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首页> 美国卫生研究院文献>Journal of Clinical Microbiology >Comparison of Methods for Detection of Chlamydia trachomatis and Neisseria gonorrhoeae Using Commercially Available Nucleic Acid Amplification Tests and a Liquid Pap Smear Medium
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Comparison of Methods for Detection of Chlamydia trachomatis and Neisseria gonorrhoeae Using Commercially Available Nucleic Acid Amplification Tests and a Liquid Pap Smear Medium

机译：使用市售核酸扩增试验和液体涂片涂片培养基检测沙眼衣原体和淋病奈瑟菌的方法比较

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Annual screening for Chlamydia trachomatis infection is currently recommended for sexually active women 15 to 25 years old and for women older than 25 if they have a new or multiple sex partners and have not used condoms during the previous 3 months. Annual screening for cervical abnormalities using the Pap smear has achieved a substantial reduction in morbidity and mortality from cervical cancer. Screening for Neisseria gonorrhoeae infection has likely contributed significantly to the reduction in the rates of gonococcal infection. The introduction of liquid Pap smear methods using exfoliated cervical cells presents an opportunity to screen for these three conditions using one specimen. We evaluated the preservation of C. trachomatis and Neisseria gonorrhoeae DNAs from ThinPrep liquid media (PreservCyt; Cytyc Corp., Boxborough, Mass.); tested the feasibility of using a clinical specimen of this medium for the detection of cytologic abnormalities, C. trachomatis, and N. gonorrhoeae; evaluated the agreement between ligase chain reaction (LCR) performed on PreservCyt and LCR performed on a cervical specimen; and compared the performance of LCR performed on PreservCyt to those of LCR performed on a cervical specimen, culture, PCR performed on a cervical specimen, on urine, and on a vaginal specimen (a multiple-site infection status standard), and transcription-mediated amplification (for C. trachomatis only) from 255 sexually active adolescent women. The agreement between LCR performed on PreservCyt and LCR from a cervical swab in LCx transport medium was high (for C. trachomatis, agreement = 0.97 and kappa = 0.92; for N. gonorrhoeae, agreement = 0.99 and kappa = 0.96). Test performances were similar for LCR-urine, LCR-cervix, and LCR-ThinPrep, with sensitivities from 93 to 99% for C. trachomatis and 81 to 83% for N. gonorrhoeae and specificities from 95.5 to 99% for C. trachomatis and 99.1 to 99.6% for N. gonorrhoeae using a PCR-based multiple-site infection status standard. This is the first study to examine the agreement between liquid cytologic media and multiple nucleic acid amplification tests for the detection of C. trachomatis and N. gonorrhoeae from patient samples. Cytologic fluid shows promise for simultaneous screening for cytologic abnormalities and sexually transmitted infections.
机译：目前建议对15至25岁的性活跃女性和25岁以上的女性（如果她们有新的或多个性伴侣并且在过去的三个月内未使用安全套）进行年度沙眼衣原体感染筛查。每年使用宫颈涂片检查筛查宫颈异常，已大大降低了宫颈癌的发病率和死亡率。淋病奈瑟氏球菌感染的筛查可能对降低淋球菌感染率有重要贡献。使用脱落的宫颈细胞引入液体巴氏涂片检查法提供了使用一个标本筛查这三种情况的机会。我们评估了从ThinPrep液体培养基（PreservCyt； Cytyc Corp.，Boxborough，MA）得到的沙眼衣原体和淋病奈瑟氏球菌DNA的保存情况。测试了使用这种培养基的临床标本检测细胞学异常，沙眼衣原体和淋病奈瑟氏菌的可行性；评估在PreservCyt上进行的连接酶链反应（LCR）与在宫颈标本上进行的LCR之间的一致性；并比较了在PreservCyt上进行的LCR性能与在宫颈标本，培养液，在宫颈标本，尿液和阴道标本上进行的LCR性能（多部位感染状态标准）以及转录介导的性能255名活跃于性的青春期妇女的扩增（仅针对沙眼衣原体）。在PreservCyt上执行的LCR与来自LCx传输介质中子宫颈拭子的LCR之间的一致性很高（对于沙眼衣原体，一致性= 0.97，kappa = 0.92；对于淋病奈瑟氏球菌，一致性= 0.99，kappa = 0.96）。 LCR-尿，LCR-宫颈和LCR-ThinPrep的测试性能相似，沙眼衣原体的敏感性为93％至99％，淋病奈瑟氏菌的敏感性为81％至83％，沙眼衣原体和使用基于PCR的多部位感染状况标准，对于淋病奈瑟氏球菌为99.1至99.6％。这是检查液体细胞学培养基和多种核酸扩增试验之间的一致性的第一项研究，该试验可用于从患者样品中检测沙眼衣原体和淋病奈瑟氏球菌。细胞学液有望同时筛查细胞学异常和性传播感染。

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