Magder L S, Klontz K C, Bush L H, Barnes R C
Division of Sexually Transmitted Diseases, Centers for Disease Control, Atlanta, Georgia 30333.
J Clin Microbiol. 1990 Apr;28(4):781-4. doi: 10.1128/jcm.28.4.781-784.1990.
We compared the performance of a commercial enzyme immunoassay (EIA) (Chlamydiazyme; Abbott Diagnostics, North Chicago, Ill.) with that of cell culture for the detection of Chlamydia trachomatis cervical infection in 1,417 women attending public health clinics. Confirmatory chlamydial testing by a direct fluorescent-antibody test (MicroTrak; Syva Co., Palo Alto, Calif.) was performed on specimens from women who had positive EIAs. Overall, only 57% of women who had a positive chlamydial test by cell culture were also positive by EIA. We noted a strong association between the number of chlamydial inclusions in cell culture and a positive EIA outcome. The proportion of culture-positive women who also had a positive EIA declined with age and a history of previous sexually transmitted disease and increased among oral contraceptive users. The results of direct fluorescent-antibody confirmatory testing suggested that cell culture was also insensitive for the detection of C. trachomatis infection. Our observations demonstrate that the performance of the chlamydial EIA may vary greatly with individual patient characteristics and that the utility of EIA as a screening test may be limited, especially in older women.
我们比较了一种商用酶免疫测定法（EIA）（衣原体酶免疫测定试剂盒；雅培诊断公司，伊利诺伊州北芝加哥）与细胞培养法在检测1417名前往公共卫生诊所就诊的女性沙眼衣原体宫颈感染方面的表现。对酶免疫测定法结果呈阳性的女性的标本进行直接荧光抗体检测（MicroTrak；赛瓦公司，加利福尼亚州帕洛阿尔托）以进行衣原体确诊检测。总体而言，通过细胞培养衣原体检测呈阳性的女性中，只有57%的人酶免疫测定法结果也呈阳性。我们注意到细胞培养中衣原体包涵体的数量与酶免疫测定法阳性结果之间存在密切关联。酶免疫测定法结果也呈阳性的培养阳性女性比例随年龄增长、有既往性传播疾病史而下降，在口服避孕药使用者中则升高。直接荧光抗体确诊检测结果表明，细胞培养法在检测沙眼衣原体感染方面也不敏感。我们的观察结果表明，衣原体酶免疫测定法的表现可能因个体患者特征而有很大差异，并且酶免疫测定法作为一种筛查试验的效用可能有限，尤其是在老年女性中。
