TY - JOUR
T1 - Diagnosis of Chlamydia infection in women
AU - Su, Wen Hsiang
AU - Tsou, Tsung Shan
AU - Chen, Chien Sheng
AU - Ho, Tien Yu
AU - Lee, Wen Ling
AU - Yu, Yuan Yi
AU - Chen, Tien Jui
AU - Tan, Chia Hsuan
AU - Wang, Peng Hui
N1 - Funding Information:
This work was supported in part by grants from Veterans General Hospitals University System of Taiwan Joint Research Program ( VGHUST99-G4-3 ) and Taipei Veterans General Hospital ( V99-C1-085 and V99F-014 ), Taiwan.
PY - 2011/9
Y1 - 2011/9
N2 - Objects: Chlamydia (Chlamydia trachomatis) is a common sexually transmitted infection that places a heavy burden on women and neonatal health. To avoid severe sequelae such as female infertility, ectopic pregnancy, neonatal infection, such as ophthalmitis, and chronic pelvic pain prompt and appropriate antibiotic treatment seems the best policy in treating this group of patients. However, adequate treatment is not easy because many factors can interfere with an early and rapid identification of Chlamydia infection, including complicated mixed microflora of the vagina and cervix, a nonuser-friendly detection system, and the time required for identification, even with the combination of specific complaints and a high level of clinical alertness. When dealing with a female patient in a point-of-care (POC) clinic, we need to find the best strategy to provide the most efficient way to detect this infection. Materials and Methods: Totally five traditional methods and advanced technologies used for the diagnosis of Chlamydia infection in women were reviewed. A criterion proposed by World Health Organization with an acronym of ASSURED, representing affordable price, high sensitivity, high specificity, user-friendly design, rapid process, minimal equipment, and delivered-or-not, was used to reexamine these tools if they are the best tools. A multiplexed microchip-based immunoassay was evaluated as a potential tool. The ASSURED score was compared and a Chi-square test with a p value less than 0.05 was considered significant. Results: Traditional methods, such as symptoms approach, microscopic examination, and microorganism culture that have been broadly used once, are affordable, simple, and equipment-free but their relatively low sensitivity and specificity limit their use as a test of POC setting for these infected women. On the other hand, advanced technologies, such as antigen detection by immunoassay and nucleic acid amplification tests, have contributed to major progress in the diagnosis of Chlamydia because of its accuracy, convenience, and time saving. However, nucleic acid amplification tests are too expensive, so they cannot be accepted as a screening tool in a developing country. The only significant finding with p value less than 0.01 was achieved when a more sensitive immunoassay system developed successfully as a test of POC setting. Conclusions: Eventually, advances in laboratory techniques will satisfy our needs to detect Chlamydia infection economically and instantly. Microarray chips might be a relatively rapid, easy, inexpensive, and sensitive tool to detect many pathogens, including Chlamydia, using a one-time vaginal sampling process, which might make a POC policy possible.
AB - Objects: Chlamydia (Chlamydia trachomatis) is a common sexually transmitted infection that places a heavy burden on women and neonatal health. To avoid severe sequelae such as female infertility, ectopic pregnancy, neonatal infection, such as ophthalmitis, and chronic pelvic pain prompt and appropriate antibiotic treatment seems the best policy in treating this group of patients. However, adequate treatment is not easy because many factors can interfere with an early and rapid identification of Chlamydia infection, including complicated mixed microflora of the vagina and cervix, a nonuser-friendly detection system, and the time required for identification, even with the combination of specific complaints and a high level of clinical alertness. When dealing with a female patient in a point-of-care (POC) clinic, we need to find the best strategy to provide the most efficient way to detect this infection. Materials and Methods: Totally five traditional methods and advanced technologies used for the diagnosis of Chlamydia infection in women were reviewed. A criterion proposed by World Health Organization with an acronym of ASSURED, representing affordable price, high sensitivity, high specificity, user-friendly design, rapid process, minimal equipment, and delivered-or-not, was used to reexamine these tools if they are the best tools. A multiplexed microchip-based immunoassay was evaluated as a potential tool. The ASSURED score was compared and a Chi-square test with a p value less than 0.05 was considered significant. Results: Traditional methods, such as symptoms approach, microscopic examination, and microorganism culture that have been broadly used once, are affordable, simple, and equipment-free but their relatively low sensitivity and specificity limit their use as a test of POC setting for these infected women. On the other hand, advanced technologies, such as antigen detection by immunoassay and nucleic acid amplification tests, have contributed to major progress in the diagnosis of Chlamydia because of its accuracy, convenience, and time saving. However, nucleic acid amplification tests are too expensive, so they cannot be accepted as a screening tool in a developing country. The only significant finding with p value less than 0.01 was achieved when a more sensitive immunoassay system developed successfully as a test of POC setting. Conclusions: Eventually, advances in laboratory techniques will satisfy our needs to detect Chlamydia infection economically and instantly. Microarray chips might be a relatively rapid, easy, inexpensive, and sensitive tool to detect many pathogens, including Chlamydia, using a one-time vaginal sampling process, which might make a POC policy possible.
KW - Chlamydia
KW - Rapid diagnosis
KW - Sexually transmitted infections
UR - http://www.scopus.com/inward/record.url?scp=80955169388&partnerID=8YFLogxK
U2 - 10.1016/j.tjog.2011.07.001
DO - 10.1016/j.tjog.2011.07.001
M3 - 回顧評介論文
C2 - 22030037
AN - SCOPUS:80955169388
SN - 1028-4559
VL - 50
SP - 261
EP - 267
JO - Taiwanese Journal of Obstetrics and Gynecology
JF - Taiwanese Journal of Obstetrics and Gynecology
IS - 3
ER -