核酸扩增检测对男男性行为人群性传播疾病门诊患者外生殖器淋病和衣原体感染检测的影响。

Effect of nucleic acid amplification testing on detection of extragenital gonorrhea and chlamydial infections in men who have sex with men sexually transmitted disease clinic patients.

机构信息

From the *Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA; †Public Health-Seattle & King County HIV/STD Program, Seattle, WA; and ‡Department of Epidemiology, University of Washington, Seattle, WA.

出版信息

Sex Transm Dis. 2014 Mar;41(3):168-72. doi: 10.1097/OLQ.0000000000000093.

DOI:10.1097/OLQ.0000000000000093

PMID:24521722

Abstract

BACKGROUND

In 2010, the Centers for Disease and Control and Prevention recommended using nucleic acid amplification tests (NAATs) for extragenital gonorrhea (GC) and chlamydia (CT) testing because of NAATs' improved sensitivity compared with culture.

METHODS

In 2011, the Public Health-Seattle & King County Sexually Transmitted Disease Clinic introduced NAAT-based testing for extragenital GC and CT infection in men who have sex with men (MSM) using AptimaCombo2. We compared extragenital GC and CT test positivity and infection detection yields in the last year of culture-based testing (2010) to the first year of NAAT testing (2011).

RESULTS

Test positivity of GC increased by 8% for rectal infections (9.0%-9.7%) and 12% for pharyngeal infections (5.8%-6.5%) from 2010 to 2011; CT test positivity increased 61% for rectal infections (7.4%-11.9%). Pharyngeal CT was identified in 2.3% of tested persons in 2011 (not tested in 2010). We calculated the ratio of extragenital cases per 100 urethral infections to adjust for a possible decline in GC/CT incidence in 2011; the GC rectal and pharyngeal ratios increased 77% and 66%, respectively, and the CT rectal ratio increased 127%. The proportion of infected persons with isolated extragenital infections (i.e., extragenital infections without urethral infection) increased from 43% in 2010 to 57% in 2011.

CONCLUSIONS

Extragenital testing with NAAT substantially increases the number of infected MSM identified with GC or CT infection and should continue to be promoted.

摘要

背景

2010 年，由于核酸扩增检测（NAAT）比培养法具有更高的灵敏度，疾病控制与预防中心建议将其用于生殖道外淋病（GC）和衣原体（CT）检测。

方法

2011 年，公共卫生-西雅图和金县性传播疾病诊所（Public Health-Seattle & King County Sexually Transmitted Disease Clinic）在男男性行为者（MSM）中引入 AptimaCombo2 进行基于 NAAT 的生殖道外 GC 和 CT 感染检测。我们比较了基于培养的检测（2010 年）的最后一年和 NAAT 检测（2011 年）的第一年的生殖道外 GC 和 CT 检测阳性率和感染检出率。

结果

2010 年至 2011 年，直肠感染的 GC 检测阳性率从 9.0%升至 9.7%（增加了 8%），咽感染的 GC 检测阳性率从 5.8%升至 6.5%（增加了 12%）；直肠感染的 CT 检测阳性率增加了 61%（从 7.4%升至 11.9%）。2011 年，检测出 2.3%的受检者有咽 CT（2010 年未检测）。我们计算了生殖道外病例与每 100 例尿道感染的比值，以调整 2011 年 GC/CT 发病率可能下降的情况；GC 直肠和咽的比值分别增加了 77%和 66%，CT 直肠的比值增加了 127%。2010 年，有孤立性生殖道外感染（即无尿道感染的生殖道外感染）的感染者比例为 43%，2011 年增加到 57%。