连接酶链反应检测男性就诊者尿标本中的沙眼衣原体(英文)

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

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。

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.