalis infection.
性传播感染（STIs）是一个重要的全球公共卫生问题。使用敏感且特异的实验室方法诊断这种疾病对于减少性传播感染的传播及后遗症至关重要。本综述描述了目前用于诊断性传播感染的微生物学方法。淋病奈瑟菌和沙眼衣原体是尿道和宫颈感染中最常涉及的病原体。培养仍然是诊断淋病的金标准。核酸扩增检测被认为是诊断沙眼衣原体的新金标准，尽管培养仍是最特异的技术。由梅毒螺旋体、杜克雷嗜血杆菌或单纯疱疹病毒引起的生殖器溃疡在临床和细菌学方面关联不大；因此，进行微生物学诊断至关重要。梅毒一期或二期出现的损害可通过暗视野显微镜诊断。其余阶段的血清学诊断基于非梅毒螺旋体试验及确证性梅毒螺旋体试验。细胞培养被认为是单纯疱疹病毒的金标准，尽管分子方法的敏感性和特异性也接近100%。目前，对杜克雷嗜血杆菌和性病性淋巴肉芽肿的微生物学诊断是通过对从溃疡或淋巴结病获取的样本使用分子方法来实现的。在大多数情况下，免疫功能正常患者的尖锐湿疣诊断基于临床发现，因为这些损害具有足够的特征性。培养被认为是阴道毛滴虫感染的参考方法。
