用于诊断新生儿和成人沙眼衣原体引起的结膜炎的培养、酶联免疫吸附测定和免疫荧光试验。

Culture, ELISA and immunofluorescence tests for the diagnosis of conjunctivitis caused by Chlamydia trachomatis in neonates and adults.

作者信息

Stenberg K, Herrmann B, Dannevig L, Elbagir A N, Mårdh P A

机构信息

Department of Ophthalmology, University of Gothenburg, Sweden.

出版信息

APMIS. 1990 Jun;98(6):514-20.

PMID:2200446

Abstract

The relative value of culture, direct specimen antigen detection tests, i.e., enzyme-linked immunosorbent assay (ELISA) and immunofluorescence (IF) tests in the diagnosis of Chlamydia trachomatis infection was studied in 125 newborns and 121 adults with signs of conjunctivitis. Eye and nasopharyngeal samples were tested by culture using cycloheximide-treated or irradiated McCoy cells, ELISA (i.e., Chlamydiazyme, Abbott) and IF tests (i.e., Chlamyset, Orion and MicroTrak, Syva). Of the neonates, 70 (35 boys and 35 girls) and 54 (33 males and 21 females) of the adults were positive in one or both eyes in one or more tests: 191 (39%) in cultures, 173 (35%) in ELISA and 160 (33%), 176 (36%) in each of the IF tests. Using culture as standard reference, the sensitivities of ELISA and the IF tests were 88%, 81% and 87%, while the corresponding specificities were 99%, 98% and 97%, respectively. The predictive values for a negative test (PVN) were 93%, 89% and 92% and for a positive test (PVP) 98%, 96% and 94%. Of the 124 cases chlamydia-positive in the eyes, 67 (54%), 76 (61%), 64 (52%) and 70 (57%) were positive in nasopharyngeal samples in one or more of culture, ELISA and the two IF tests, respectively. The sensitivities of ELISA and the IF tests in nasopharyngeal samples were 87%, 78% and 81%, while the corresponding specificities were 90%, 93% and 91%, respectively. The predictive values for a negative (PVN) test were 95%, 92% and 93%, and for a positive test (PVP) 76%, 81%, and 77%. Nasopharyngeal swabs were more often positive in cases with 2 or more weeks' duration of symptoms than in those with shorter duration.

摘要

在125名有结膜炎体征的新生儿和121名成人中，研究了培养法、直接标本抗原检测试验，即酶联免疫吸附测定（ELISA）和免疫荧光（IF）试验在沙眼衣原体感染诊断中的相对价值。使用经放线菌酮处理或辐照的 McCoy 细胞通过培养法对眼和鼻咽样本进行检测，同时进行 ELISA（即 Chlamydiazyme，雅培公司）和 IF 试验（即 Chlamyset，奥立安公司和 MicroTrak，赛瓦公司）。在新生儿中，70名（35名男孩和35名女孩）以及54名成人（33名男性和21名女性）在一只或两只眼睛的一项或多项检测中呈阳性：培养法检测出191例（39%）阳性，ELISA检测出173例（35%）阳性，每项IF试验分别检测出160例（33%）和176例（36%）阳性。以培养法作为标准参考，ELISA和IF试验的敏感性分别为88%、81%和87%，而相应的特异性分别为99%、98%和97%。阴性试验预测值（PVN）分别为93%、89%和92%，阳性试验预测值（PVP）分别为98%、96%和94%。在124例眼部衣原体阳性病例中，在培养法、ELISA和两项IF试验中的一项或多项检测中，鼻咽样本呈阳性的分别有67例（54%）、76例（61%）、64例（52%）和70例（57%）。ELISA和IF试验在鼻咽样本中的敏感性分别为87%、78%和81%，而相应的特异性分别为90%、93%和91%。阴性试验预测值（PVN）分别为95%、92%和93%，阳性试验预测值（PVP）分别为76%、81%和77%。症状持续2周或更长时间的病例中鼻咽拭子阳性的情况比症状持续时间较短的病例更常见。