Sonjai K, Soisangwan R, Sakolvaree Y, Kurazono H, Chongsa-nguan M, Tapchaisri P, Mahakunkijcharoen Y, Nair G B, Hayashi H, Chaicumpa W
Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Asian Pac J Allergy Immunol. 2001 Jun;19(2):115-27.
Rapid Diagnosis of salmonellosis and shigellosis was performed using six different diagnostic test kits which recently have been made available commercially. They were Salmo-Dot, Typhi-Dot, Shigel Dot A, B, C, and D test kits for detection of Salmonella spp., group D salmonellae, and groups A, B, C, and D Shigella spp., respectively. The principle of all test kits is a membrane (dot) ELISA using specific monoclonal antibodies to the respective pathogens as the detection reagents. The present study was designed to validate the accuracy of the test kits, at a laboratory in a provincial hospital in Thailand, in comparison with the conventional bacterial culture method alone or with the combined results of the culture and the Western blot analysis (WB) for detecting the respective bacterial lipopolysacchharides (LPS) in specimens. Five hundred rectal swab samples of patients with diarrhea who seeked treatment at the hospital, were evaluated. The diagnostic accuracy of the Salmo-Dot was 91.0% when compared with the conventional bacterial culture method alone but was 100.0% in comparison with the combined results of the culture and the WB. The Typhi-Dot and the Shigel-Dot A, B, C, and D showed 100%, 99.2%, 95.0%, 94.0% and 96.4%, respectively when compared with the culture alone and all were 100% in comparison with the combination of the results of the bacterial culture and the WB. The Shigel-Dot A revealed antigen of type 1 Shigella dysenteriae in several specimens in which the bacteria could not be recovered by the culture method. This difference is important as type 1 Shigella dysenteriae have high epidemic potential and often cause severe morbidity. Unawareness of their presence by the conventional culture may have great impact on disease surveillance for public health. The pathogen detection using the six diagnostic test kits is sensitive, specific, rapid, and relatively simple and less expensive. Several specimens can be tested at the same time without much increase in turn around time. Moreover, these kits produce no contaminated waste as compared with the bacterial culture method. The test kits should be used for rapid screening of specimens of patients with diarrhea especially in areas where culture facilities are inadequate.
使用最近已在市场上销售的六种不同诊断试剂盒对沙门氏菌病和志贺氏菌病进行快速诊断。它们分别是用于检测沙门氏菌属、D群沙门氏菌以及A、B、C和D群志贺氏菌属的Salmo - Dot、Typhi - Dot、Shigel Dot A、B、C和D试剂盒。所有试剂盒的原理都是基于膜（斑点）酶联免疫吸附测定法，使用针对各自病原体的特异性单克隆抗体作为检测试剂。本研究旨在泰国一家省级医院的实验室中，将这些试剂盒的准确性与单独的传统细菌培养方法，或与培养和蛋白质印迹分析（WB）相结合的结果进行比较，以检测标本中各自细菌的脂多糖（LPS）。对在该医院寻求治疗的500例腹泻患者的直肠拭子样本进行了评估。与单独的传统细菌培养方法相比，Salmo - Dot的诊断准确率为91.0%，但与培养和WB相结合的结果相比则为100.0%。与单独培养相比，Typhi - Dot以及Shigel - Dot A、B、C和D的准确率分别为100%、99.2%、95.0%、94.0%和96.4%，与细菌培养和WB结果相结合相比均为100%。Shigel - Dot A在几个用培养方法无法回收细菌的标本中检测出了痢疾志贺氏菌1型抗原。这种差异很重要，因为痢疾志贺氏菌1型具有很高的流行潜力，且常导致严重发病。传统培养方法未意识到它们的存在可能会对公共卫生疾病监测产生重大影响。使用这六种诊断试剂盒进行病原体检测具有灵敏、特异、快速、相对简单且成本较低的特点。可以同时检测多个标本，周转时间不会大幅增加。此外，与细菌培养方法相比，这些试剂盒不会产生污染性废物。这些试剂盒应用于腹泻患者标本的快速筛查，特别是在培养设施不足的地区。
