在男性沙眼衣原体的检测中影响尿EIA敏感性的因素

通过四种变量:尿道炎症状和体征,尿中多形核白细胞(PMN)数,尿道拭子衣原体细胞培养的包涵体数和末次排尿与试验间隔时间来评价酶免疫法(EIA)检测男性尿标本衣原体的敏感性。病例来源于在STD诊所就诊的有或无尿道炎症状和(或)体征的男性共318名。嘱患者提供20ml清晨首次尿或较长时间(至少4小时)不排尿后的首次尿标本并取三份尿道拭子,分别做革兰染色、衣原体培养和淋球菌培养。将尿标本分成五份,三份分别用三种EIA试剂盒检测衣原体,另外两份进行衣原体培养和PMN计数。结果:在男性,沙眼衣原体(CT)的感染率为14.8％(47/318)。14例淋病患者中6例合并CT感染。除外淋病患者,有尿道分泌物体征     

用细胞培养和酶免疫法检测泌尿生殖道标本中沙眼衣原体的研究

用细胞培养和酶免疫法对１００例性病门诊病人的泌尿生殖道标本作了沙眼衣原体检测。在细胞培养法阳性的２２价标本中，用酶免疫法检测阳性的为２１份，在细胞培养阴性的７８份标本中，用酶免疫法检出阳性的１份。与细胞培养法比较，酶免疫法检测沙眼衣原体的敏感性为９５．５％，特异性为９８．７％。结果表明，酶免疫法不失为一种快速诊断泌尿生殖道沙眼衣原体感染的方法。     

聚合酶链反应与淋球菌培养法检测淋病奈瑟茵的比较研究

目的 比较聚合酶链反应（PCR）和淋球菌培养法检测淋病奈瑟菌的检出率。方法 采用PCR法和淋球菌培养法检测192例生殖道感染的患者淋病奈瑟菌。结果 两种方法检测均阳性77例，均阴性98例，PCR阳性而培养阴性12例，PCR阴性而培养阳性5例。PCR法阳性检出率为46．35％，而培养法为42．71％。结论 淋球菌培养与PCR法检测淋病奈瑟菌有很好的一致性。     

宫颈拭子混合标本PCR法在检测淋球菌和衣原体感染中的应用

背景：多聚酶链反应在衣原体和淋球菌感染的检测中，具有高敏感性和特异性的特点，但价格相对比较昂贵，在检测大宗筛查标本时较为费力；目的：确定混合标本法在对宫颈拭子标本衣原体和淋球菌检测中的可用性。方法：对人工流产妇女宫颈标本采用混合标本PCR法检测衣原体和淋球菌。结果：在2020份宫颈拭子标本中，衣原体检出率4.8%，淋球菌检出率为0.4%，与单个标本检测相比，混合标本法可节约经费62%，且明显减少了工作量。结论：在妇女衣原体和淋球菌筛查中，混合标本PCR法不仅可用于尿液标本，亦可用于宫颈拭子标本。     

聚合酶链反应与淋球菌培养法检测淋病奈瑟菌的比较研究

目的比较聚合酶链反应(PCR)和淋球菌培养法检测淋病奈瑟菌的检出率.方法采用PCR法和淋球菌培养法检测192例生殖道感染的患者淋病奈瑟菌.结果两种方法检测均阳性77例,均阴性98例,PCR阳性而培养阴性12例,PCR阴性而培养阳性5例.PCR法阳性检出率为46.35%,而培养法为42.71%.结论淋球菌培养与PCR法检测淋病奈瑟菌有很好的一致性.     

