Pooling urine samples for ligase chain reaction screening for genital Chlamydia trachomatis infection in asymptomatic women

被引:76
作者
Kacena, KA
Quinn, SB
Howell, MR
Madico, GE
Quinn, TC
Gaydos, CA
机构
[1] Johns Hopkins Univ, Div Infect Dis, Sch Hyg & Publ Hlth, Baltimore, MD 21205 USA
[2] Johns Hopkins Univ, Div Infect Dis, Baltimore, MD USA
[3] NIAID, NIH, Bethesda, MD 20892 USA
[4] Univ Peruana Cayetano Heredia, Lima, Peru
关键词
D O I
10.1128/JCM.36.2.481-485.1998
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
The accuracy of pooling urine samples for the detection of genital Chlamydia trachomatis infection by ligase chain reaction (LCR) was examined, A model was also developed to determine the number of samples to be pooled for optimal cost savings at various population prevalences, Estimated costs included technician time, laboratory consumables, and assay costs of testing pooled samples and retesting individual specimens from presumptive positive pools: Estimation of population prevalence based on the pooled LCR results was also applied, After individual urine specimens were processed, 568 specimens were pooled by 4 into 142 poets and another 520 specimens were pooled by 10 into 52 pools. For comparison, all 1,088 urine specimens were tested individually. The sample-to-cut-off ratio was lowered from 1.0 to 0.2 for pooled samples, after a pilot study which tested 148 samples pooled by 4 was conducted. The pooling algorithm was 100% (48 of 48) sensitive when samples were pooled by 4 and 98.4% (61 of 62) Sensitive when samples were pooled by 10. Although 2.0% (2 of 99) of the negative pools of 4 and 7.1% (1 of 14) of the negative pools of 10 tested presumptive positive, all samples in these presumptive-positive pools were negative when retested individually, making the pooling algorithm 100% specific. In a population with 8% genital C. trachomatis prevalence, pooling by four would reduce costs by 39%. The model demonstrated that with a lower prevalence of 2%, pooling eight samples would reduce costs by 59%. Pooling urine samples for detection of C. trachomatis by LCR is sensitive, specific, and cost saving compared to testing individual samples.
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收藏
页码:481 / 485
页数:5
相关论文
共 18 条
[1]   SUCCESSFUL USE OF POOLED SERA TO DETERMINE HIV-1 SEROPREVALENCE IN ZAIRE WITH DEVELOPMENT OF COST-EFFICIENCY MODELS [J].
BEHETS, F ;
BERTOZZI, S ;
KASALI, M ;
KASHAMUKA, M ;
ATIKALA, L ;
BROWN, C ;
RYDER, RW ;
QUINN, TC .
AIDS, 1990, 4 (08) :737-741
[2]   Ability of commercial ligase chain reaction and PCR assays to diagnose Chlamydia trachomatis infections in men by testing first-void urine [J].
Chernesky, MA ;
Chong, S ;
Jang, D ;
Luinstra, K ;
Sellors, J ;
Mahony, JB .
JOURNAL OF CLINICAL MICROBIOLOGY, 1997, 35 (04) :982-984
[3]   DIAGNOSIS OF CHLAMYDIA-TRACHOMATIS INFECTIONS IN MEN AND WOMEN BY TESTING FIRST-VOID URINE BY LIGASE CHAIN-REACTION [J].
CHERNESKY, MA ;
JANG, D ;
LEE, H ;
BURCZAK, JD ;
HU, H ;
SELLORS, J ;
TOMAZICALLEN, SJ ;
MAHONY, JB .
JOURNAL OF CLINICAL MICROBIOLOGY, 1994, 32 (11) :2682-2685
[4]  
*I MED, 1997, HIDD EP CONFR SEX TR, P28
[5]   DIRECT DETECTION OF CHLAMYDIA-TRACHOMATIS IN URINE SPECIMENS FROM SYMPTOMATIC AND ASYMPTOMATIC MEN BY USING A RAPID POLYMERASE CHAIN-REACTION ASSAY [J].
JASCHEK, G ;
GAYDOS, CA ;
WELSH, LE ;
QUINN, TC .
JOURNAL OF CLINICAL MICROBIOLOGY, 1993, 31 (05) :1209-1212
[6]   EVALUATION OF HUMAN IMMUNODEFICIENCY VIRUS SEROPREVALENCE IN POPULATION SURVEYS USING POOLED SERA [J].
KLINE, RL ;
BROTHERS, TA ;
BROOKMEYER, R ;
ZEGER, S ;
QUINN, TC .
JOURNAL OF CLINICAL MICROBIOLOGY, 1989, 27 (07) :1449-1452
[7]   NON-ULCERATIVE SEXUALLY-TRANSMITTED DISEASES AS RISK-FACTORS FOR HIV-1 TRANSMISSION IN WOMEN - RESULTS FROM A COHORT STUDY [J].
LAGA, M ;
MANOKA, A ;
KIVUVU, M ;
MALELE, B ;
TULIZA, M ;
NZILA, N ;
GOEMAN, J ;
BEHETS, F ;
BATTER, V ;
ALARY, M ;
HEYWARD, WL ;
RYDER, RW ;
PIOT, P .
AIDS, 1993, 7 (01) :95-102
[8]   DIAGNOSIS OF CHLAMYDIA-TRACHOMATIS GENITOURINARY INFECTION IN WOMEN BY LIGASE CHAIN-REACTION ASSAY OF URINE [J].
LEE, HH ;
CHERNESKY, MA ;
SCHACHTER, J ;
BURCZAK, JD ;
ANDREWS, WW ;
MULDOON, S ;
LECKIE, G ;
STAMM, WE .
LANCET, 1995, 345 (8944) :213-216
[9]   DETECTION OF CHLAMYDIA-TRACHOMATIS IN INDIVIDUAL AND POOLED ENDOCERVICAL AND URETHRAL SCRAPES BY A COMMERCIALLY AVAILABLE POLYMERASE CHAIN-REACTION [J].
LISBY, G ;
SCHEIBEL, J ;
ABRAHAMSSON, LO ;
CHRISTENSEN, ES ;
PALOHEIMO, S .
APMIS, 1994, 102 (10) :797-800
[10]   DETECTION OF CHLAMYDIA TRACHOMATIS BY THE POLYMERASE CHAIN-REACTION IN SWABS AND URINE FROM MEN WITH NONGONOCOCCAL URETHRITIS [J].
PALMER, HM ;
GILROY, CB ;
THOMAS, BJ ;
HAY, PE ;
GILCHRIST, C ;
TAYLORROBINSON, D .
JOURNAL OF CLINICAL PATHOLOGY, 1991, 44 (04) :321-325