Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae--2014.

IF 33.7 1区 医学 Q1 Medicine
Mmwr Recommendations and Reports Pub Date : 2014-03-14
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引用次数: 0

Abstract

This report updates CDC's 2002 recommendations regarding screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections (CDC. Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections-2002. MMWR 2002;51[No. RR-15]) and provides new recommendations regarding optimal specimen types, the use of tests to detect rectal and oropharyngeal C. trachomatis and N. gonorrhoeae infections, and circumstances when supplemental testing is indicated. The recommendations in this report are intended for use by clinical laboratory directors, laboratory staff, clinicians, and disease control personnel who must choose among the multiple available tests, establish standard operating procedures for collecting and processing specimens, interpret test results for laboratory reporting, and counsel and treat patients. The performance of nucleic acid amplification tests (NAATs) with respect to overall sensitivity, specificity, and ease of specimen transport is better than that of any of the other tests available for the diagnosis of chlamydial and gonococcal infections. Laboratories should use NAATs to detect chlamydia and gonorrhea except in cases of child sexual assault involving boys and rectal and oropharyngeal infections in prepubescent girls and when evaluating a potential gonorrhea treatment failure, in which case culture and susceptibility testing might be required. NAATs that have been cleared by the Food and Drug Administration (FDA) for the detection of C. trachomatis and N. gonorrhoeae infections are recommended as screening or diagnostic tests because they have been evaluated in patients with and without symptoms. Maintaining the capability to culture for both N. gonorrhoeae and C. trachomatis in laboratories throughout the country is important because data are insufficient to recommend nonculture tests in cases of sexual assault in prepubescent boys and extragenital anatomic site exposure in prepubescent girls. N. gonorrhoeae culture is required to evaluate suspected cases of gonorrhea treatment failure and to monitor developing resistance to current treatment regimens. Chlamydia culture also should be maintained in some laboratories to monitor future changes in antibiotic susceptibility and to support surveillance and research activities such as detection of lymphogranuloma venereum or rare infections caused by variant or mutated C. trachomatis.

2014年沙眼衣原体和淋病奈瑟菌实验室检测建议
本报告更新了疾病预防控制中心2002年关于检测沙眼衣原体和淋病奈瑟菌感染的筛查试验的建议。检测沙眼衣原体和淋病奈瑟菌感染的筛选试验-2002年。51 MMWR 2002;[不。RR-15]),并就最佳标本类型、检测直肠和口咽沙眼衣原体和淋病奈瑟菌感染的检测方法以及需要进行补充检测的情况提供了新的建议。本报告中的建议旨在供临床实验室主任、实验室工作人员、临床医生和疾病控制人员使用,他们必须在多种可用的检测中进行选择,建立收集和处理标本的标准操作程序,为实验室报告解释检测结果,并为患者提供咨询和治疗。核酸扩增试验(NAATs)在总体敏感性、特异性和标本运输便利性方面的表现优于用于诊断衣原体和淋球菌感染的任何其他检测。实验室应使用NAATs检测衣原体和淋病,但涉及男孩的儿童性侵犯和青春期前女孩的直肠和口咽感染以及评估淋病治疗可能失败的情况除外,在这种情况下,可能需要进行培养和药敏试验。已被美国食品和药物管理局(FDA)批准用于检测沙眼衣原体和淋病奈索菌感染的NAATs被推荐作为筛查或诊断测试,因为它们已在有症状和无症状的患者中进行了评估。在全国各地的实验室中保持培养淋病奈瑟菌和沙眼奈瑟菌的能力是很重要的,因为数据不足,无法推荐对青春期前男孩的性侵犯和青春期前女孩的生殖器外解剖部位暴露进行非培养测试。需要进行淋病奈瑟菌培养,以评估淋病治疗失败的疑似病例,并监测对当前治疗方案产生的耐药性。一些实验室还应保持衣原体培养,以监测抗生素敏感性的未来变化,并支持监测和研究活动,如检测性病淋巴肉芽肿或由变异或突变沙眼衣原体引起的罕见感染。
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来源期刊
Mmwr Recommendations and Reports
Mmwr Recommendations and Reports PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
36.00
自引率
0.00%
发文量
3
期刊介绍: The MMWR series of publications is published by the Office of Science, Centers for Disease Control and Prevention (CDC), U.S. The MMWR Recommendations and Reports contain in-depth articles that relay policy statements for prevention and treatment in all areas in the CDC’s scope of responsibility (e.g., recommendations from the Advisory Committee on Immunization Practices).
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