从培养法过渡到核酸扩增检测后，男男性行为者咽部和直肠淋病的检测率增加。

Increased Detection of Pharyngeal and Rectal Gonorrhea in Men Who Have Sex With Men After Transition From Culture To Nucleic Acid Amplification Testing.

作者信息

Cornelisse Vincent J, Chow Eric P F, Huffam Sarah, Fairley Christopher K, Bissessor Melanie, De Petra Vesna, Howden Benjamin P, Denham Ian, Bradshaw Catriona S, Williamson Deborah, Chen Marcus Y

机构信息

From the *Melbourne Sexual Health Centre, Alfred Health; †Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University; and ‡Microbiological Diagnostic Unit, Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.

出版信息

Sex Transm Dis. 2017 Feb;44(2):114-117. doi: 10.1097/OLQ.0000000000000553.

DOI:10.1097/OLQ.0000000000000553

PMID:27984552

Abstract

BACKGROUND

This before-and-after study measured the impact of a change in testing methods from culture to nucleic acid amplification testing (NAAT) on the detection of pharyngeal and rectal gonorrhea in men who have sex with men (MSM) on a sexual health service level, including the effect on subgroups anticipated to have higher rates of gonorrhea.

METHODS

In March 2015, Melbourne Sexual Health Centre changed its laboratory method for gonococcal testing from culture to NAAT using the Aptima Combo 2 and Aptima GC tests. We compared the proportion of tests positive for rectal and pharyngeal gonorrhea in MSM using culture in 2014 with those using NAAT in 2015.

RESULTS

The proportion of tests positive for rectal gonorrhea by NAAT was double that obtained by culture (8% vs 3.9%; prevalence ratio [PR], 2.0; 95% confidence interval [CI], 1.8-2.4) and 5-fold for pharyngeal gonorrhea (8.3% vs 1.6%; PR, 5.2; 95% CI, 4.2-6.4). Similar increases in test positivity were observed in human immunodeficiency virus (HIV)-positive and HIV-negative men. By NAAT, test positivity for rectal gonorrhea was higher in HIV-positive compared with HIV-negative men (15.4% vs 7.3%; PR, 2.1; 95% CI, 1.7-2.6). Culture and NAAT had similar test positivity for rectal gonorrhea among men who reported contact with gonorrhea (24.9% vs 25.3%, PR 1.0, 95% CI 0.8-1.4) and men who presented with symptoms of proctitis (22.2% vs 27.9%, PR 1.3, 95% CI 0.8-2.0).

CONCLUSIONS

A switch from culture to Aptima Combo 2 testing for extragenital gonorrhea in MSM increased detection and was most marked for pharyngeal infections.

摘要

背景

这项前后对照研究评估了检测方法从培养法改为核酸扩增检测（NAAT）对性健康服务机构中男男性行为者（MSM）咽部和直肠淋病检测的影响，包括对预计淋病发病率较高的亚组的影响。

方法

2015年3月，墨尔本性健康中心将淋病检测的实验室方法从培养法改为使用Aptima Combo 2和Aptima GC检测的NAAT法。我们比较了2014年使用培养法和2015年使用NAAT法检测MSM直肠和咽部淋病的阳性检测比例。

结果

NAAT检测直肠淋病的阳性比例是培养法的两倍（8%对3.9%；患病率比[PR]，2.0；95%置信区间[CI]，1.8 - 2.4），咽部淋病为5倍（8.3%对1.6%；PR，5.2；95% CI，4.2 - 6.4）。在人类免疫缺陷病毒（HIV）阳性和HIV阴性男性中观察到类似的检测阳性率增加。通过NAAT检测，HIV阳性男性直肠淋病的检测阳性率高于HIV阴性男性（15.4%对7.3%；PR，2.1；95% CI，1.7 - 2.6）。在报告接触过淋病的男性（24.9%对25.3%，PR 1.0，95% CI 0.8 - 1.4）和出现直肠炎症状的男性（22.2%对27.9%，PR 1.3，95% CI 0.8 - 2.0）中，培养法和NAAT检测直肠淋病的阳性率相似。