2016—2020年深圳某综合医院淋球菌监测结果分析

目的了解深圳某综合医院(2016～2020)年淋病奈瑟菌(淋球菌)的检出情况,了解本地区淋球菌的流行状况和为制订淋病的防控措施提供依据。方法统计分析南方医科大学深圳医院(2016～2020)年淋球菌送检情况和阳性患者的临床信息,检测阳性结果定义为革兰阴性双球菌涂片、淋球菌培养或淋球菌核酸定性检测任一结果为阳性。结果共收到6 362份送检标本,其中涂片705份、分离培养868份、核酸定性检测4 789份。共检出921例淋球菌阳性(14.5%),其中涂片291份(41.3%)、分离培养132份(15.2%)、核酸检测498份(10.4%)。(2016～2020)年送检标本的淋球菌检出率分别为15.1%、18.2%、18.0%、10.0%、14.3%。921例淋球菌感染患者中男女比例为23∶1;(21～30)岁年龄段占比最高(43.4%),其次为(31～40)岁(33.9%)。结论 (2016～2020)年本地区淋球菌的检出率较高,多种检测方法联合可提高淋球菌的检出率。淋球菌感染者以男性为主,(21～40)岁中青年为主要感染人群,应对该人群加强宣传教育。     

衣原体快速免疫法检测淋病患者中泌尿生殖道沙眼衣原体的研究

我们采用“立明”衣原体快速免疫法(Clearviewchlamydia,简称C-C快速法)对110例我院门诊的淋病患者进行了衣原体的检测,现将结果报告如下。资料和方法1.病例选择　110例中,男59例,女51例,年龄18～59岁,平均26.4岁。全部男性患者及18例女性患者有不洁性交史,33例是由其丈夫传染。男性有尿道炎症状及尿道口脓性分泌物,女性有白带增多或尿道刺激症状。本组病例在诊断前均未做过任何治疗。2.标本采集　同时取两份标本,1份做淋球菌镜检加培养,1份做衣原体检测。取材方法见文献[1]。无论男女病人均要取到柱状上皮细胞,这样才能提高检测的阳性率…     

PCR检验技术在性病临床标本实验诊断中应用价值的研究

目的 评价聚合酶链反应（PCR）检测技术在性病临床诊断中的应用价值。方法 比较PCR与传统检测手段对淋病和非淋菌性尿道炎病原体的检测结果。淋球菌以加多粘菌素的GC血液琼脂分离；衣原体用McCoy细胞培养；支原体用高效支原体培养基培养。PCR试验用基因释放剂作前处理，以1．5％琼脂糖凝胶电泳观察结果。结果 用PCR法检测淋病、衣原体和支原体感染的临床标本其敏感性和特异性均比传统的培养法高，作PCR试验的标本取材要求不如作培养那样严格，但作PCR应使用正规的试剂盒、规范的操作和严格的防污染措施，否则极易引起交叉污染。结论 PCR检验技术在性病诊断中具有巨大的应用潜力，对一些培养困难的病原菌，可在规范操作和标准化试剂盒的基础上逐步加以使用。PCR检测不宜用作判愈。     

抗菌药物对泌尿生殖道沙眼衣原体临床株培养的影响

【摘要】 目的 探讨抗菌药物对泌尿生殖道沙眼衣原体感染者衣原体培养结果的影响,并分析药敏变化。 方法 取临床经直接免疫荧光检测确定为衣原体感染者的尿道或宫颈拭子进行传代培养,碘染后发现包涵体者为培养阳性。分析患者临床用药与培养阳性及阳性代数之间的关系,并对阳性菌株进行体外药敏测试。结果 2010—2012年,共培养临床标本285份,阳性39份;未用药即培养的标本61份,阳性17份（27.87%）;用药后培养224份,阳性22份（9.82%）,两组阳性率比较,χ2 = 13.22,P ＜ 0.05。未用药组阳性的17例中,1代阳性4例,2代5例,3代5例,4代2例,5代1例;用药后组阳性的22例中,2代2例,3代3例,4代9例,5代6例,6代2例,未用药与用药后培养标本首次出现沙眼衣原体包涵体的代数经秩和检验,差异有统计学意义（P ＜ 0.05）,未用药标本出现阳性代数早于用药后的标本。对培养阳性的39份的标本进行体外药敏检测,结果发现,未用药患者的MIC值低于用药患者。 结论 与未用药患者的标本相比,用抗菌药物患者的标本在应用细胞培养法检测衣原体时阳性率低,出现阳性者需增加传代才能检出。 【关键词】 衣原体, 沙眼; 治疗结果; 培养技术; 微生物敏感性试验     

