Diagnostic Value of Enzyme Immunoassay for Chlamydia Trachomatis: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 AN Ni ^1,2 , GE Long ^1,2 , XU Junfeng ^1,2 , SHI Xintong ^1,2 , LIANG Li ^1,2 , ZHOU Weiwen ^1,3 , LIU Yinchun ^1,2 , MA Jichun ¹ , NA Heya ¹ , TIAN Jinhui ¹

1. Evidence-Based Medicine Center of Lanzhou University, School of Basic Medical Sciences of Lanzhou University, Lanzhou 730000, China;2. The First Clinical Medical College of Lanzhou University, Lanzhou 730000, China;3. The Second Clinical Medical College of Lanzhou University, Lanzhou 730000, China;

Corresponding author：

AN Ni, Email: tjh996@163.com

Keywords：

Enzyme immunoassay; Chlamydia trachomatis; Diagnostic test; Meta-analysis

DOI：

10.7507/1672-2531.20130029

Video：

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Objective 　To evaluate the diagnostic accuracy of enzyme immunoassay (EIA) for chlamydia trachomatis (CT).
Methods 　The diagnosis trials on EIA for CT were searched in the databases such as PubMed (1966 to Dec. 2011), The Cochrane Library (Issue 12, 2011), EMbase (1974 to Dec. 2011), CNKI (1994 to Dec. 2011), VIP (1989 to Dec. 2011) and CBM (1978 to Dec. 2011), meanwhile the manual and other retrieves were also conducted. Two reviewers evaluated the quality of the included trials according to the quality assessment of diagnostic accuracy studies (QUADAS), and then meta-analysis was performed using Meta Analyst and RevMan 5.0 software.
Results 　A total of 17 trials involving 9 461 participants were included. The results of meta-analysis showed that the weighted sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and the area under SROC curve were 0.847 (95%CI 0.571 to 0.995), 0.964 (95%CI 0.890 to 0.994), 25.972 (95%CI 18.587 to 36.293), 0.156 (95%CI 0.114 to 0.212), 228.875 (95%CI 127.136 to 412.028), and 0.953, respectively.
Conclusion 　EIA for CT has higher sensitivity and specificity, so EIA is recommended for preliminary screening CT and diagnosing the highly suspected cases or the patients without obvious signs and symptoms.

Citation： AN Ni,GE Long,XU Junfeng,SHI Xintong,LIANG Li,ZHOU Weiwen,LIU Yinchun,MA Jichun,NA Heya,TIAN Jinhui. Diagnostic Value of Enzyme Immunoassay for Chlamydia Trachomatis: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2013, 13(2): 165-169. doi: 10.7507/1672-2531.20130029 Copy

