连接酶链反应检测性病患者沙眼衣原体感染

目的 评价连接酶链反应(LCR)诊断性病患者尿道/宫颈中沙眼衣原体(Ct)的意义。方法 STD门诊尿道(宫颈)炎患者276例,取尿道/宫颈拭子,以LCR分析法检测Ct。采用每4份标本相混合的方法分别以LCR分析法检测尿道/宫颈拭子标本中的Ct,其中56例患者同时进行尿道/宫颈拭子Ct细胞培养。差异性结果由PCR法扩增Ct的主要外膜蛋白基因来进行确认,确定LCR分析法检测Ct的敏感性、特异性。结果 LCR分析法检测尿道/宫颈拭子Ct的敏感性、特异性分别为96.7%和100%。采用每4份标本相混合的方法分别以LCR分析法检测尿道/宫颈拭子标本中的Ct,与单独用每份标本逐一进行LCR检测比较,结果完全一致,符合率为100%。结论 以尿道/宫颈拭子为标本,LCR分析法检测Ct的敏感性、特异性高。适用于诊断泌尿生殖道Ct感染。用标本相混合的方法LCR分析检测尿道/宫颈拭子标本中的Ct,适用于Ct感染的普查。     

拭子和尿液取材荧光定量PCR检测沙眼衣原体的比较研究

近年来对CT感染检测方法的研究比较活跃.荧光定量PCR(fluorescent quantitative PCR,FQ-PCR)技术是近几年才研究成功的,解决了常规PCR技术检测CT定性不定量的问题.国内一般用其检测尿道/宫颈拭子(urinary tract swabs/cervical swabs,US/VS)标本,敏感性和特异性均可达90%以上.我们利用荧光定量PCR技术检测了179例就诊于宣武医院性病门诊的患者,同时检测尿道/宫颈拭子和尿液标本,阳性者以尿液LCR进行确证,对两种取材方法的检测结果进行比较分析.     

阴道拭子PCR检测诊断女性淋病的研究

目的：评估阴道拭子标本PCR检测在诊断女性淋病的效果和依从性。方法：选择了242例患者,取宫颈拭子和尿道拭子各1个,取阴道拭子2个。其中一个阴道拭子行淋球菌培养,其余标本均行PCR检测。以宫颈拭子和尿道拭子PCR结果为标准判断阴道拭子PCR的检测效果。结果：19例宫颈拭子PCR阳性患者的阴道拭子PCR均阳性,5例尿道拭子PCR阳性者中有4例阴道拭子PCR阳性。阴道拭子PCR的敏感性为95．8％,优于宫颈拭子PCR及阴道拭子培养。结论：无创伤性阴道拭子PCR检测是诊断淋病较理想的方法。     

非淋菌性尿道炎男性病人尿标本检测沙眼衣原体的价值

尿道拭子取材是检测非淋菌性尿道炎(NGU)病人衣原体的常规采样方法。既往曾采用尿液标本培养来诊断衣原体感染,但不如尿道拭子培养方法敏感。随着衣原体免疫学诊断方法的发展,人们试图用尿液标本这种不需插入尿道的采样方法取代尿道拭子取材。本文对直接免疫荧光法(MT)及酶免疫法(IDEIA)检测尿液中衣原体进行了综合性的研究和评价。 112例研究对象为到圣玛丽医院就诊的患有急性NGU的同性恋病人,3个月内使用     

全自动酶免疫荧光分析仪检测泌尿生殖道沙眼衣原体感染的评价

近年来，欧美国家广泛采用全自动酶免疫荧光检测系统检测泌尿生殖道标本中的沙眼衣原体，标本采用男性尿液或尿道拭子、女性宫颈分泌物，临床使用方便，结果判断客观犤１－３犦。我们于２００１年４～６月，采用法国bioMérieux公司生产的miniVIDAS全自动酶免疫荧光分析仪作了男性尿液标本和女性宫颈拭子标本中的沙眼衣原体检测（VIDASCHL检测法），并与ClearviewChlamydia试验、衣原体培养及PCR（Roche公司试剂盒）检测进行了比较，现将结果报道如下。一、材料与方法（一）病例来源：１２３例患者均来自２００１年４～６月间我所性…     

