Stary A, Najim B, Lee H H
Outpatients' Center for Diagnosis of Infectious Venero-Dermatological Diseases, Vienna, Austria.
J Clin Microbiol. 1997 Apr;35(4):836-8. doi: 10.1128/jcm.35.4.836-838.1997.
A ligase chain reaction (LCR)-based assay was recently shown to be highly sensitive and specific for the detection of Chlamydia trachomatis not only in cervical specimens but also in first-void urine (FVU) specimens form women. The suitability of using vulval swabs as an alternative specimen that can be obtained by noninvasive means for the diagnosis of genital chlamydial infection by LCR was investigated. In a first study of 169 women, vulval, endocervical, and urethral swabs were tested by LCR, culture, and a combination of enzyme immunoassay (EIA) followed by confirmation by direct fluorescent-antibody assay (DFA), and the results were compared with those obtained by testing FVU specimens by LCR and EIA-DFA by using a specimen from an infected patient as a reference standard. Of the 169 women tested, 27 (16%) were shown to be infected. Whereas LCR showed high sensitivities with all specimen types (85.2% for vulval, urine, and endocervical specimens; 92.6% for urethral swabs), the sensitivities of culture and EIA-DFA were high only with endocervical swabs (74.1 and 70.4%, respectively), being 22.2 and 40.7%, respectively, with vulval swabs. In addition, urine testing by EIA-DFA also showed a poor sensitivity (48.1%). In order to further compare LCR performance with vulval specimens to that with FVU specimens, a second study was carried out with specimens from 312 women, of whom 26 were infected. Comparable sensitivity was obtained by LCR with vulval swabs (88.5%; 23 of 26) and FVU specimens (92.3%; 24 of 26). The results indicate that vulval swabs may serve as suitable alternative to specimens that can be obtained by noninvasive means for the detection of C. trachomatis by LCR.
最近有研究表明，基于连接酶链反应（LCR）的检测方法不仅对宫颈标本中沙眼衣原体的检测具有高灵敏度和特异性，而且对女性首次晨尿（FVU）标本中沙眼衣原体的检测也具有高灵敏度和特异性。本研究探讨了使用外阴拭子作为一种可通过非侵入性方法获取的替代标本，用于通过LCR诊断生殖器衣原体感染的适用性。在第一项针对169名女性的研究中，采用LCR、培养法以及酶免疫测定（EIA）联合直接荧光抗体测定（DFA）进行确认的方法，对外阴、宫颈管和尿道拭子进行检测，并将结果与以感染患者的标本为参考标准，通过LCR和EIA-DFA检测FVU标本所获得的结果进行比较。在接受检测的169名女性中，有27名（16%）被证实感染。LCR对所有标本类型均显示出高灵敏度（外阴、尿液和宫颈管标本的灵敏度为85.2%；尿道拭子的灵敏度为92.6%），而培养法和EIA-DFA仅对宫颈管拭子具有高灵敏度（分别为74.1%和70.4%），对外阴拭子的灵敏度分别为22.2%和40.7%。此外，EIA-DFA检测尿液的灵敏度也较低（48.1%）。为了进一步比较LCR对外阴标本和FVU标本的检测性能，对312名女性的标本进行了第二项研究，其中26名感染。LCR对外阴拭子（88.5%；26例中的23例）和FVU标本（92.3%；26例中的24例）的检测灵敏度相当。结果表明，外阴拭子可作为通过LCR检测沙眼衣原体的非侵入性获取标本的合适替代物。
