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Journal of Clinical Microbiology, May 2001, p. 1751-1756, Vol. 39, No. 5
0095-1137/01/$04.00+0 DOI: 10.1128/JCM.39.5.1751-1756.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Detection of Chlamydia trachomatis and
Neisseria gonorrhoeae by Enzyme Immunoassay, Culture, and
Three Nucleic Acid Amplification Tests
E.
Van Dyck,1,*
M.
Ieven,2
S.
Pattyn,1
L.
Van
Damme,1 and
M.
Laga1
STD/HIV Research and Intervention Unit,
Department of Microbiology, Institute of Tropical
Medicine,1 and Department of
Microbiology, University Hospital,2 Antwerp,
Belgium
Received 3 November 2000/Returned for modification 16 January
2001/Accepted 6 February 2001
The purpose of this study was to evaluate and compare three
commercially available nucleic acid amplification tests (NAATs) for the
detection of Neisseria gonorrhoeae and Chlamydia
trachomatis. Roche PCR and Becton Dickinson strand displacement
amplification (SDA) were performed on 733 endocervical swab specimens
from commercial sex workers. Abbott ligase chain reaction (LCR) was
performed on a subset of 396 samples. Endocervical specimens from all
women were also tested by culture for N. gonorrhoeae and by
Syva MicroTrak enzyme immunoassay (EIA) for C. trachomatis.
A positive N. gonorrhoeae result was defined as a positive
result by culture or by two NAATs, and a positive C. trachomatis result was defined as a positive result by two tests.
According to these definitions, the sensitivities and specificities for
the subsample of 396 specimens of N. gonorrhoeae culture,
PCR, SDA, and LCR were 69.8, 95.2, 88.9, and 88.9% and 100, 99.4, 100, and 99.1%, respectively; the sensitivities and specificities of
C. trachomatis EIA, PCR, SDA, and LCR were 42.0, 98.0, 94.0, and 90.0% and 100, 98.0, 100, and 98.6%, respectively. The
performance characteristics of N. gonorrhoeae culture, PCR, and SDA and C. trachomatis EIA, PCR, and SDA for all 733 specimens were defined without inclusion of LCR results and by
discrepant analysis after resolution of discordant N. gonorrhoeae PCR results and of discordant C. trachomatis EIA and PCR results by LCR testing. The sensitivities
of N. gonorrhoeae culture, PCR, and SDA before and after
LCR resolution were 67.8, 95.7, and 93.9% and 65, 95.8, and 90.0%,
respectively. The sensitivities of C. trachomatis EIA, PCR,
and SDA decreased from 39.4, 100, and 100% to 38.7, 98.7, and 94.7%,
respectively. All three NAATs proved to be superior to N. gonorrhoeae culture and to C. trachomatis EIA. The
accuracies of the different NAATs were quite similar. SDA was the only
amplification assay with 100% specificity for detection of both
N. gonorrhoeae and C. trachomatis in
endocervical specimens.
*
Corresponding author. Mailing address: STD/HIV Research
and Intervention Unit, Department of Microbiology, Institute of
Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, Belgium. Phone: 32 3 247 63 29. Fax: 32 3 247 63 33. E-mail:
evandyck{at}itg.be.
Journal of Clinical Microbiology, May 2001, p. 1751-1756, Vol. 39, No. 5
0095-1137/01/$04.00+0 DOI: 10.1128/JCM.39.5.1751-1756.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
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