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首页> 外文期刊>Journal of Clinical Microbiology >Vulvovaginal-Swab or First-Catch Urine Specimen To Detect Chlamydia trachomatis in Women in a Community Setting?
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Vulvovaginal-Swab or First-Catch Urine Specimen To Detect Chlamydia trachomatis in Women in a Community Setting?

机译：在社区环境中检测女性阴道炎性沙眼衣原体拭子还是首次捕获的尿液标本？

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Screening for chlamydia in women is widely recommended. We evaluated the performance of two nucleic acid amplification tests for detecting Chlamydia trachomatis in self-collected vulvovaginal-swab and first-catch urine specimens from women in a community setting and a strategy for optimizing the sensitivity of an amplified enzyme immunoassay on vulvovaginal-swab specimens. We tested 2,745 paired vulvovaginal-swab and urine specimens by PCR (Roche Cobas) or strand displacement amplification (SDA; Becton Dickinson). There were 146 women infected with chlamydia. The assays detected 97.3% (95% confidence interval [CI], 93.1 to 99.2%) of infected patients with vulvovaginal-swab specimens and 91.8% (86.1 to 95.7%) with urine specimens. We tested 2,749 vulvovaginal-swab specimens with both a nucleic acid amplification test and a polymer conjugate-enhanced enzyme immunoassay with negative-gray-zone testing. The relative sensitivities obtained after retesting specimens in the negative gray zone were 74.3% (95% CI, 62.8 to 83.8%) with PCR and 58.3% (95% CI, 46.1 to 69.8%) with SDA. In community settings, both vulvovaginal-swab and first-catch urine specimens from women are suitable substrates for nucleic acid amplification tests, but enzyme immunoassays, even after negative-gray-zone testing, should not be used in screening programs.
机译：广泛建议筛查女性衣原体。我们评估了两种核酸扩增测试在社区环境中从女性自行收集的阴道阴道拭子和首次捕获的尿液标本中检测沙眼衣原体的性能，以及优化扩增灵敏度的策略阴道阴道拭子标本上的酶免疫测定。我们通过PCR（Roche Cobas）或链置换扩增（SDA; Becton Dickinson）测试了2,745对成对的阴道阴道拭子和尿液标本。有146名妇女感染了衣原体。该检测方法检测出感染阴唇阴道拭子标本的患者为97.3％（95％置信区间[CI]，为93.1至99.2％），尿液标本为91.8％（86.1至95.7％）。我们通过核酸扩增测试和带有负灰色区域测试的聚合物共轭增强酶免疫测定法测试了2749个外阴拭子标本。使用PCR重新测试阴性灰色区域中的样本后获得的相对灵敏度为74.3％（95％CI，62.8至83.8％），使用SDA的相对灵敏度为58.3％（95％CI，46.1至69.8％）。在社区环境中，女性的外阴阴道拭子和初次采集的尿液标本都是进行核酸扩增测试的合适底物，但是即使在阴性灰色区域测试后，也不应在筛查程序中使用酶免疫法。

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