Xu K, Glanton V, Johnson S R, Beck-Sagué C, Bhullar V, Candal D H, Pettus K S, Farshy C E, Black C M
National Center for Infectious Diseases, Centers for Disease Control and Prevention, Public Health Service, U.S. Department of Health & Human Services, Atlanta, Georgia 30333, USA.
Sex Transm Dis. 1998 Nov;25(10):533-8. doi: 10.1097/00007435-199811000-00007.
Culture, the conventional method for detection of Neisseria gonorrhoeae, requires invasive sampling and stringent specimen transport conditions. The recently developed ligase chain reaction test (LCR; Abbott Laboratories; North Chicago, IL) allows noninvasive sampling and stable transport conditions, but has not been evaluated with specimens from adolescent populations.
To perform a comparative evaluation of a commercial LCR test and culture for the diagnosis of N. gonorrhoeae in adolescent women.
Urine and endocervical swab specimens from 330 teenage women seen in two public health adolescent clinics were tested by LCR and culture. For resolution of discordant results, a polymerase chain reaction (PCR) test was developed that directly amplifies N. gonorrhoeae DNA from urine samples processed for LCR.
Thirty-one of 330 (9.4%) cervical specimens were culture-positive for N. gonorrhoeae, and 30 of 330 (9.1%) urine specimens were positive by LCR. After resolution of 13 discordant results, the sensitivity, specificity, and positive and negative predictive values of LCR for urine were 88.2%, 100%, 100%, 98.7%, respectively, and for culture of endocervical specimens were 82.3%, 98.9%, 90.3% and 98%, respectively.
Although more expensive than culture, LCR offers a sensitive means for the detection of N. gonorrhoeae in urine samples and may be useful for this purpose in settings where pelvic examinations are difficult to perform and simultaneous detection of N. gonorrhoeae and Chlamydia trachomatis is advantageous.
培养法是检测淋病奈瑟菌的传统方法，需要进行侵入性采样并严格遵守标本运输条件。最近开发的连接酶链反应检测法（LCR；雅培实验室；伊利诺伊州北芝加哥）允许非侵入性采样和稳定的运输条件，但尚未在青少年人群的标本中进行评估。
对一种商用LCR检测法和培养法在诊断青春期女性淋病奈瑟菌感染方面进行比较评估。
对在两家公共卫生青少年诊所就诊的330名少女的尿液和宫颈拭子标本进行LCR检测和培养。为了解决不一致的结果，开发了一种聚合酶链反应（PCR）检测法，可直接从经LCR处理的尿液样本中扩增淋病奈瑟菌DNA。
330份宫颈标本中有31份（9.4%）淋病奈瑟菌培养阳性，330份尿液标本中有30份（9.1%）LCR检测呈阳性。在解决了13个不一致的结果后，LCR对尿液检测的敏感性、特异性、阳性预测值和阴性预测值分别为88.2%、100%、100%、98.7%，对宫颈标本培养的敏感性、特异性、阳性预测值和阴性预测值分别为82.3%、98.9%、90.3%和98%。
尽管LCR检测法比培养法更昂贵，但它为检测尿液样本中的淋病奈瑟菌提供了一种敏感的方法，在难以进行盆腔检查且同时检测淋病奈瑟菌和沙眼衣原体具有优势的情况下，可能对此有用。
