Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA
Seattle Children's Hospital, Seattle, Washington, USA.
J Clin Microbiol. 2020 Jan 28;58(2). doi: 10.1128/JCM.01433-19.
Laboratory diagnosis of microbial agents associated with sexually transmitted infections plays an important role in both the care of victims of child sexual abuse (CSA) and the investigation of suspected CSA incidents, with law enforcement implications. Rapid and sensitive test results prompt immediate actions to treat and protect the victimized children. The development and maturation of automated nucleic acid amplification tests (NAATs) has greatly improved the assay sensitivity and specificity, with only a 1- to 2-h turnaround time. Unfortunately, the performance characteristics of NAATs have been determined largely with a few limited specimen types and evaluated in adults only. This minireview attempts to cover the scope of infectious agents potentially implicated in CSA, specimen collection, laboratory test modalities, and laboratory report constraints, further complicated by infrequently collected specimen types from prepubertal children <13 years of age.
实验室诊断与性传播感染相关的微生物病原体在儿童性虐待(CSA)受害者的护理以及疑似 CSA 事件的调查中都发挥着重要作用,具有执法意义。快速、灵敏的检测结果可促使及时采取行动,对受虐待儿童进行治疗和保护。自动化核酸扩增检测(NAAT)的发展和成熟极大地提高了检测的灵敏度和特异性,检测周转时间仅为 1-2 小时。遗憾的是,NAAT 的性能特征主要是通过少数几种有限的标本类型来确定的,并且仅在成年人中进行了评估。这篇迷你综述试图涵盖可能与 CSA 相关的感染病原体、标本采集、实验室检测方式以及实验室报告限制的范围,而来自<13 岁青春期前儿童的标本类型采集频率较低,使情况变得更加复杂。