Performance of 4 Molecular Assays for Detection of Chlamydia and Gonorrhea in a Sample of Human Immunodeficiency Virus-Positive Men Who Have Sex With Men
Performance of 4 Molecular Assays for Detection of Chlamydia and Gonorrhea in a Sample of Human Immunodeficiency Virus-Positive Men Who Have Sex With Men
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DOI：
10.1097/olq.0000000000001115
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发表时间：
2020-03-01
影响因子：
3.1
通讯作者：
Van der Pol, Barbara
中科院分区：
文献类型：
--
作者：
Footman, Alison;Dionne-Odom, Jodie;Van der Pol, Barbara
背景核酸扩增检测（NAAT）是检测沙眼衣原体和淋病奈瑟菌的首选方法，但需要有关当前可用检测方法性能的信息。本研究评估了 Aptima Combo 2、GeneXpert、cobas4800 和 ProbeTec Q(X) (CTQ/GCQ) 检测咽部、直肠和尿液样本中衣原体和淋病的性能。方法在阿拉巴马州伯明翰城市人类免疫缺陷病毒诊所就诊的成年男性患者，报告与男性发生性行为（与男性发生性关系的男性）并且过去未使用抗生素2014 年 11 月至 2016 年 12 月期间入组 30 天。基线调查后，自行收集直肠和初始排尿样本。使用复合感染标准，其中将 1 种检测与其他 3 种检测进行比较，以确定直肠和尿液样本的敏感性和特异性估计。临床医生收集了两份咽部样本进行衣原体和淋病检测，两者都必须呈阳性才能被视为真阳性。结果在参与该研究的 181 名男性中，分别有 15.5% 和 7.2% 的人在任何部位至少有 1 项衣原体和淋病结果呈阳性。在所有 4 项检测中，直肠样本中的衣原体敏感性范围为 82% 至 96%。直肠淋病敏感性估计范围为 67% 至 99%。与其他检测相比，GCQ 检测在检测直肠淋病方面的敏感性较低 (P = 0.02)。结论 仅尿液筛查会漏掉 80% 以上的衣原体和淋病感染，这凸显了使用 NAAT 检测男男性行为者中衣原体和淋病感染的重要性。
BackgroundNucleic acid amplification testing (NAAT) is the preferred method to detect Chlamydia trachomatis and Neisseria gonorrhoeae, but information regarding performance of currently available assays is needed. This study evaluated the performance of the Aptima Combo 2, GeneXpert, cobas4800, and ProbeTec Q(X) (CTQ/GCQ) to detect chlamydia and gonorrhea in pharyngeal, rectal, and urine specimen.MethodsAdult male patients seen at an urban human immunodeficiency virus clinic in Birmingham, Alabama who reported sex with men (men who have sex with men) and no antibiotic use in the past 30 days were enrolled between November 2014 and December 2016. Following a baseline survey, rectal and initial void urine specimens were self-collected. A composite infection standard was used, where 1 assay was compared with 3 others to determine sensitivity and specificity estimates for rectal and urine samples. Two pharyngeal samples were clinician-collected for chlamydia and gonorrhea testing and both had to be positive to be considered a true positive.ResultsAmong the 181 men enrolled into the study, 15.5% and 7.2% had at least 1 positive chlamydia and gonorrhea result at any site, respectively. Among all 4 assays, chlamydia sensitivity rates ranged from 82% to 96% among rectal samples. Rectal gonorrhea sensitivity estimates ranged from 67% to 99%. The GCQ assay was less sensitive in detecting rectal gonorrhea compared with the other assays (P = 0.02).ConclusionsMore than 80% of chlamydia and gonorrhea infections would have been missed with urine-only screening, highlighting the importance in using NAATs to detect chlamydia and gonorrhea infections among men who have sex with men.