Интересная градация диагноза гонореи от СDС:
Identification of N. gonorrhoeae: Definitions
Because of the serious social and medicolegal consequences of misdiagnosing gonorrhea or misidentifying strains of N. gonorrhoeae, the CDC has recommended criteria for reporting diagnoses of gonorrhea (15). Three levels of diagnosis are defined on the basis of clinical findings or the results of laboratory diagnostic tests. A definitive diagnosis of gonorrhea must be obtained for medicolegal purposes.
A Suggestive diagnosis is defined by the presence of:
(i) a mucopurulent endocervical or urethral exudate on physical examination and
(ii) sexual exposure to a person infected with N. gonorrhoeae.
A Presumptive diagnosis of gonorrhea is made on the basis of two of the following three criteria:
(i) typical gram-negative intracellular diplococci on microscopic examination of a smear of urethral exudate (men) of endocervical secretions (women);
(ii) growth of N. gonorrhoeae, from the urethra (men) or endocervix (women), on culture medium, and demonstration of typical colonial morphology, positive oxidase reaction, and typical gram- negative morphology; and/or
(iii) detection of N. gonorrhoeae by a nonculture laboratory test (Antigen detection test (e.g., Gonozyme [Abbott]), direct specimen nucleic acid probe test (e.g., Pace II [GenProbe]), nucleic acid amplification test (e.g., LCR [Abbott]).
A Definitive diagnosis of gonorrhea requires:
(i) isolation of N. gonorrhoeae from sites of exposure (e.g., urethra, endocervix, throat, rectum) by culture (usually a selective medium) and demonstrating typical colonial morphology, positive oxidase reaction, and typical gram-negative morphology and
(ii) confirmation of isolates by biochemical, enzymatic, serologic, or nucleic acid testing e.g., carbohydrate utilization, rapid enzyme substrate tests, serologic methods such as coagglutination or fluorescent antibody tests supplemented with additional tests that will ensure accurate identification of isolates, or a DNA probe culture confirmation technique.
Подскажите, как наиболее адекватно перевести на русский термины Suggestive, Presumptive, Definitive?
Если исходить из этих критериев, чисто бактериоскопический диагноз гонореи (внутриклеточные грамотрицательные диплококки) , допустимый у взрослых у нас, в Америке даже не предположительный (Presumptive).
Имеет кто нибудь опыт работы российскими тест - системами ПЦР в образцах культуры грам-отрицательных диплококков?
Возможно ли это как "DNA probe culture confirmation technique"?.
Имеет кто-нибудь опыт работы на средах GONOLINE DUO (BioMerieux, Франция)?
