Andrews W W, Lee H H, Roden W J, Mott C W
Department of Obstetrics and Gynecology, University of Alabama at Birmingham 35233-7333, USA.
Obstet Gynecol. 1997 Apr;89(4):556-60. doi: 10.1016/S0029-7844(97)00003-3.
To compare the sensitivity and specificity of a ligase chain reaction assay of cervical swabs and voided urine with those of cervical swab tissue culture for the detection of genitourinary tract infection with Chlamydia trachomatis in pregnant women.
Infection with C trachomatis was assessed in cervical swabs by culture and in both cervical swabs and voided urine specimens by a ligase chain reaction assay specific for C trachomatis plasmid DNA. The matched cervical swab and voided urine specimens were collected from 462 women during routine visits to prenatal clinics. Standard criteria that defined infection included: 1) a positive cervical culture result or 2) a negative culture but a positive ligase chain reaction result in either the urine or cervical specimen that was confirmed by supplementary testing. Test performance was assessed by determination of sensitivity and specificity, and differences in paired results were determined using McNemar analysis.
The prevalence of genitourinary C trachomatis infection was 6.1% (n = 28) by cervical culture (sensitivity 30.1%; specificity 100%), 18.2% (n = 84) by ligase chain reaction of cervical swabs (sensitivity 90.3%; specificity 100%), and 16.9% (n = 78) by ligase chain reaction of urine (sensitivity 83.9%; specificity 99.5%). Relative to the number of women with a positive culture or a confirmed ligase chain reaction-positive cervical swab, the sensitivity and specificity were 82.8% and 97.9%, respectively, for ligase chain reaction of urine and 96.6% and 100%, respectively, for ligase chain reaction of cervical swabs. Ligase chain reaction of cervical swabs and urine detected 89.3% and 82.1%, respectively, of women with a positive cervical culture.
Ligase chain reaction assay of cervical or urine specimens detected considerably more pregnant women with C trachomatis infection of the genitourinary tract than did cervical culture. Ligase chain reaction testing of urine is a simple and effective means of screening pregnant women for genitourinary tract infection with C trachomatis.
比较宫颈拭子和晨尿连接酶链反应检测法与宫颈拭子组织培养法检测孕妇沙眼衣原体生殖道感染的敏感性和特异性。
采用沙眼衣原体质粒DNA特异性连接酶链反应检测法，对宫颈拭子和晨尿标本进行沙眼衣原体感染评估，同时对宫颈拭子进行培养。在产前门诊常规就诊时，从462名女性中采集配对的宫颈拭子和晨尿标本。定义感染的标准为：1）宫颈培养结果阳性；或2）培养阴性，但尿液或宫颈标本连接酶链反应结果阳性，且经补充检测确认。通过测定敏感性和特异性评估检测性能，使用McNemar分析确定配对结果的差异。
宫颈培养法检测到的生殖道沙眼衣原体感染患病率为6.1%（n = 28）（敏感性30.1%；特异性100%），宫颈拭子连接酶链反应检测法为18.2%（n = 84）（敏感性90.3%；特异性100%），晨尿连接酶链反应检测法为16.9%（n = 78）（敏感性83.9%；特异性99.5%）。相对于培养阳性或连接酶链反应阳性宫颈拭子确认的女性数量，晨尿连接酶链反应的敏感性和特异性分别为82.8%和97.9%，宫颈拭子连接酶链反应分别为96.6%和100%。宫颈拭子和晨尿连接酶链反应分别检测出宫颈培养阳性女性的89.3%和82.1%。
与宫颈培养相比，宫颈或尿液标本连接酶链反应检测法能检测出更多患有沙眼衣原体生殖道感染的孕妇。尿液连接酶链反应检测是筛查孕妇沙眼衣原体生殖道感染的一种简单有效的方法。
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