Johns Hopkins Medical Institutions, Baltimore, MD.
Sex Transm Dis. 2018 Nov;45(11):723-727. doi: 10.1097/OLQ.0000000000000865.
This study compared performance of the Atlas io polymerase chain reaction-based, point-of-care (POC) assay for Chlamydia trachomatis (CT), to Aptima Combo 2, a standard of care nucleic acid amplification assay, and evaluated patient attitudes toward POC testing.
Women 14 years or older undergoing CT screening/testing were recruited from Teen Health Center and a sexually transmitted disease clinic. Participants provided self-obtained vaginal swabs for testing with the Atlas io and Aptima Combo 2, and completed questionnaires assessing attitudes toward POC testing.
Of 296 women recruited, 284 (192 from sexually transmitted disease clinic, 92 from Teen Health Center) had Aptima Combo 2 and Atlas io results available; 273 completed the questionnaire. Average age was 27.4 years (SD, 10.8 years). Sensitivity and specificity of the Atlas io test were 83.9% (26/31 specimens; 95% confidence interval [CI], 70.9-96.8%) and 98.8% (250/253 specimens; 95% CI, 97.5-100%), respectively. When specimens with discrepant results were included in the analyses, adjudicated sensitivity and specificity were 92.9% (26/28 specimens; 95% CI, 83.3 to 100%) and 98.8% (253/256 specimens; 95% CI, 97.5 to 100%), respectively.A majority (70%) of women preferred to collect vaginal self-swab if a POC test were available. Most (61%) were willing to wait up to 20 minutes, and 26% were willing to wait up to 40 minutes for results, if they could be treated before leaving clinic.
A POC polymerase chain reaction test detecting CT had high sensitivity and specificity when testing prospective, vaginal swab samples. Availability of CT results during patients' visits may decrease time to treatment.
本研究比较了 Atlas io 基于聚合酶链反应的即时检测(POC)检测沙眼衣原体(CT)的性能,与作为临床护理标准的 Aptima Combo 2 核酸扩增检测,并评估了患者对 POC 检测的态度。
从青少年健康中心和性传播疾病诊所招募年龄在 14 岁及以上的 CT 筛查/检测女性参与者。参与者提供了自身阴道拭子,用于 Atlas io 和 Aptima Combo 2 检测,并完成了评估对 POC 检测态度的问卷。
共招募了 296 名女性,其中 284 名(92 名来自青少年健康中心,192 名来自性传播疾病诊所)有 Aptima Combo 2 和 Atlas io 的检测结果;273 名完成了问卷。平均年龄为 27.4 岁(标准差,10.8 岁)。Atlas io 检测的敏感性和特异性分别为 83.9%(26/31 份标本;95%置信区间[CI],70.9-96.8%)和 98.8%(250/253 份标本;95%CI,97.5-100%)。当纳入检测结果不一致的标本进行分析时,经裁决的敏感性和特异性分别为 92.9%(26/28 份标本;95%CI,83.3-100%)和 98.8%(253/256 份标本;95%CI,97.5-100%)。大多数(70%)女性如果有 POC 检测可用,她们更愿意自行采集阴道拭子。大多数(61%)愿意等待最多 20 分钟,如果可以在离开诊所前得到治疗,有 26%愿意等待最多 40 分钟得到结果。
在检测前瞻性阴道拭子样本时,POC 聚合酶链反应检测 CT 的敏感性和特异性较高。在患者就诊期间获得 CT 结果可能会减少治疗时间。