Schachter J, Moncada J, Whidden R, Shaw H, Bolan G, Burczak J D, Lee H H
Department of Laboratory Medicine, University of California, San Francisco, USA.
J Infect Dis. 1995 Nov;172(5):1411-4. doi: 10.1093/infdis/172.5.1411.
Ligase chain reaction (LCR) to diagnose Chlamydia trachomatis infection was evaluated using first-catch urine (FCU) specimens from 4053 women. Results were compared with those of cell culture (TC) isolation from cervix (all) and urethra (2812 women). The reference standard was TC positivity or positive LCR for chlamydial plasmid DNA confirmed by direct fluorescent antibody test or LCR for another chlamydial gene. Compared with cervical culture, LCR was 88.2% sensitive and 100% specific. Adding urethral culture increased TC sensitivity from 67.1% to 74% and reduced LCR sensitivity to 85.9%. The prevalence of chlamydial infection was 5% (142/2812) by the dual culture system and 5.9% (165/2812) by LCR on FCU specimens. LCR on FCU specimens is highly sensitive and specific for diagnosing chlamydial infection. It is more sensitive than TC and may well present public health authorities with a useful noninvasive screening test for chlamydial infection in asymptomatic women.
采用4053名女性的首次晨尿（FCU）样本对用于诊断沙眼衣原体感染的连接酶链反应（LCR）进行了评估。将结果与来自宫颈（全部）和尿道（2812名女性）的细胞培养（TC）分离结果进行比较。参考标准为通过直接荧光抗体试验确认的沙眼衣原体质粒DNA的TC阳性或LCR阳性，或另一个沙眼衣原体基因的LCR阳性。与宫颈培养相比，LCR的敏感性为88.2%，特异性为100%。增加尿道培养可使TC敏感性从67.1%提高到74%，并使LCR敏感性降低至85.9%。通过双重培养系统，沙眼衣原体感染的患病率为5%（142/2812），而基于FCU样本的LCR检测结果为5.9%（165/2812）。基于FCU样本的LCR对诊断沙眼衣原体感染具有高度敏感性和特异性。它比TC更敏感，很可能为公共卫生当局提供一种用于无症状女性沙眼衣原体感染的有用的非侵入性筛查试验。