巢式聚合酶链反应检测男性尿道炎患者尿液中阴道毛滴虫

目的 建立两种巢式聚合酶链反应（PCR）方法检测男性尿道炎患者尿液中阴道毛滴虫感染状况,评价两种巢式PCR在临床诊断中的应用价值。 方法 2011年4月至2013年12月来我院性病门诊就诊的1 088例男性尿道炎患者为研究对象,收集尿道拭子标本做分泌物涂片镜检、阴道毛滴虫湿片检测以及淋球菌培养,同时收集尿液标本提取DNA,针对阴道毛滴虫重复基因组和β微管蛋白基因,采用两种巢式PCR法检测尿液中阴道毛滴虫。 结果 湿片法检测阴道毛滴虫的阳性率为0,而两种巢式PCR法均检测出29例阳性标本,阳性率为2.67%,且两种巢式PCR法检测出的阳性标本一致。 结论 与湿片法相比,巢式PCR法检测男性尿液标本阴道毛滴虫具有较高的灵敏度和特异性。     

尿道和宫颈标本淋球菌阳性率检测结果分析

1实验对象及检测方法标本取自2001年11月~2003年10月在本院接受泌尿生殖道淋球菌检测的女性患者1 129例,年龄1 5~8 2岁,平均3 0.1 2岁。均以一无菌棉拭子插入尿道口0.5 cm,旋转并停留数秒取出后立刻接种T-M培养基。另取一棉拭子以同法在宫颈管内1~2 cm取材,取材时棉拭子避免接触阴道壁。必要时进行糖发酵试验[1]。用SPSS 10.0软件对数据进行卡方检验。2结果2.1不同部位标本淋球菌培养结果尿道和宫颈淋球菌双阳性973例(86.2%),仅尿道阳性104例(9.2%),仅宫颈阳性52例(4.6%)。仅尿道采样灵敏度95.4%,漏检率4.6%;仅宫颈采样灵敏度90.8%,漏检…     

培养法及聚合酶链反应检测男性非淋菌性尿道炎患者中阴道毛滴虫

目的：研究男性非淋菌性尿道炎（NGU）患者中阴道毛滴虫感染的状况;评价尿液及尿道拭子聚合酶链反应（PCR）检测阴道毛滴虫感染的敏感性和特异性,建立一种非侵入性检测男性阴道毛滴虫感染的方法。方法：共收集105例患者。每例取2份尿道拭子标本,分别进行InPouchTV培养和PCR检测;取1份尿液标本进行PCR检测。以培养法为“金标准”,将两种PCR法与之比较,分别计算其敏感性、特异性、阳性预测值和阴性预测值。结果：InPouchTV培养法检出率为4．76％（5／105）;尿液PCR法检出率为3．81％（4／105）;尿道拭子PCR法检出率为4．76％（5／105）。尿液PCR法和尿道拭子PCR法的敏感性,特异性,阳性预测值和阴性预测值分别为80％．100％、100％、99％和80％、99％、80％、99％。结论：阴道毛滴虫感染是男性NGU的病因之一,在本研究中,阴道毛滴虫感染在男性NGU中的检出率为4．76％。尿液PCR法具有较高的敏感性和特异性且适用于非侵入性标本的检测,是具有临床应用价值的检测阴道毛滴虫的方法。     

解脲支原体基因群与非淋菌性尿道(宫颈)炎相关性研究

目的:探讨解脲支原体(Uu)基因群与非淋菌性尿道(宫颈)炎[NGU(MPC)]的相关性。方法:采用病例对照研究,收集单纯Uu阳性的性病门诊NGU(MPC)患者和非NGU(MPC)就诊者尿道拭子/宫颈拭子标本,通过培养法和PCR法检测Uu及基因分群。结果:共收集标本137例。男性组Uu基因群1占24.3%(18/74),基因群2占59.5%(44/74),基因群1,2同时阳性6.8%(5/74);女性组Uu基因群1占38.1%(24/63),基因群2占54%(34/63),基因群1,2同时阳性7.9%(5/63)。男女性别中Uu分布均以基因群2为主,Uu基因群1,2在男性NGU组与非NGU组间、女性MPC组与非MPC组间的分布没有统计学差异(P均>0.05)。结论:不同基因群Uu在尿道(宫颈)炎患者与非尿道(宫颈)炎就诊者之间的分布无差异,提示与非淋菌性尿道(宫颈)炎无相关性。     

