Identifying a consensus sample type to test for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis and human papillomavirus
Identifying a consensus sample type to test for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis and human papillomavirus
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DOI：
10.1016/j.cmi.2018.03.013
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发表时间：
2018-12-01
影响因子：
14.2
通讯作者：
Padalko, E.
中科院分区：
文献类型：
--
作者：
Coorevits, L.;Traen, A.;Padalko, E.
目的：性传播感染（STIs）是全球急性疾病的一个原因。早期发现在阻断传播和预防并发症方面发挥着至关重要的作用。然而，由于缺乏总体上首选的样本类型，性传播感染检测的可及性受到限制。通过对女性性工作者（FSW）的前瞻性研究，比较了不同解剖部位标本对淋病奈瑟菌、沙眼衣原体、阴道毛滴虫、生殖道支原体和人乳头瘤病毒的敏感性。此外，我们还记录了该高危人群中每种性传播感染的患病率。方法：我们选择了303名FSW，通过对来自不同制造商的两份阴道和宫颈拭子、宫颈涂片和首次尿液进行核酸扩增检测，对他们进行每种性传播感染的检测。每种样品类型的敏感性进行了比较，以确定一个共识的样品type.Results：阴道拭子优于所有其他样品类型的上级，与86%的总体灵敏度。首次排尿的敏感性最低，仅检测到63%的阳性病例。淋球菌感染率为3.3%（10/299），沙眼衣原体感染率为9.0%（27/299），阴道毛滴虫感染率为7.4%（22/298），生殖支原体感染率为10.8%（32/296），人乳头瘤病毒感染率为55.6%（158/284）。当检测性传播感染时，阴道拭子是首选样本，应避免首次排尿。指定（自采样）阴道拭子作为共识样本类型，使性病检测和测试扩展到大量的未经筛选的女性的协调。(C)2018年欧洲临床微生物学和传染病学会。由爱思唯尔有限公司出版。保留所有权利。
Objectives: Sexually transmitted infections (STIs) are a global cause of acute illness. Early detection plays a crucial role in interrupting transmission and preventing complications. However, the accessibility of STI testing is curbed by the lack of an overall preferred sample type. By means of a prospective study in female sex workers (FSW), we compared the sensitivity of samples from different anatomical sites in detecting Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma genitalium and human papillomavirus. Besides, we documented the prevalence of each STI in this high-risk population.Methods: We selected 303 FSW and tested them for each STI by nucleic acid amplification testing on two vaginal and cervical swabs from different manufacturers, cervical smear and first-void urine. The sensitivity of each sample type was compared for each infectious agent in order to identify a consensus sample type.Results: Vaginal swabs were superior to all other sample types, with an overall sensitivity of 86%. The sensitivity was the lowest for first-void urine, detecting only 63% of positive cases. The prevalence was 3.3% (10/299) for Neisseria gonorrhoeae; 9.0% (27/299) for Chlamydia trachomatis; 7.4% (22/298) for Trichomonas vaginalis; 10.8% (32/296) for Mycoplasma genitalium and 55.6% (158/284) for human papillomavirus.Conclusions: When testing for STIs, vaginal swabs are the sample of choice and first-void urine should be avoided. Designating (self-sampled) vaginal swabs as a consensus sample type enables harmonization of STI testing and extension of testing to large numbers of unscreened females. (C) 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.