连接酶链反应检测男性就诊者尿标本中的沙眼衣原体

南方医科大学学报 ›› 2004, Vol. 24 ›› Issue (05): 485-488.

连接酶链反应检测男性就诊者尿标本中的沙眼衣原体

彭学标, 曾抗

第一军医大学南方医院皮肤科, 广东, 广州, 510515

出版日期:2004-05-20 发布日期:2004-05-20
基金资助:
基金项目:The study is supported by Guangdong Provincial Foundation Medical Sci-entific Research (A1998353)
作者简介:PENG Xue-biao, MD, Tel: 020-61641984

Ligase chain reaction for Chlamydia trachomatis detection in urine specimens from symptomatic and asymptomatic men

PENG Xue-biao, ZENG Kang

第一军医大学南方医院皮肤科, 广东, 广州, 510515

Online:2004-05-20 Published:2004-05-20

摘要/Abstract

摘要： 目的评价连接酶链反应(LCR)检测性病专科门诊男性就诊者尿标本中沙眼衣原体(CT)的敏感性和特异性。方法取852例患者尿道拭子作CT培养;同时取患者较长时间(2 h以上)不排尿后的首次尿(FVU)标本,用质粒LCR检测CT。对培养法和质粒LCR结果相异的标本,用另一针对CT主要外膜蛋白基因的LCR进行确证,参照“扩大的金标准”来确定检测结果。结果质粒LCR敏感性和特异性分别为98.6%和99.4%,而培养法分别为77.4%和99.5%,前者敏感性高于后者(P<0.001)。在伴或不伴尿道症状的就诊者间LCR敏感性和特异性无显著性差异。结论 LCR是一种既敏感又特异的CT诊断方法。FVU可作为筛检男性CT感染的一种非损伤方法。

Abstract: Objective To determine the sensitivity and specificity of ligase chain reaction (LCR) for detection of Chlamydia trachomatis (C. trachomatis) in the urine of symptomatic and asyptomatic men. Methods C. trachomatis was detected by LCR in both first-void urine (FVU) and urethral swab cultures from 852 randomly selected male outpatients seeking medical attention for sexually transmitted diseases. In cases with discrepancy between the results yielded by the two methods, a second LCR directed against a gene fragment encoding the major outer membrane protein was performed. The results were evaluated on the basis of an expanded gold standard. Results The sensitivity and specificity was 98.6% and 99.4% with LCR, respectively, and was 77.4% and 99.5% with urethral swab culture. The sensitivity of LCR was much higher than that of urethral swab culture(P<0.001).The presence or absence of urethral symptoms did not show any influence on the results. Conclusion LCR is sensitive and specific for detecting C. trachomatis infections, and FVU can be used for non-invading diagnosis and screening of the infection in men.

中图分类号:

R711.3

彭学标, 曾抗. 连接酶链反应检测男性就诊者尿标本中的沙眼衣原体[J]. 南方医科大学学报, 2004, 24(05): 485-488.

PENG Xue-biao, ZENG Kang. Ligase chain reaction for Chlamydia trachomatis detection in urine specimens from symptomatic and asymptomatic men[J]. Journal of Southern Medical University, 2004, 24(05): 485-488.

参考文献

[1] Johnson RE, Green TA, Schachter J, et al. Evaluation of nucleic acid amplification tests as reference tests for Chlamydia trachomatis infections in asymptomatic men [J]. J Clin Microbiol, 2001, 38(12):4382-6
[2] Pimenta JM, Catchpole M, Rogers PA, et al. Opportunistic screening for genital chlamydial infection. Ⅱ: prevalence among healthcare attenders, outcome, and evaluation of positive cases [J]. Sex Transm Infect. 2003, 79(1): 22-7
[3] Verhoeven V, Avonts D, Meheus A, et al. Chlamydial infection: an accurate model for opportunistic screening in general practice [J].Sex Transm Infect, 2003,79(4):313-7.
[4] Miller WC, Hoffman IF, Owen ODowd J, et al. Selective screening for chlamydial infection: which criteria to use[J]? Am J Prey Med,2000, 18(2): 115-22.
[5] Watson EJ, Templeton A, Russell I, et al. The accuracy and efficacy of screening tests for Chlamydia trachomatis: a systematic review[J]. J Med Microbiol, 2002, 51(12): 1021-31.
[6] Cheng H, Macaluso M, Vermund SH, et al. Relative accuracy of nucleic acid amplification and culture in detecting Chlamydia in asymptomatic men[J]. J Clin Microbiol, 2001, 39(11): 3927-37.
[7] Jang D, Sellor JW, Mahony JB, et al. Effect of broadening the gold standard on the performance of a chemiluminometric immunoassay to detect Chlamydia trachmatis antigens in centrifuged first void urine and urethral swab sample from men[J]. Sex Trans Dis, 1992,19(2): 315-9.
[8] Gaydos CA, Crotchfelt KA, Howell MR, et al. Molecular amplification assays to detect Chlamydial infections in urine specimens from high school female students and to monitor the persistence of chlamydial DNA after therapy[J]. J Infect Dis, 1998, 177(2): 417-24.
[9] Tan HH, Chan RK, Teo AS, et al. Use ofligase chain reaction and polymerase chain reaction on urine specimens to detect Chlamydia trachomatis infections in a sexually transmitted diseases clinic in Singapore [J]. Ann Acad Med Singapore, 1999, 28(2): 245-51.
[10] Battle TJ, Golden MR, Suchland KL, et al. Evaluation of laboratory testing methods for Chlamydia trachomatis infection in the era of nucleic acid amplification[J]. J Clin Microbiol, 2001, 39(8): 2924-7.
[11] Schepetiuk S, Kok T, Martin L, et al. Detection of Chlamydia trachomatis in urine samples by nucleic acid tests:comparison with cuture and enzyme immmunoassay of genital swab specimens [J]. J Clin Microbiol, 1997, 35(10): 3355-7.
[12] Chernesky MA, Chong S, Jang D, et al. Ability of commercial ligase chain reaction and PCR assays to diagnose Chlamydia trachomatis infections in men by testing first-void urine [J]. J Clin Microbiol,1997, 35(3): 982-4.
[13] Jang D, Sellors J, Howard M, et al. Correlation between culture testing of swabs and ligase chain reaction of first void urine from patients recently treated for Chlamydia trachomatis [J]. Sex Transm Infect, 2003, 79(3): 237-9.
[14] Stary A. Correct samples for diagnostic tests in sexually transmitted diseases: which sample for which test [J]? FEMS Immunol Med Microbiol, 1999, 24(4): 455-9.
[15] Stary A, Schuh E, Kerschbaumer M, et al. Performance of transcription-mediated amplification and ligase chain reaction assays for detection of chlamydial infection in urogenital samples obtained by invasive and noninvasive methods [J]. J Clin Microbiol, 1998, 36(9):2666-70.