Microtrak Ⅱ EIA法检测泌尿生殖道沙眼衣原体感染

目的 :评价MicrotrakⅡEIA法用于女性宫颈拭子、男性尿道拭子和尿沉渣标本沙眼衣原体检测效果。方法 :采用细胞培养法作为“金标准”方法 ,PCR为辅助标准 ,MicrotrakⅡEIA法平行测定。结果 :共检测 1 64例标本 ,以细胞培养法作金标准 ,总体MicrotrakⅡEIA检出率高于细胞培养法 ( χ2 =5 0 0 ,P <0 0 5 ) ;对于女性宫颈和男性尿沉渣标本 ,MicrotrakⅡEIA法与培养法的检出率无显著性差异( χ2 =1 0 0和 χ2 =0 2 0 ,P均 >0 0 5 ) ,而男性尿道拭子标本的MicrotrakⅡEIA法检出率高于培养法 ,差异有统计学意义 ( χ2 =4 0 0 ,P <0 0 5 )。以细胞培养法加PCR法作标准 ,检测各样本的结果差异无统计学意义。结论 :MicrotrakⅡEIA法具有较高的敏感性和特异性 ,适合于泌尿生殖道沙眼衣原体感染的实验室诊断。     

江苏省部分城市男男性接触者性传播疾病流行情况调查

【摘要】 目的 探讨江苏省部分城市男男性接触者（MSM）人群性传播疾病（STD）的流行情况。 方法 用横断面调查。选择在江苏省部分城市MSM酒吧活动的人群,填写调查问卷并自愿选择STD检测。对MSM人群性传播疾病病原体相关因素分析用单因素分析和Logistic回归分析。结果 388人接受问卷调查、体检并提供检测标本,仅有同性性行为者占45.6％。尿液及尿拭子实验室检测：淋球菌阳性率1.3％（5/388）,沙眼衣原体9.4％（36/385）,生殖支原体17.2％（66/384）。血清学检查人类免疫缺陷病毒（HIV）抗体阳性率1.0% （4/388）,梅毒螺旋体明胶凝集试验（TPPA）阳性率18.8％（73/388）,快速血浆反应素试验（RPR）阳性率12.1％（47/388）,2型单纯疱疹病毒（HSV-2）IgG抗体阳性率9.8％（38/388）,乙型肝炎病毒表面抗原（HBsAg）、 丙型肝炎病毒（HCV）抗体、戊型肝炎病毒（HEV）抗体的阳性率分别为9.8％（38/388）、1.0%（4/388）和2.1％（8/388）。尿拭子涂片中性粒细胞计数是沙眼衣原体感染的独立相关因素［调整比值比（AOR）：5.30,95% CI：2.04 ~ 13.77,P < 0.01］。生殖支原体感染与年龄（AOR：2.84,95% CI：1.17 ~ 6.87,P < 0.05）、尿拭子涂片中性粒细胞计数（AOR：2.37,95% CI：1.01 ~ 5.57,P < 0.05）、尿道不适症状（AOR：2.43,95% CI：1.18 ~ 5.02,P < 0.05）的相关性具有统计学意义。梅毒感染（RPR与TPPA检测同时阳性）与年龄（AOR：2.46,95% CI：1.05 ~ 5.75,P < 0.05）、HSV-2抗体（AOR：3.70,95% CI：1.62 ~ 8.44,P < 0.01）有显著相关性。结论 MSM人群中具有较高的STD患病率,沙眼衣原体和生殖支原体是MSM人群尿道炎的主要病原体。 【关键词】 同性恋,男性; 性传播疾病; 性行为     

Should we consider alternatives to combined cervical and urethral swabs for detection of Chlamydia trachomatis in females?

BACKGROUND: The optimum approach for detecting Chlamydia trachomatis (CT) is considered to be combined cervical and urethral testing. OBJECTIVE: To assess the contribution of female urethral swabs in CT diagnosis and to examine alternatives. METHOD: Urethral and endocervical samples for CT were performed on 757 sexually active female patients, >16 years, attending the genitourinary medicine clinic at Macclesfield District General Hospital from October 2005 to November 2006. Swabs were collected and transported to the laboratory in separate AC2 sample collection tubes and were tested by AC2 assay. RESULTS: Of the 757 patients tested simultaneously by both endocervical and urethral swab, a total of 90 had CT identified by either method giving a positivity rate of 11.9%. Results for urethral and endocervical swabs were concordant in 77 patients (85.6%). Eighty two infections (91.1%) would have been diagnosed by swabbing the cervix only but an additional 8 (8.9%) were picked up by urethral swab. Urethral symptoms had been mentioned by 1 of these 8 women. CONCLUSION: 8.9% infected women were positive only on urethral swab. One of these would have been picked up owing to presenting symptoms, hence reducing the extra yield to 7.8% and leaving only 7 positives on 757 urethral swabs with a detection rate of 1% of all urethral swabs. Considering the low yield and the discomfort of urethral swabbing, an additional urethral swab appears unwarranted on grounds of both cost and patient care. As a small number of cases were detected at the urethra but not the cervix, it may be worthwhile investigating the performance of AC2 when placing an endocervical swab in first catch urine. An effective and simpler approach may be a switch to testing vaginal swabs by AC2.     

