Moncada J, Schachter J, Shafer M A, Williams E, Gourlay L, Lavin B, Bolan G
Department of Laboratory Medicine, University of California, San Francisco.
Sex Transm Dis. 1994 Jan-Feb;21(1):8-12. doi: 10.1097/00007435-199401000-00003.
Non-invasive tests are needed to detect Chlamydia trachomatis in the genital tract. For men, urine appears to be a useful specimen for chlamydial antigen or nucleic acid detection.
To evaluate enzyme immunoassays (EIA) for chlamydial antigens in first catch urine (FCU) from symptomatic and asymptomatic men.
We conducted five different studies; FCUs and urethral swabs were collected from 1,341 symptomatic and 816 asymptomatic males. Four EIAs (SureCell, Chlamydiazyme, MicroTrak and IDEIA) were tested on the FCU sediments.
Prevalence of chlamydia by tissue culture isolation was 6% for asymptomatic and 14% for symptomatic men. With symptomatic males, the EIA sensitivities and specificities were: SureCell 85% and 97%, IDEIA 82% and 98%, MicroTrak 86% and 99%, and Chlamydiazyme 91% and 95%. For asymptomatic men, Chlamydiazyme sensitivity was 35% with frozen urine vs 77% with fresh urine. Overall, tissue culture sensitivity was about 90%.
EIA results on FCU sediments are comparable to that of tissue culture isolation on urethral swabs. In many settings, FCU may be the specimen of choice for diagnosing chlamydial infections in men.
需要采用非侵入性检测方法来检测生殖道中的沙眼衣原体。对于男性而言，尿液似乎是用于衣原体抗原或核酸检测的有用标本。
评估酶免疫分析法（EIA）用于检测有症状和无症状男性首次晨尿（FCU）中的衣原体抗原。
我们开展了五项不同的研究；从1341名有症状男性和816名无症状男性中采集了首次晨尿和尿道拭子。对首次晨尿沉淀物进行了四种酶免疫分析法（SureCell、Chlamydiazyme、MicroTrak和IDEIA）检测。
通过组织培养分离法检测出的衣原体患病率，无症状男性为6%，有症状男性为14%。对于有症状男性，酶免疫分析法的敏感性和特异性分别为：SureCell为85%和97%，IDEIA为82%和98%，MicroTrak为86%和99%，Chlamydiazyme为91%和95%。对于无症状男性，Chlamydiazyme对冷冻尿液的敏感性为35%，对新鲜尿液的敏感性为77%。总体而言，组织培养的敏感性约为90%。
首次晨尿沉淀物的酶免疫分析法结果与尿道拭子的组织培养分离法结果相当。在许多情况下，首次晨尿可能是诊断男性衣原体感染的首选标本。
