D'Angelo L J, Mohla C, Sneed J, Woodward K
J Adolesc Health Care. 1987 Jul;8(4):344-8. doi: 10.1016/0197-0070(87)90006-4.
A timely and accurate technique for diagnosing gonorrhea is necessary if prompt therapy is to be instituted. We screened 567 adolescents who presented for routine gynecologic care or for specific gynecologic or urologic problems. Each patient was tested by standard culture, Gonozyme (Abbott Labs), and Gram's stain. One hundred five patients (18.5%) had an ELISA immunoassay or culture evidence of infection. Overall sensitivity was 90% for Gonozyme and 56% for Gram's stain (females 41%, males 94%). Overall specificity was 97% for Gonozyme and 99% for Gram's stain. No increase in sensitivity of either test was found in women with signs of upper genital tract involvement. The predictive value of a negative Gonozyme was 98% and 85% for a positive result compared to Gram's stain values of 99% and 95%, respectively. Overall clinical efficacy was 96% for Gonozyme and 93% for Gram's stain. Gonozyme, although a sensitive and specific test, has a limited role in the diagnosis of gonorrhea. Gram's stain, although more limited in women, may serve as a useful adjunct in diagnosing gonorrhea.
若要及时开展治疗，就需要一种及时且准确的淋病诊断技术。我们对567名前来接受常规妇科护理或因特定妇科或泌尿科问题就诊的青少年进行了筛查。每位患者都接受了标准培养、淋球菌酶免疫测定法（Gonozyme，雅培实验室产品）和革兰氏染色检测。105名患者（18.5%）有酶联免疫吸附测定（ELISA）免疫测定或培养感染证据。Gonozyme的总体敏感性为90%，革兰氏染色的总体敏感性为56%（女性为41%，男性为94%）。Gonozyme的总体特异性为97%，革兰氏染色的总体特异性为99%。在上生殖道受累有体征的女性中，未发现任何一种检测的敏感性有所提高。Gonozyme检测结果为阴性时的预测值为98%，检测结果为阳性时的预测值为85%，与之相比，革兰氏染色检测结果为阴性时的预测值分别为99%，检测结果为阳性时的预测值为95%。Gonozyme的总体临床疗效为96%，革兰氏染色的总体临床疗效为93%。Gonozyme虽然是一种敏感且特异的检测方法，但在淋病诊断中的作用有限。革兰氏染色虽然对女性的作用更有限，但可作为淋病诊断的一种有用辅助手段。