【开放获取】急性期带状疱疹患者不同标本中水痘-带状疱疹病毒的检测研究

【摘要】 目的 探讨急性期带状疱疹患者血液、唾液、皮疹、接触皮疹处衣物中水痘-带状疱疹病毒（VZV）DNA阳性率及其临床意义。方法 选取2019年4月至2020年8月在南方医科大学深圳医院皮肤科确诊的带状疱疹患者为研究对象。采用荧光定量PCR检测患者抗病毒治疗前后血液、唾液、皮疹和接触皮疹处衣物中VZV DNA，用χ2检验比较头面颈部与非头面颈部带状疱疹患者唾液标本中VZV DNA阳性率，分析治疗前后不同标本VZV DNA阳性率的变化。结果 共纳入86例带状疱疹患者，其中男26例，女60例，年龄（52.65 ± 14.83）岁，病程（5.23 ± 2.10） d。24例头面颈部带状疱疹患者唾液标本中10例（41.67%）VZV DNA阳性，62例非头面颈部带状疱疹患者中8例（12.90%）阳性，两组比较，χ2 = 7.63，P < 0.05。治疗前后，37例采集了血液标本，35例采集了唾液标本，28例采集了皮疹标本，27例采集了接触皮疹处衣物标本。治疗前，血液、唾液、皮疹、接触皮疹处衣物标本中VZV DNA阳性分别为32例（86.49%）、8例（22.86%）、26例（92.86%）、24例（88.89%），治疗（6.82 ± 2.23） d后，这4种标本的VZV DNA阳性率分别下降为51.35%、8.57%、89.29%、85.18%，仅血液标本治疗前后VZV DNA阳性率差异有统计学意义（χ2 = 9.60，P = 0.003），其余标本阳性率差异均无统计学意义（均P > 0.05）。结论 急性期头面颈部带状疱疹患者唾液VZV DNA阳性率高于其他部位患者；抗病毒治疗前后衣物处VZV DNA阳性率均较高。     

Evaluation of an enzyme-linked immunoassay and confirmatory test for the detection of Chlamydia trachomatis in male urine samples.

First pass urine (FPU) samples were compared with urethral swab culture from 304 males attending a genitourinary medicine clinic using an enzyme immuno assay (EIA). All of the EIA positive samples were retested by incorporating a novel blocking reagent into the EIA protocol; 101 were positive by culture of which 83 were also positive by FPU EIA, an additional four were detected in FPU only and not by culture; 86 of these 87 were also confirmed positive by the blocking reagent. Discrepant results were evaluated by Syva MicroTrak. The sensitivity and specificity of FPU EIA as compared with urethral swab culture was 82.2% (83/101) and 98% (199/203) respectively with positive and negative predictive values of 95.4% (83/87) and 91.7% (199/217). Male urethral swab culture is more sensitive than FPU EIA; however, when culture is not available then FPU offers a reliable non-invasive alternative to swab EIA which may be of enormous benefit in community screening of asymptomatic as well as symptomatic patients.     

Human papillomavirus DNA in the urogenital tracts of men with gonorrhoea, penile warts or genital dermatoses.