296例性淫乱人员的性病病原体的调查

为了解性淫乱人群中沙眼衣原体、梅毒、淋病及尖锐湿疣的发病情况及相互之间的关系。取２９６名淫乱人员的尿道或宫颈口分泌物，用沙眼衣原体抗原免疫快速法试剂盒检测沙眼衣原体，用上海市性病防治中心配制的巧克力平板培养淋球菌，以血清ＲＰＲ和ＴＰＨＡ检测梅毒螺旋体，用活组织病理检测尖锐湿疣。结果：沙眼衣原体感染率高达３６．４８％，男女无显著差异。淋球菌感染率高达１４．１９％，这两者合并感染率５．０７％，尖锐湿疣     

Evaluation of chlamydia and gonorrhea screening criteria: San Francisco sexually transmitted disease clinic: 1997 to 1998

BACKGROUND AND OBJECTIVES: The advent of more sensitive diagnostic testing technologies and competition in public healthcare spending have resulted in a reevaluation of sexually transmitted disease (STD) screening practices in an attempt to target populations at greatest risk. Screening among populations with a < 2% prevalence of chlamydia and a < 1% prevalence of gonorrhea may not be cost-effective. GOAL: To identify subpopulations with a low prevalence of chlamydia or gonorrhea. STUDY DESIGN: The prevalence of genital chlamydia and gonorrhea among asymptomatic STD patients screened from 1997 to 1998 at San Francisco City Clinic was stratified by demographic and behavioral risk factors. RESULTS: The prevalence of chlamydia and gonorrhea was 3.4% and 1.1% among asymptomatic women and 4.0% and 1.0% among asymptomatic men, respectively. Two low-prevalence subpopulations identified among asymptomatic patients were women older than 29 years (chlamydia, 1.2%) and men who have sex with women (gonorrhea, 0.8%). CONCLUSIONS: These data identified low-prevalence subpopulations among asymptomatic STD patients. As a result, the STD screening criteria at San Francisco City Clinic were changed accordingly.     

Chlamydia and gonorrhea screening in San Francisco high schools

BACKGROUND: Previous school-based studies in cities with a high prevalence of chlamydia found a substantial prevalence of chlamydial infection among students. GOAL: The goal was to determine the feasibility and acceptability of chlamydia and gonorrhea screening in San Francisco high schools. STUDY DESIGN: Sexually transmitted disease (STD) education and screening were conducted at four high schools. Students provided basic demographic information and urine specimens for chlamydia and gonorrhea ligase chain reaction testing. RESULTS: Among 283 asymptomatic females screened, 3.9% had chlamydia and 0.7% had gonorrhea. The prevalence of chlamydia was 1.5% among females <16 years of age and 4.6% among females >or=16 years of age. Only 0.8% of asymptomatic males (3/381) had chlamydia, and none had gonorrhea. CONCLUSION: STD screening was both feasible and acceptable in San Francisco high schools. STD screening in high schools should be prioritized as follows: (1) chlamydia screening over gonorrhea screening, (2) female screening over male screening, and (3) screening of older students (juniors and seniors) over screening of younger students.     

前列腺液检测在性病诊断中的应用分析

目的：分析性病患者的确诊过程,总结确诊性病的指标和方法,研究采用前列腺液检测进行判定的准确性。方法：从2012年6月至2013年6月入我院进行性病检查者共153例,从中选取50例,采集其前列腺液,采用三种检测方法,即制作淋球菌涂片,培养和支原体培养,进行阳性检测,对比检测结果。结果：50例受试者中共16例检测出有感染现象,其中有7例淋球菌检测呈阳性确诊为淋病患者,单纯性的非淋球菌性尿道炎患者5例,混合感染患者4例。结论：对于前列腺液的检测可以准确的反映出患者的感染情况,对于性病的进一步确诊有很大的辅助作用,可以尽快的判断患者感染情况,值得推广应用。     

Community-based chlamydia and gonorrhea screening through the United States mail, San Francisco