1.	Bassiri M, Hu HY, Domeika MA, et al. Detection of Chlamydia trachomatis in Urine Specimens from Women by Ligase Chain Reaction. J Clin Microbiol, 1995, 33(4): 898-900.
2.	Washington AE, Johnson RE, Sanders LL, et al. Chlamydia trachomatis Infections in the United States. JAMA, 1987, 257: 2070-2072.
3.	Mårdh PA, Møller BR, Paavonen J (ed.). Chlamydia trachomatis in genital and related infections. Almqvist & Wiksell International, Stockholm. Medical chlamydiology—a position paper, 1982: 3-8.
4.	Stamm WE, Clark A. Use of the Abbott LCR assay to identify chlamydia-infected men and women using urine specimens. Sex. Transm. Dis, 1994, 21(Suppl.): 126.
5.	Centers for Disease Control. Chlamydia trachomatis infections, policy guidelines for prevention and control. Morbid. Mortal. Weekly Rep, 1985, 34 Suppl 3: 53S-74S.
6.	Rahm VA, Gnarpe H, Odlind V. Chlamydia trachomatis among sexually active teenage girls. Lack of correlation between chlamydial infection, history of the patient and clinical signs of infection. Br J Obstet Gynaecol, 1988, 95(9): 916-919.
7.	姚兵, 杨岳琴, 朱启锭. 套式聚合酶链反应结合直接荧光法检测女性生殖道沙眼衣原体. 中华医学检验杂志, 1998, 21: 338-341.
8.	Thejls H, Gnarpe J, Gnarpe H, et al. Expanded gold standard in the diagnosis of Chlamydia trachomatis in a low prevalence population: diagnostic efficacy of tissue culture, direct immunofluorescence, enzyme immunoassay, PCR and serology. Genitourin Med, 1994, 70(5): 300-303.
9.	Markus B, Heiner B, Matthias E, et al. The Bayes Library of Diagnostic Studies and Reviews. 2nd edition. 2002.
10.	Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Metodol, 2003, 3: 2-5.
11.	郑和平, 李美玲, 黄进梅, 等. MicrotrakⅡ EIA 法检测泌尿生殖道沙眼衣原体感染. 岭南皮肤性病科杂志, 2004, 11(3): 207-209.
12.	叶顺章, 陶俊, 钟铭英, 等. 细胞培养法检测淋病患者泌尿生殖道沙眼衣原体的研究. 中国皮肤性病学杂志, 1995, 9(3): 142-143.
13.	张莉, 宋卫忠, 梁艳华, 等. 细胞培养和酶联免疫法检测沙眼衣原体的比较研究. 中国热带医学杂志, 2006, 6(8): 1471-1472.
14.	Warren R, Dwyer B, Plackett M, et al. Comparative Evaluation of Detection Assays for Chlamydia trachomatis. J Clin Microbiol, 1993, 31(6): 1663-1666.
15.	Mumtaz G, Clark S, Ridgway GL, et al. Comparison of an enzyme immuno- assay (Antigenz Chlamydia) with cell culture for thedetection of genital chlamydial infection in high and low risk populations. Genitourin Med, 1993, 69(2): 119-122.
16.	Chomvarin C, Chantarasuk Y, Thongkrajai P, et al. Development of EIA for detection of Chlamydia trachomatis in genital specimens. Southeast Asian J Trop Med Public Health, 2000, 31(1): 96-103.
17.	Mumtaz G, Ridgway GL, Nayagam A, et al. Enzyme immunoassay compared with cell culture and immunofluorescence for detecting genital chlamydia. J Clin Pathol, 1989, 42(6): 658-660.
18.	Ehret JM, Leszcynski JC, Douglas JM, et al. Evaluation of Chlamydiazyme Enzyme Immunoassay for Detection of Chlamydia trachomatis in Urine Specimens from Men. J Clin Microbiol, 1993, 31(10): 2702-2705.
19.	Srivasin V, Lim KB, Thirumoorthy T, et al. Enzyme immunoassay (Chlamydiazyme) for the detection of chlamydial antigen in endocervical specimens. Singapore Med J, 1989, 30(5): 449-450.
20.	Talbot H, Romanowski B. Factors affecting urine EIA sensitivity in the detection of Chlamydia trachomatis in men. Genitourin Med, 1994, 70(2): 101-104.
21.	Tjiam KH, van Heijst BY, van Zuuren A, et al. Evaluation of an enzyme immunoassay for the diagnosis of chlamydial infections in urogenital specimens. J Clin Microbiol, 1986, 23(4): 752-754.
22.	Jones MF, Smith TF, Houglum AJ, et al. Detection of Chlamydia trachomatis in Genital Specimens by the Chlamydiazyme Test. J Clin Microbiol, 1984, 20(3): 465-467.
23.	LeBar W, Herschman B, Jemal C, et al. Comparison of DNA probe, monoclonal antibody enzyme immunoassay, and cell culture for the detection of Chlamydia trachomatis. J Clin Microbiol, 1989, 27(5): 826-828.
24.	Hammerschlag MR, Roblin PM, Cummings C, et al. Comparison of enzyme immunoassay and culture for diagnosis of chlamydial conjunctivitis and respiratory infections in infants. J Clin Microbiol, 1987, 25(12): 2306-2308.
25.	Mahony J, Castriciano S, Sellors J, et al. Diagnosis of Chlamydia trachomatis genital infections by cell culture and two enzyme immunoassays detecting different chlamydial antigens. J Clin Microbiol, 1989, 27(9): 1934-1938.
26.	Clarke LM, Sierra MF, Daidone BJ, et al. Comparison of the Syva MicroTrak enzyme immunoassay and Gen-Probe PACE 2 with cell culture for diagnosis of cervical Chlamydia trachomatis infection in a high-prevalence female population. J Clin Microbiol, 1993, 31(4): 968-971.
27.	El-Sayed M, Badwy W, Bakr A. Rapid Hybridization Probe Assay and PCR for Detection of Chlamydia trachomatis in Urinary Tract Infections: A Prospective Study. Curr Microbiol, 2006, 53(5): 379-383.

