Hallsworth P G, Hefford C, Waddell R G, Gordon D L
Department of Microbiology and Infectious Diseases, Flinders Medical Centre, Bedford Park, South Australia.
Pathology. 1995 Apr;27(2):168-71. doi: 10.1080/00313029500169812.
An in-house polymerase chain reaction (PCR) test using ribosomal RNA gene primers was compared with chlamydia antigen detection (DIF) and culture for the detection of Chlamydia trachomatis. Five hundred and forty-eight fresh (unstored) genital swabs and 174 urines (collected at the same time) from patients attending a sexually-transmitted diseases clinic were examined. PCR, DIF and culture detected chlamydia in 43, 35 and 42 swabs respectively from the 43 resolved positive cases. The specificity on the resolved negative specimens was 100% for each of the tests. From the urines, PCR and DIF detected the organism in 16 and 15 cases respectively of the 23 resolved positive males tested but in only 2 and 3 cases respectively of the 9 resolved positive females tested. Specificities were 100% in all cases. Both of the non-culture tests manifested problems with urine due to inhibitory activity (in PCR test) or excessive debris (in DIF test) in about 5% of the specimens. Culture of the urines yielded sensitivities of 40% in the males and 22% in the females. Overall PCR was more sensitive than either culture or DIF on both urethral and cervical swabs and urines. The urines yielded less than three-quarters the number of positives that was obtained from the swabs and were considered to be an unsatisfactory specimen for chlamydial diagnosis. It is concluded that PCR is a satisfactory alternative to culture on genital swabs and may be preferable in situations where the viability of the organisms is in question. DIF remains useful because of its speed and simplicity but is insufficiently sensitive to be relied upon by itself.
采用核糖体RNA基因引物进行的内部聚合酶链反应（PCR）检测，与衣原体抗原检测（直接免疫荧光法，DIF）及培养法用于沙眼衣原体检测的效果进行了比较。对一家性传播疾病诊所的548份新鲜（未保存）生殖器拭子样本以及174份同时采集的尿液样本进行了检测。在43例确诊为阳性的病例中，PCR、DIF及培养法分别从43份、35份及42份拭子样本中检测出衣原体。在确诊为阴性的样本中，三种检测方法的特异性均为100%。在检测的23例确诊为阳性的男性尿液样本中，PCR和DIF分别在16例和15例样本中检测到病原体；而在9例确诊为阳性的女性尿液样本中，PCR和DIF分别仅在2例和3例样本中检测到病原体。所有情况下特异性均为100%。约5%的样本中，两种非培养检测方法均出现了问题，PCR检测存在抑制活性问题，DIF检测存在过多杂质问题。尿液培养法在男性中的敏感性为40%，在女性中的敏感性为22%。总体而言，在尿道和宫颈拭子样本以及尿液检测中，PCR比培养法或DIF更敏感。尿液样本检测出的阳性病例数不到拭子样本的四分之三，因此被认为是衣原体诊断不理想的样本。结论是，PCR是生殖器拭子培养的一种令人满意的替代方法，在病原体生存能力存疑的情况下可能更可取。DIF因其速度快和操作简单仍有用，但敏感性不足，不能单独依靠。
