van Voorst Vader P C, Posma A L, Lier J G, Schröder F P, Schirm J, Kauer F M
Afd. Dermatovenereologie, Academisch Ziekenhuis, Groningen.
Ned Tijdschr Geneeskd. 1991 Feb 23;135(8):328-31.
We studied the value of the determination of the serum IgM antibody level for the diagnosis of genital Chlamydia trachomatis infection in women and the value of the urethra in addition to the cervix as a sampling site for the diagnosis of C. trachomatis infection by culture and direct immune-fluorescence (IF) test. Of 205 women, mean age 26 years (range 14-56), who visited the Sexually Transmitted Disease clinic of the University Hospital Groningen from July 1985 until November 1987, single serum samples were obtained for the determination of IgM and IgG anti-C. trachomatis antibodies using FITC conjugates, in addition to swabs of cervix and urethra for culture and direct IF test. In women with a negative culture and positive IgM serology the culture was repeated. The culture was used as golden standard. In 17/205 (36%) women positive C. trachomatis IgM serology (greater than or equal to 1:32) and in 190/205 (93%) positive IgG serology (greater than or equal to 1:40) was found. In 67/205 (33%) women the C. trachomatis culture of cervix and (or) urethra was positive. The positive and negative predictive values of C. trachomatis IgM serology were 41% and 72%. In 3/20 women with negative culture results and positive IgM serology a second culture was positive. In 176 women, of whom samples from both cervix and urethra were available, the only C. trachomatis positive site by culture was the urethra in 7/54 (13%) and by direct IF in 3/42 (7%). The increase in the prevalence obtained by collecting material not only from the cervix but also from the urethra was 4% by culture and 2% by direct IF.2+n
我们研究了血清IgM抗体水平测定对女性生殖道沙眼衣原体感染诊断的价值，以及除宫颈外尿道作为沙眼衣原体感染诊断的培养和直接免疫荧光（IF）检测采样部位的价值。在1985年7月至1987年11月期间到格罗宁根大学医院性传播疾病门诊就诊的205名平均年龄26岁（范围14 - 56岁）的女性中，除了采集宫颈和尿道拭子进行培养和直接IF检测外，还采集了单份血清样本用于使用异硫氰酸荧光素（FITC）偶联物测定抗沙眼衣原体IgM和IgG抗体。对于培养阴性但IgM血清学阳性的女性，重复进行培养。培养被用作金标准。在205名女性中，发现17/205（8.3%）女性沙眼衣原体IgM血清学阳性（≥1:32），190/205（92.7%）女性IgG血清学阳性（≥1:40）。67/205（32.7%）女性宫颈和（或）尿道的沙眼衣原体培养呈阳性。沙眼衣原体IgM血清学的阳性和阴性预测值分别为41%和72%。在20名培养结果阴性但IgM血清学阳性的女性中，有3名再次培养呈阳性。在176名同时有宫颈和尿道样本的女性中，培养仅尿道沙眼衣原体阳性的占7/54（13%），直接IF检测仅尿道阳性的占3/42（7%）。通过不仅从宫颈而且从尿道采集材料，培养患病率增加了4%，直接IF检测患病率增加了2%。
