直接涂片法、乳胶免疫层析法检测淋球菌效果比较

Comparison of the effect of direct smear method and latex immunochromatography method for detecting neisseria gonorrhoeae

目的:比较直接涂片法、乳胶免疫层析检测淋球菌效果。方法:收集2017年8月-2022年8月本院就诊临床疑似淋球菌感染的患者216例标本,其中男性尿道分泌物标本115例、女性宫颈分泌物标本101例。以细菌培养法检测为金标准,比较直接涂片法和乳胶免疫层析法检测淋球菌效果。结果:细菌培养法显示,216例临床样本中,淋球菌阳性173例(80.1%)、阴性43例(19.9%),115例男性标本中淋球菌阳性96例(83.5%)、阴性19例(16.5%),101例女性标本中,淋球菌阳性77例(76.3%)、阴性24例(23.8%)。与金标准比较,直接涂片法216例样本检出淋球菌阳性154例(71.3%),115例男性样本中检出淋球菌阳性85例(82.6%),101例女性样本中检出淋球菌阳性59例(58.4%);乳胶免疫层析法216例样本中检出淋球菌阳性177例(81.9%),115例样本中检出淋球菌阳性96例(87.8%),101例女性样本中检出淋球菌阳性76例(75.3%)。乳胶免疫层析法对所有样本、男性样本、女性样本中检出淋球菌的灵敏度、特异度、阳性预测值、阴性预测值、准确度均高于直接涂片法。直接涂片法与乳胶免疫层析法检出所有样本、男性样本、女性样本中检出淋球菌的Kappa值分别为(0.45±0.07)、(0.67±0.10)、(0.29±0.10),男性样本Kappa值≥0.6,一致性较好。结论:与直接涂片法相比,乳胶免疫层析法检测疑似淋病患者分泌物淋球菌检出效能相对较高,两种方法对男性样本中淋球菌的检出效果相当。

Objective:To compare the effect of direct smear method and latex immunochromatography method for detecting neisseria gonorrhoeae.Methods:From August 2017 to August 2022,216 secretion samples of urethra or cervix uteri of the patients with clinical suspected neisseria gonorrhoeae infection were collected,which included 115 urethra secretion samples of the male patients and 101 cervix uteri secretion samples of the female patients.The bacterial culture method was used as the gold standard,and the results of the latex immunochromatography method and the direct smear method were compared for finding the neisseria gonorrhoeae infection in these samples.Results:The bacterial culture method showed that among 216 secretions samples,there were 173(80.1%)cases with the positive neisseria gonorrhoeae and 43(19.9%)cases with the negative neisseria gonorrhoeae.Among 115 male urethral secretions samples,there were 96(83.5%)cases with the positive neisseria gonorrhoeae and 19(16.5%)cases with the negative neisseria gonorrhoeae.Among 101 female cervix uteri secretions samples,there were 77(76.2%)cases were positive for neisseria gonorrhoeae and 24(23.8%)cases were negative for neisseria gonorrhoeae.Compared to that of the golden standard,the direct smear method showed that 154(71.3%)cases among 216 samples were positive for neisseria gonorrhoeae,which including 85(82.6%)cases with the positive neisseria gonorrhoeae among 115 male urethral secretions and 59(58.4%)cases with the positive neisseria gonorrhoeae among 101 female cervix uteri secretions samples.Compared to that of the golden standard,the latex immunochromatography method showed that 177(81.9%)cases among 216 samples were positive for neisseria gonorrhoeae,which including 96(87.8%)cases with the positive neisseria gonorrhoeae among 115male urethral secretions and 76(75.3%)cases with the positive neisseria gonorrhoeae among 101female cervix uteri secretions samples.The sensitivity,the specificity,the positive predictive value,the negative predictive value and the accuracy of the latex immunochromatography method for detecting the neisseria gonorrhoeae in all the secretions samples,in the male urethral secretion samples or in the female cervix uteri secretions samples were significantly higher than those of the direct smear method.The Kappa values between the latex immunochromatography method and the direct smear method for detecting the neisseria gonorrhoeae in all the secretions samples,in the male urethral secretions samples or in the female cervix uteri secretions samples were(0.45±0.07),(0.67±0.10)and(0.29±0.10),respectively,and the Kappa value between the latex immunochromatography method and the direct smear method for detecting the neisseria gonorrhoeae in the male urethral secretions samples was≥0.6,and which had better consistency.Conclusion:Compared with that of the direct smear method,the latex immunochromatography method has the higher efficiency for detecting the neisseria gonorrhoeae in the secretion samples of the patients with suspected gonorrhea infection.The efficacy of the direct smear method and the latex immunochromatography method for detecting neisseria gonorrhoeae in the secretion samples of the male patients is similar.