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Journal of Clinical Microbiology, December 1998, p. 3624-3628, Vol. 36, No. 12
Division of Disease Control,
Received 12 June 1998/Returned for modification 30 July
1998/Accepted 9 September 1998
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
from positive pools. Finally, the pooling algorithm results were
compared to culture results for a subset of 344 students from the
original 600 HSS 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 24) and 100% (17 of 17) pool specific. In the subset
of 344 HSS 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 HSS 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.
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Pooling of Urine Samples for Screening for Neisseria
gonorrhoeae by Ligase Chain Reaction: Accuracy and
Application
*
Corresponding author. Mailing address: The Johns
Hopkins University, Division of Infectious Diseases, Ross Research
Bldg., Room 1159, 720 Rutland Ave., Baltimore, MD 21205. Phone: (410) 614-0933. Fax: (410) 614-9775. E-mail:
cgaydos{at}welchlink.welch.jhu.edu.
Journal of Clinical Microbiology, December 1998, p. 3624-3628, Vol. 36, No. 12
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
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