1. Bassiri M, Hu HY, Domeika MA, et al. Detection of Chlamydia trachomatis in Urine Specimens from Women by Ligase Chain Reaction. J Clin Microbiol, 1995, 33(4): 898-900.
2. Washington AE, Johnson RE, Sanders LL, et al. Chlamydia trachomatis Infections in the United States. JAMA, 1987, 257: 2070-2072.
3. Mårdh PA, Møller BR, Paavonen J (ed.). Chlamydia trachomatis in genital and related infections. Almqvist & Wiksell International, Stockholm. Medical chlamydiology—a position paper, 1982: 3-8.
4. Stamm WE, Clark A. Use of the Abbott LCR assay to identify chlamydia-infected men and women using urine specimens. Sex. Transm. Dis, 1994, 21(Suppl.): 126.
5. Centers for Disease Control. Chlamydia trachomatis infections, policy guidelines for prevention and control. Morbid. Mortal. Weekly Rep, 1985, 34 Suppl 3: 53S-74S.
6. Rahm VA, Gnarpe H, Odlind V. Chlamydia trachomatis among sexually active teenage girls. Lack of correlation between chlamydial infection, history of the patient and clinical signs of infection. Br J Obstet Gynaecol, 1988, 95(9): 916-919.
7. 姚兵, 杨岳琴, 朱启锭. 套式聚合酶链反应结合直接荧光法检测女性生殖道沙眼衣原体. 中华医学检验杂志, 1998, 21: 338-341.
8. Thejls H, Gnarpe J, Gnarpe H, et al. Expanded gold standard in the diagnosis of Chlamydia trachomatis in a low prevalence population: diagnostic efficacy of tissue culture, direct immunofluorescence, enzyme immunoassay, PCR and serology. Genitourin Med, 1994, 70(5): 300-303.
9. Markus B, Heiner B, Matthias E, et al. The Bayes Library of Diagnostic Studies and Reviews. 2nd edition. 2002.
10. Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Metodol, 2003, 3: 2-5.
11. 郑和平, 李美玲, 黄进梅, 等. MicrotrakⅡ EIA 法检测泌尿生殖道沙眼衣原体感染. 岭南皮肤性病科杂志, 2004, 11(3): 207-209.
12. 叶顺章, 陶俊, 钟铭英, 等. 细胞培养法检测淋病患者泌尿生殖道沙眼衣原体的研究. 中国皮肤性病学杂志, 1995, 9(3): 142-143.
13. 张莉, 宋卫忠, 梁艳华, 等. 细胞培养和酶联免疫法检测沙眼衣原体的比较研究. 中国热带医学杂志, 2006, 6(8): 1471-1472.
14. Warren R, Dwyer B, Plackett M, et al. Comparative Evaluation of Detection Assays for Chlamydia trachomatis. J Clin Microbiol, 1993, 31(6): 1663-1666.
15. Mumtaz G, Clark S, Ridgway GL, et al. Comparison of an enzyme immuno- assay (Antigenz Chlamydia) with cell culture for thedetection of genital chlamydial infection in high and low risk populations. Genitourin Med, 1993, 69(2): 119-122.
16. Chomvarin C, Chantarasuk Y, Thongkrajai P, et al. Development of EIA for detection of Chlamydia trachomatis in genital specimens. Southeast Asian J Trop Med Public Health, 2000, 31(1): 96-103.
17. Mumtaz G, Ridgway GL, Nayagam A, et al. Enzyme immunoassay compared with cell culture and immunofluorescence for detecting genital chlamydia. J Clin Pathol, 1989, 42(6): 658-660.
18. Ehret JM, Leszcynski JC, Douglas JM, et al. Evaluation of Chlamydiazyme Enzyme Immunoassay for Detection of Chlamydia trachomatis in Urine Specimens from Men. J Clin Microbiol, 1993, 31(10): 2702-2705.
19. Srivasin V, Lim KB, Thirumoorthy T, et al. Enzyme immunoassay (Chlamydiazyme) for the detection of chlamydial antigen in endocervical specimens. Singapore Med J, 1989, 30(5): 449-450.
20. Talbot H, Romanowski B. Factors affecting urine EIA sensitivity in the detection of Chlamydia trachomatis in men. Genitourin Med, 1994, 70(2): 101-104.
21. Tjiam KH, van Heijst BY, van Zuuren A, et al. Evaluation of an enzyme immunoassay for the diagnosis of chlamydial infections in urogenital specimens. J Clin Microbiol, 1986, 23(4): 752-754.
22. Jones MF, Smith TF, Houglum AJ, et al. Detection of Chlamydia trachomatis in Genital Specimens by the Chlamydiazyme Test. J Clin Microbiol, 1984, 20(3): 465-467.
23. LeBar W, Herschman B, Jemal C, et al. Comparison of DNA probe, monoclonal antibody enzyme immunoassay, and cell culture for the detection of Chlamydia trachomatis. J Clin Microbiol, 1989, 27(5): 826-828.
24. Hammerschlag MR, Roblin PM, Cummings C, et al. Comparison of enzyme immunoassay and culture for diagnosis of chlamydial conjunctivitis and respiratory infections in infants. J Clin Microbiol, 1987, 25(12): 2306-2308.
25. Mahony J, Castriciano S, Sellors J, et al. Diagnosis of Chlamydia trachomatis genital infections by cell culture and two enzyme immunoassays detecting different chlamydial antigens. J Clin Microbiol, 1989, 27(9): 1934-1938.
26. Clarke LM, Sierra MF, Daidone BJ, et al. Comparison of the Syva MicroTrak enzyme immunoassay and Gen-Probe PACE 2 with cell culture for diagnosis of cervical Chlamydia trachomatis infection in a high-prevalence female population. J Clin Microbiol, 1993, 31(4): 968-971.
27. El-Sayed M, Badwy W, Bakr A. Rapid Hybridization Probe Assay and PCR for Detection of Chlamydia trachomatis in Urinary Tract Infections: A Prospective Study. Curr Microbiol, 2006, 53(5): 379-383.

Chinese Journal of Evidence-Based Medicine

Diagnostic Value of Enzyme Immunoassay for Chlamydia Trachomatis: A Meta-Analysis

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