BACKGROUND: Because gonococcal and chlamydial infections are often asymptomatic, disease control requires population-based screening. This report describes the feasibility of home-based testing for sexually transmitted diseases (STDs) and of specimen transport via the US mail. GOAL: This project sought to establish the efficacy and acceptability to the public of screening by means of urine kits made available in public places and mailed in for STD testing. STUDY DESIGN: Self-selected community participants obtained STD test kits from local businesses, collected urine specimens at home, and mailed kits to the health department for nucleic acid amplification testing. RESULTS: Participants picked up 209 test kits and returned 80 (38%): 3 (3.8%) of 76 were positive for gonorrhea and 1 (1.3%) of 76 was positive for chlamydia. The majority (95%) of participants were white gay men. The cost of specimen collection and transport was similar to that of other population-based screening programs. CONCLUSION: Using the mail for home-based testing for gonorrhea and chlamydia was feasible and may be a useful addition to STD control efforts.     

Missed opportunities for early detection of chlamydia and gonorrhea in school-based health centers

OBJECTIVE: The purpose of the study was to assess the extent to which students are screened for sexually transmitted diseases (STDs) in their school-based health centers (SBHCs) in a Louisiana school district. GOAL: The goal of this study was to determine the proportion of students who reported having been tested or treated for STDs at their SBHCs in the past 3 months and the prevalence of chlamydia and gonorrhea among respondents. STUDY DESIGN: During the 2002-2003 and 2003-2004 school years, 487 students registered in their SBHCs, and who visited routinely their SBHC at least once in the past 3 months, participated in a chlamydia and gonorrhea screening independent of services their SBHCs provide. Participants were asked whether in the past 90 days they had been tested or treated for an STD at their SBHC. RESULTS: Among respondents, 47/482 (9.8%) reported having been tested or treated for an STD at the SBHC in the previous 3 months. Overall, 65/487 (13.3%) tested positive for chlamydia or gonorrhea. Of the 65 students who tested positive, 53 (81.5%) were not tested or treated for an STD at the SBHC. CONCLUSIONS: Many infections could have been detected by testing students during routine visits in SBHCs. Lack of routine screening in these SBHCs clearly represents missed opportunities for early detection of chlamydia and gonorrhea among local teens.     

Trends in the use of sexually transmitted disease diagnostic technologies in California, 1996-2003

OBJECTIVE: To describe trends in STD diagnostic test volume and test technology in California from 1996 to 2003. STUDY: A self-administered survey was mailed annually to licensed clinical laboratories in California that performed STD testing. Data were collected on volume and diagnostic test type for chlamydia, gonorrhea, syphilis, chancroid, HIV, hepatitis B, herpes simplex virus (HSV), and human papilloma virus (HPV). Data were analyzed for trends over time. RESULTS: Response rates ranged from 77% to 99% per survey year. The total number of chlamydia, gonorrhea, and syphilis tests increased from 8.1 to 9.3 million annually. The proportion of chlamydia and gonorrhea tests performed using nucleic acid amplification testing increased from 5% to 66% and from 1% to 59%, respectively. Gonorrhea culture testing decreased from 42% to 10% of all gonorrhea tests. HIV test volume increased from 2.4 to 3.1 million tests. Newer technology tests for HSV and HPV were less common but increased in use. Non-public health laboratories conducted over 90% of all STD testing. CONCLUSIONS: Analyzing trends in diagnostic technologies enhances our understanding of the epidemiology of STDs and monitoring laboratory capacity and practices facilitates implementation of STD control activities.     

