Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America.
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America.
PLoS One. 2021 Sep 27;16(9):e0255878. doi: 10.1371/journal.pone.0255878. eCollection 2021.
The COVID-19 pandemic illuminated the benefits of telemedicine. Self-collected specimens are a promising alternative to clinician-collected specimens when in-person testing is not feasible. In this study, we assessed the adequacy of self-collected pharyngeal and rectal specimens for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae among individuals undergoing chlamydia and gonorrhea screening.
We used data from a large cohort study that included male and female adolescents between the ages of 12-24 years. We considered self-collected specimens adequate for clinical use if the human synthase gene (a control target of the assay) was detected in the specimen.
In total, 2,458 specimens were included in the analysis. The human synthase gene was detected in 99.2% (2,439/2,458) of all self-collected specimens, 99.5% (1,108/1,114) of the pharyngeal specimens, and 99.0% (1,331/1,344) of the rectal specimens.
Self-collected pharyngeal and rectal specimens demonstrated a very high proportion of human gene presence, suggesting that self-collection was accurate. A limitation of this study is that the sample adequacy control detects the presence or absence of the human hydroxymethylbilane synthase gene, but it does not indicate the specific anatomic origin of the human hydroxymethylbilane synthase gene. Self-collected specimens may be an appropriate alternative to clinician-collected specimens.
COVID-19 大流行凸显了远程医疗的好处。当无法进行面对面检测时,自我采集的标本是替代临床医生采集标本的有前途的选择。在这项研究中,我们评估了自我采集的咽和直肠标本在衣原体和淋病筛查个体中检测沙眼衣原体和淋病奈瑟菌的充分性。
我们使用了一项大型队列研究的数据,该研究包括 12-24 岁的男性和女性青少年。如果在标本中检测到人类合成酶基因(检测的对照靶标),则认为自我采集的标本适合临床使用。
总共分析了 2458 个标本。在所有自我采集的标本中,人类合成酶基因的检出率为 99.2%(2439/2458),在咽标本中的检出率为 99.5%(1108/1114),在直肠标本中的检出率为 99.0%(1331/1344)。
自我采集的咽和直肠标本显示出非常高的人类基因存在比例,表明自我采集是准确的。本研究的一个局限性是样本充分性控制仅检测到人羟甲基胆烷合成酶基因的存在或不存在,而不能指示人羟甲基胆烷合成酶基因的具体解剖来源。自我采集的标本可能是替代临床医生采集标本的合适选择。