Pooling of urine samples for screening for Neisseria gonorrhoeae by ligase chain reaction:: Accuracy and application
Pooling of urine samples for screening for Neisseria gonorrhoeae by ligase chain reaction:: Accuracy and application
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DOI：
10.1128/jcm.36.12.3624-3628.1998
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发表时间：
1998-12-01
影响因子：
9.4
通讯作者：
Gaydos, CA
中科院分区：
文献类型：
--
作者：
Kacena, KA;Quinn, SB;Gaydos, CA
本文应用连接酶链反应（LCR）检测三个人群混合尿标本中生殖道淋球菌感染的准确性。其次，对300份中学生（MSS）尿标本进行LCR检测，并将处理后的标本分别冻存，以备后续检测。第三，对600份高中生（HSS）冻存尿标本进行LCR合并检测，即：在一个检测单位剂量中检测4个样本池中的处理标本，并在阳性样本池前重新检测单个标本。最后，将合并算法结果与最初600名IISS中344名学生的培养结果进行比较，学校护士执业者自行决定从这些学生中采集宫颈或尿道样本。与FMR人群中通过LCR对标本进行的个体检测相比，4个样本合并算法的灵敏度为100%（5/5），特异性为100%（70/70），6个样本合并算法的灵敏度为100%（5/5），特异性为100%（45/45）。在MSS人群中，合并4算法的敏感性为95.8%（23/24），特异性为100%（52/52），合并10算法的敏感性为95.8%（23/23），特异性为100%（17/17）。在采集宫颈内或尿道标本进行培养的344名IISS亚组中，31名尿液LCR呈阳性，26名培养呈阳性。在通过确证性LCR检测判定培养和LCR之间的结果不一致后，合并算法的敏感性为93.8%（30/32），特异性为99.7%（311/312）。344份IISS培养的敏感性为81.3%（26/32）。与HSS标本的个体检测相比，淋病LCR检测的敏感性和特异性均为60%。
The accuracy of detection of genital Neisseria gonorrhoeae infection in pooled urine samples by ligase chain reaction (LCR) was examined in three populations, Firstly, urine specimens from 300 female military recruits (FMR) were tested by LCR individually and in pools of four and six. Secondly, 300 urine specimens from middle-school students (MSS) were tested individually by LCR, and then the processed specimens were stored frozen for subsequent testing in pools of 4 and 10, Thirdly, 600 frozen urine specimens from high-school students (HSS) were tested by using the LCR pooling algorithm, i.e., testing processed specimens in pools of four in one test unit dose, and retesting individual specimens front positive pools. Finally, the pooling algorithm results were compared to culture results for a subset of 344 students from the original 600 IISS from whom cervical or urethral samples were taken at the discretion of the school nurse practitioners. Compared to individual testing of specimens by LCR in the FMR population, the pooling-by-four algorithm was 100% sensitive (5 of 5) and 100% pool specific (70 of 70), and the pool-by-six algorithm was 100% sensitive (5 of 5) and 100% pool specific (45 of 45). In the MSS population, the pool-by-4 algorithm was 95.8% sensitive (23 of 24) and 100% (52 of 52) pool specific, and the pool-by-10 algorithm was 95.8% sensitive (23 of 23) and 100% (17 of 17) pool specific. In the subset of 344 IISS from whom endocervical or urethral specimens were collected for culture, 31 were positive by LCR in urine and 26 were positive by culture. After results discrepant between culture and LCR were adjudicated by a confirmatory LCR test, the pooling algorithm was 93.8% (30 of 32) sensitive and 99.7% (311 of 312) specific. Culture from these 344 IISS was 81.3% (26 of 32) sensitive, The pooling algorithm reduced the cost of the N. gonorrhoeae LCR assay by 60% compared to individual testing of the HSS specimens and was both sensitive and specific.