Asymptomatic gonorrhea and chlamydial infections detected by nucleic acid amplification tests among Boston area men who have sex with men

BACKGROUND: The purpose of this project was to determine the prevalence of asymptomatic sexually transmitted diseases (STDs) among men who have sex with men (MSM) in the Boston area who had been sexually active (oral and/or anal sex) with another male within the past year. METHODS: Over a 1-month period (March 2007), asymptomatic MSM in care at a Boston community health center (n = 114) were screened for gonorrhea and chlamydia using the BD ProbeTec technique. Deidentified medical record data were analyzed and linked to prevalence monitoring results. RESULTS: Eleven percent of the sample tested positive for one of the 2 STDs (gonorrhea or chlamydia) from at least one mucosal site. Individuals who were infected with an STD were considerably more likely to have a prior history of one or more STD infections when compared with those without an STD history (OR = 3.69; P <0.02). There were no significant differences observed in psychosocial and other behavioral risk factors between patients with or without an STD. CONCLUSIONS: Screening asymptomatic MSM using nucleic acid amplification tests (NAATs) revealed a substantial STD burden that might not have been diagnosed using traditional assays. These data are critical for the design of effective public health interventions for this population.     

Time to treatment for women with chlamydial or gonococcal infections: a comparative evaluation of sexually transmitted disease clinics in 3 US cities

BACKGROUND: Many women with positive screening tests for chlamydia or gonorrhea are not promptly treated and are at risk for complications and further disease transmission. Improved methods for notifying infected patients might increase timely treatment in this population. GOAL: Describe notification procedures at STD clinics in Washington, DC; Los Angeles; and San Diego and compare timeliness of treatment during 2000 to 2002. STUDY: Interviews were conducted to determine methods for notifying infected patients. Data were abstracted from 327 medical records of women with chlamydia or gonorrhea who had not been treated presumptively. The interval between specimen collection and treatment ("time to treatment") was calculated. RESULTS: Each clinic had different procedures for notifying untreated infected women. Among those treated, the median time to treatment was 18 days in Washington, DC, and 8 days in Los Angeles. In San Diego, the median time to treatment was initially 14 days, which improved to 7 days after patient-notification procedures were changed. CONCLUSION: Simple changes in patient notification procedures can decrease time to treatment at STD clinics. STD programs should evaluate time to treatment and institute methods for efficient patient follow-up.     

A survey of sexually transmitted diseases/HIV coinfection testing and reporting practices among health care providers in New Jersey

OBJECTIVES: A survey was conducted to ascertain the adherence of health care providers (HCPs) to national guidelines recommending human immunodeficiency virus (HIV) testing among persons with sexually transmitted diseases (STDs) and STD testing among HIV-infected persons. STUDY: A random sample of HCPs reporting STD and HIV cases in New Jersey were surveyed regarding their STD/HIV testing and reporting practices. RESULTS: Questionnaires were returned by 90 of 162 (55.5%) STD and 73 of 135 (54.1%) HIV HCPs. Sixty-six percent of STD HCPs reported offering HIV testing to persons with gonorrhea, chlamydia, or syphilis. However, up to 42.1% of HIV HCPs who managed HIV-positive patients never or almost never performed initial STD screening in these patients. Among HIV-infected patients, 36.4% of HIV HCPs reported that they never or almost never conducted annual gonorrhea or chlamydia screening in women; 48.6% never conducted screening in men. CONCLUSIONS: Further efforts are needed to optimize the implementation of national guidelines for STD/HIV coinfection testing.     

High prevalence of asymptomatic STDs in incarcerated minority male youth: a case for screening

BACKGROUND AND OBJECTIVES: To assess STD prevalence among a sample of incarcerated minority male youth in a southern US city. METHODS: A consecutive entrant, cross-sectional study of 284 minority males 14 to 18 years was performed. All adolescents were screened for gonorrhea and chlamydia using ligase chain reaction tests. RESULTS: Eighteen percent of youth were identified as having either gonorrhea, chlamydia, or both. Approximately 84% of those with sexually transmitted diseases (STDs) self-reported having no symptoms. Failure to use condoms in the past month was significantly associated with a positive test result for STDs (odds ratio = 1.9, 95% CI = 1.1-3.3). CONCLUSIONS: The findings indicate an urgent need for routine STD screening and STD-prevention programs for adolescent males in detention facilities. A study of 284 detained black male adolescents revealed 18% prevalence of gonorrhea, chlamydia, or both. Approximately 84% of those with sexually transmitted diseases self-reported not having symptoms.