Vogels W H, van Voorst Vader P C, Schröder F P
Laboratory for Medical Microbiology, University Hospital, Groningen, The Netherlands.
J Clin Microbiol. 1993 May;31(5):1103-7. doi: 10.1128/jcm.31.5.1103-1107.1993.
A study to compare the polymerase chain reaction (PCR) test with the cell culture method in diagnosing urogenital Chlamydia trachomatis infections was performed. From 497 patients (212 women, 285 men) attending an outpatient clinic for sexually transmitted diseases, a total of 814 samples (female patients, cervix and urethra; male patients, urethra) were collected. This total included follow-up samples from 35 women and 35 men positive for C. trachomatis by cell culture and/or PCR test, which were collected 2 weeks after treatment with doxycycline (two 100-mg doses per day for 7 days). The PCR test was performed directly on clinical samples without performing phenol-chloroform extraction and ethanol precipitation of DNA. The prevalence of C. trachomatis as measured by positive cell culture was 64 of 497 (12.9%) for all patients, 31 of 212 (14.6%) for women, and 33 of 285 (11.6%) for men. The prevalences as measured by positive PCR test were 71 of 497 (14.3%), 36 of 212 (17.0%), and 35 of 285 (12.3%), respectively. The sensitivities of the cell culture and the PCR test compared with that of true-positive samples were 77.5 to 78.4% and 99.0 to 100.0%, respectively. Discrepancies between cell culture and the PCR test were found for 23 of 497 patients (4.9%), 19 of 212 females (9.0%), and 4 of 285 males (1.4%). Nineteen pretreatment samples from 19 patients (4 female endocervical, 13 female urethral, and 2 male urethral samples) were cell culture negative and PCR test positive, while 1 pretreatment female endocervical sample was cell culture positive and PCR test negative. The posttreatment samples from all patients were cell culture negative, but the PCR test remained positive for 3 of 70 patients (1 female endocervical and 2 male urethral samples). One of these samples became spontaneously negative in three more weeks. The medical history of the individual patient and the negative PCR tests after treatment for nearly all patients support our hypothesis that the positive PCR test results were clinically relevant for the cell culture-negative but PCR test-positive but PCR test-positive patients of the population studied.
开展了一项研究，比较聚合酶链反应（PCR）检测与细胞培养法在诊断泌尿生殖系统沙眼衣原体感染中的效果。从497名到性传播疾病门诊就诊的患者（212名女性，285名男性）中，共采集了814份样本（女性患者采集宫颈和尿道样本；男性患者采集尿道样本）。这其中包括35名女性和35名男性的随访样本，这些患者通过细胞培养和/或PCR检测确诊为沙眼衣原体阳性，在接受强力霉素治疗（每日两次，每次100毫克，共7天）2周后采集样本。PCR检测直接在临床样本上进行，无需对DNA进行酚-氯仿提取和乙醇沉淀。通过细胞培养检测为阳性的沙眼衣原体患病率，在所有患者中为497例中的64例（12.9%），女性为212例中的31例（14.6%），男性为285例中的33例（11.6%）。通过PCR检测为阳性的患病率分别为497例中的71例（14.3%），女性为212例中的36例（17.0%），男性为285例中的35例（12.3%）。与真阳性样本相比，细胞培养和PCR检测的灵敏度分别为77.5%至78.4%和99.0%至100.0%。在497例患者中有23例（4.9%）、212例女性中有19例（9.0%）、285例男性中有4例（1.4%）的细胞培养和PCR检测结果存在差异。19例患者的19份治疗前样本（4份女性宫颈样本、13份女性尿道样本和2份男性尿道样本）细胞培养为阴性但PCR检测为阳性，而1份女性宫颈治疗前样本细胞培养为阳性但PCR检测为阴性。所有患者的治疗后样本细胞培养均为阴性，但70例患者中有3例（1份女性宫颈样本和2份男性尿道样本）的PCR检测仍为阳性。其中1份样本在再过三周后自发转阴。个体患者的病史以及几乎所有患者治疗后的PCR检测阴性结果支持了我们的假设，即对于本研究人群中细胞培养阴性但PCR检测阳性的患者，PCR检测阳性结果具有临床相关性。
