Thomas E, Scott S D, Grefkees I, Hession G, Pollock R, Martin T, Albritton W
CMAJ. 1986 Jan 15;134(2):121-4, 146.
Although bacterial culture is considered to provide the most definitive diagnosis of gonorrhea, it has limitations when specimens must be transported long distances. A study was carried out to evaluate the validity and cost-effectiveness of an alternative method of diagnosing gonorrhea, the Gonozyme test, a commercially available enzyme immunoassay. Urogenital specimens from 100 men and 100 women with symptoms suggestive of or a history of exposure to gonorrhea were tested for the presence of Neisseria gonorrhoeae by means of bacterial culture and for gonococcal antigen with the Gonozyme test. The specimens from the men were also examined by means of microscopy of Gram-stained smears. The sensitivity and specificity of the Gonozyme test with reference to culture results were 95.6% and 97.4% respectively in the men and 84.2% and 98.7% in the women. The predictive value of a positive result was 91.6% in the men and 94.1% in the women, and the predictive value of a negative result 98.6% in the men and 96.3% in the women. The cost-effectiveness of the Gonozyme test was higher than that of bacterial culture in this population, which had a high prevalence rate of gonorrhea (23% in the men and 19% in the women). The Gonozyme test would be an adequate alternative to culture for the diagnosis of gonorrhea and contact tracing in areas far from diagnostic laboratories.
虽然细菌培养被认为是淋病最具确定性的诊断方法，但当标本必须长途运输时，它存在局限性。开展了一项研究以评估一种诊断淋病的替代方法——Gonozyme检测（一种市售酶免疫测定法）的有效性和成本效益。对100名有淋病症状提示或有淋病接触史的男性和100名女性的泌尿生殖系统标本，通过细菌培养检测淋病奈瑟菌的存在，并使用Gonozyme检测法检测淋球菌抗原。男性标本还通过革兰氏染色涂片显微镜检查。相对于培养结果，Gonozyme检测在男性中的敏感性和特异性分别为95.6%和97.4%，在女性中分别为84.2%和98.7%。阳性结果的预测值在男性中为91.6%，在女性中为94.1%，阴性结果的预测值在男性中为98.6%，在女性中为96.3%。在淋病患病率较高的人群（男性为23%，女性为19%）中，Gonozyme检测的成本效益高于细菌培养。对于远离诊断实验室地区的淋病诊断和接触者追踪，Gonozyme检测将是一种合适的替代培养的方法。