OBJECTIVE--To assess the presence of human papillomavirus (HPV) DNA in urethral and urine specimens from men with and without sexually transmitted diseases. DESIGN--Prospective study. SETTING--Two London departments of genitourinary medicine PATIENTS--100 men with urethral gonorrhoea, 31 men with penile warts and 37 men with genital dermatoses. METHODS--Urethral and urine specimens were taken, HPV DNA extracted and then amplified using the polymerase chain reaction. HPV types 6, 11, 16, 18, 31 and 33 were identified using Southern blotting followed by hybridisation. RESULTS--HPV DNA was detected in 18-31% of urethral swab specimens and in 0-14% of urine specimens. Men with penile warts had HPV detected in urethral swabs more often than did men in the other two clinical groups. "High risk" HPV types were found in 71-83% of swab specimens and in 73-80% of urine specimens containing HPV DNA. CONCLUSIONS--HPV is present in the urogenital tracts of men with gonorrhoea, penile warts and with genital dermatoses. In men with urethral gonorrhoea, detection of HPV in urethral specimens is not related to the number of sexual partners, condom usage, racial origin or past history of genital warts. HPV DNA in the urethral swab and urine specimens may represent different aspects of the epidemiology of HPV in the male genital tract. The preponderance of HPV types 16 and 18 in all three groups of men may be relevant to the concept of the "high risk male".     

Effects of broadening the gold standard on the performance of a chemiluminometric immunoassay to detect Chlamydia trachomatis antigens in centrifuged first void urine and urethral swab samples from men.

Traditionally, evaluations of nonculture assays for Chlamydia trachomatis are based on a comparison with urethral culture in men and cervical culture in women as the standard for positivity of infection, but it is known that culture may be less than 100% sensitive. A chemiluminometric immunoassay, Magic Lite (Ciba Corning, Medfield, MA) that detects C. trachomatis antigens was performed on centrifuged first void urine samples and urethral swabs collected from men attending a sexually transmitted disease (STD) clinic. Immunoassay performance was compared to urethral culture and also to a broader gold standard: an infected patient with positive culture results or a confirmed positive Chlamydiazyme enzyme immunoassay (Abbott, Chicago) result. Two studies were performed on a retrospective group of stored first void urine samples from 200 men and a prospective group of urethral swabs and first void urine samples from 199 men. Expanding the gold standard showed that a urethral swab assayed by culture had a sensitivity between 70.3% and 87.5%, with the following effects on immunoassay performance in the prospective study: the sensitivity of urethral swabbing was reduced from 96.2% to 78.4% (specificity increased from 96.0% to 98.1%) and first void urine sensitivity increased from 92.3% to 94.6% (specificity went from 87.9% to 93.8%). In the retrospective study, sensitivity of first void urine testing went from 91.4% to 92.5%, with a corresponding increase in specificity from 93.9% to 96.9%. This maneuver had relatively little impact on the negative predictive values, but dramatically increased the positive predictive values, for both samples.(ABSTRACT TRUNCATED AT 250 WORDS)     

Urine and the laboratory diagnosis of Chlamydia trachomatis in males.

OBJECTIVE--To determine whether the use of urine samples from male patients can replace urethral swabs for the rapid detection of Chlamydia trachomatis by the Pharmacia EIA. SETTING--The STD clinic, Adelaide, South Australia. PATIENTS--There were two separate groups of male patients. Group A (398) patients provided urethral specimens for the EIA and culture tests. The patients in Group B (356) provided an urethral swab and a urine sample for the EIA test. METHODS--The urine samples and urethral swabs were tested for the presence of C trachomatis by the Pharmacia Chlamydia EIA. In addition, the urethral swabs from Group A patients were cultured for the organism by standard cell cultures. The infected cell cultures were identified by an immunofluorescence test using a FITC-monoclonal antibody to C trachomatis (Kallestad). RESULTS--When the EIA was validated against culture, it showed a sensitivity of 100% and a specificity of 95% with the urethral swabs from Group A patients. The urine specimens were positive in 24% of those patients who yielded a positive EIA result in the urethral swabs. CONCLUSIONS--Although the EIA test on urethral swabs showed high sensitivity and specificity when validated against culture, our results showed that the use of urine samples cannot replace urethral swabs for the laboratory diagnosis of this sexually transmitted disease.     

取材方法对男性不育患者衣原体检测的影响

目的:探讨男性不育患者CT感染更好的临床检测方法。方法:分别采用精液法、尿道拭子法、尿道拭子加尿沉渣法三种方法,运用用金标斑点免疫层析法进行CT抗原检测。结果:精液法阳性率为7.5%;尿道拭子法为5.0%;尿道拭子加尿沉渣法为25.0%。结论:尿道拭子加尿沉渣法检测的阳性率最高,可作为男性泌尿生殖道CT感染检测的首选方法。