Gaydos C A, Crotchfelt K A, Howell M R, Kralian S, Hauptman P, Quinn T C
Infectious Disease Division, Johns Hopkins University, Baltimore City Health Department, Maryland, USA.
J Infect Dis. 1998 Feb;177(2):417-24. doi: 10.1086/514207.
Polymerase chain reaction (PCR) and ligase chain reaction (LCR) were compared for the diagnosis of Chlamydia trachomatis infections by testing urine specimens from 408 high school female students. After therapy, sequential urine specimens were tested to determine persistence of chlamydial DNA in urine. Baseline PCR of cervical specimens was positive in 53 (13.0%) students, and PCR and LCR of urine specimens were positive in 63 (15.4%) and 60 (14.7%), respectively. After discrepant analysis, 64 (15.7%) patients could be confirmed as truly infected. Follow-up urine specimens from 33 infected patients demonstrated that at 1-3 days after therapy, PCR and LCR were positive for 40% and 73.3%, respectively. Only at 15 days after therapy did all specimens test negative. Urine tests for Chlamydia organisms should not be used as a test of cure within 3 weeks after treatment. Use of urine assays for screening sexually active adolescents has the potential to significantly improve control of chlamydial infections.
通过检测408名高中女学生的尿液标本，比较了聚合酶链反应（PCR）和连接酶链反应（LCR）在诊断沙眼衣原体感染中的应用。治疗后，对连续的尿液标本进行检测，以确定衣原体DNA在尿液中的持续存在情况。宫颈标本的基线PCR检测中，53名（13.0%）学生呈阳性，尿液标本的PCR和LCR检测分别有63名（15.4%）和60名（14.7%）呈阳性。经过差异分析，64名（15.7%）患者可被确认为真正感染。33名感染患者的随访尿液标本显示，治疗后1 - 3天，PCR和LCR的阳性率分别为40%和73.3%。仅在治疗后15天，所有标本检测均为阴性。治疗后3周内，不应将衣原体尿液检测用作治愈检测。对性活跃青少年进行尿液检测筛查有可能显著改善衣原体感染的控制。
