Hammerschlag M R, Roblin P M, Gelling M, Tsumura N, Jule J E, Kutlin A
Department of Pediatrics, State University of New York Health Science Science Center at Brooklyn 11203-2098, USA.
Pediatr Infect Dis J. 1997 Mar;16(3):293-7. doi: 10.1097/00006454-199703000-00008.
Chlamydia trachomatis is the most common identifiable infectious cause of neonatal conjunctivitis. Nonculture tests including enzyme immunoassays and direct fluorescent antibody tests have been shown to perform well for the diagnosis of chlamydial conjunctivitis with sensitivities and specificities > or = 90%. However, the performance with respiratory specimens has been less than satisfactory.
We compared a new, commercially available polymerase chain reaction (PCR) assay, Roche AMPLICOR (Roche Diagnostic Systems, Branchburg, NJ) with culture for the detection of C. trachomatis in conjunctival and nasopharyngeal specimens from infants with conjunctivitis. We also evaluated AMPLICOR for the detection of C. trachomatis in the urine of mothers of positive infants.
Ocular and nasopharyngeal specimens from 75 infants with conjunctivitis were obtained for culture and PCR. AMPLICOR was equivalent to culture for eye specimens and more sensitive than culture for nasopharyngeal specimens. The sensitivity, specificity and positive and negative predictive values of PCR compared with culture for conjunctival specimens were 92.3, 100, 100 and 98.4%, respectively. The sensitivity, specificity and positive and negative predictive values for nasopharyngeal specimens were 100, 97.2, 60 and 100%, respectively. We also detected C. trachomatis by PCR in the urine of 12 mothers of culture positive infants.
PCR performed comparably to culture for detection of C. trachomatis in conjunctival and nasopharyngeal specimens from infants with conjunctivitis.
沙眼衣原体是新生儿结膜炎最常见的可识别感染病因。包括酶免疫测定和直接荧光抗体检测在内的非培养检测方法，已被证明在诊断衣原体结膜炎方面表现良好，其敏感性和特异性≥90%。然而，这些方法在呼吸道标本检测中的表现并不令人满意。
我们将一种新的、市售的聚合酶链反应（PCR）检测方法——罗氏AMPLICOR（罗氏诊断系统公司，新泽西州布兰奇堡），与培养法进行比较，以检测结膜炎婴儿结膜和鼻咽标本中的沙眼衣原体。我们还评估了AMPLICOR检测衣原体阳性婴儿母亲尿液中沙眼衣原体的情况。
采集了来自75例结膜炎婴儿的眼和鼻咽标本进行培养及PCR检测。AMPLICOR对眼标本的检测效果与培养法相当，对鼻咽标本的检测比培养法更敏感。PCR与培养法相比，结膜标本的敏感性、特异性、阳性预测值和阴性预测值分别为92.3%、100%、100%和98.4%。鼻咽标本的敏感性、特异性、阳性预测值和阴性预测值分别为100%、97.2%、60%和100%。我们还通过PCR在12例培养阳性婴儿母亲的尿液中检测到了沙眼衣原体。
在检测结膜炎婴儿结膜和鼻咽标本中的沙眼衣原体方面，PCR的表现与培养法相当。
