采用基于连接酶链反应的检测方法，利用来自不同部位的临床标本检测沙眼衣原体和淋病奈瑟菌：对诊断检测和筛查的意义
Detection of Chlamydia trachomatis and Neisseria gonorrhoeae by ligase chain reaction-based assays with clinical specimens from various sites: implications for diagnostic testing and screening.
作者信息
Buimer M, van Doornum G J, Ching S, Peerbooms P G, Plier P K, Ram D, Lee H H
机构信息
Department of Public Health, Municipal Health Service of Amsterdam, The Netherlands.
出版信息
J Clin Microbiol. 1996 Oct;34(10):2395-400. doi: 10.1128/jcm.34.10.2395-2400.1996.
Ligase chain reaction (LCR)-based tests for the diagnosis of Chlamydia trachomatis and Neisseria gonorrhoeae infections in men and women attending a sexually transmitted disease clinic were evaluated. LCR testing of urethral swab and urine specimens from men and cervical swab and urine specimens from women was compared with culture of male urethral swabs and female cervical and urethral swabs, respectively. An expanded "gold standard" was defined as a positive culture or at least one specimen confirmed to be positive by LCR testing. The prevalence of C. trachomatis infection as detected by cell culture was 7.0% among 614 men and 5.0% among 602 women. By LCR, these values increased to 11.4 and 9.9% with urethral swabs and urine, respectively, for men and 9.6 and 9.1% with cervical swabs and urine, respectively, for women. Relative to the expanded gold standard, the sensitivity of cell culture with male urethral swabs or female cervical swabs was 57.3 and 45.5%, respectively, compared with corresponding values of 93.3 and 87.9% for LCR. The sensitivity of LCR with urine specimens was 77.3 and 78.8% for men and women, respectively. The prevalence of N. gonorrhoeae infection as detected by culture was 5.9% among 220 men and 2.9% among 383 women. The corresponding values were 8.2 and 5.5%, respectively, by LCR testing of swabs. Prevalence values by LCR testing of urine were 7.3% for men and 2.9% for women. The sensitivity of culture was 72.2% for men and 50.0% for women. The sensitivities of LCR were 100% with male urethral swabs, 95.4% with female cervical swabs, 88.9% with male urine, and 50.0% with female urine. These results indicate that the LCR-based assays represent a major improvement in C. trachomatis and N. gonorrhoeae diagnostics. The sensitivity of testing of urethral or cervical swabs by LCR was markedly greater than that by culture. The sensitivity of testing female or male urine specimens was equal to or greater than that of culturing cervical or urethral specimens. LCR testing of urine specimens may prove useful for screening for C. trachomatis.
对一家性传播疾病诊所中前来就诊的男性和女性进行基于连接酶链反应（LCR）的沙眼衣原体和淋病奈瑟菌感染诊断检测进行了评估。分别将男性尿道拭子和尿液标本以及女性宫颈拭子和尿液标本的LCR检测结果与男性尿道拭子、女性宫颈和尿道拭子的培养结果进行比较。扩展的“金标准”定义为培养阳性或至少有一个标本经LCR检测确认为阳性。通过细胞培养检测出的沙眼衣原体感染率在614名男性中为7.0%，在602名女性中为5.0%。通过LCR检测，男性尿道拭子和尿液的感染率分别升至11.4%和9.9%，女性宫颈拭子和尿液的感染率分别升至9.6%和9.1%。相对于扩展的金标准，男性尿道拭子或女性宫颈拭子细胞培养的敏感性分别为57.3%和45.5%，而LCR的相应值分别为93.3%和87.9%。尿液标本LCR检测对男性和女性的敏感性分别为77.3%和78.8%。通过培养检测出的淋病奈瑟菌感染率在220名男性中为5.9%，在383名女性中为2.9%。拭子LCR检测的相应值分别为8.2%和5.5%。尿液LCR检测的感染率男性为7.3%，女性为2.9%。培养的敏感性男性为72.2%，女性为50.0%。LCR的敏感性男性尿道拭子为100%，女性宫颈拭子为95.4%，男性尿液为88.9%，女性尿液为50.0%。这些结果表明，基于LCR的检测方法在沙眼衣原体和淋病奈瑟菌诊断方面有了重大改进。LCR检测尿道或宫颈拭子的敏感性明显高于培养。检测女性或男性尿液标本的敏感性等于或高于培养宫颈或尿道标本。尿液标本的LCR检测可能对沙眼衣原体筛查有用。
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