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间接免疫过氧化物酶试验在马来西亚立克次体病血清诊断中的应用

The use of the indirect immunoperoxidase test for the serodiagnosis of rickettsial diseases in Malaysia.

作者信息

Tay S T, Rohani M Y

出版信息

Southeast Asian J Trop Med Public Health. 2002 Jun;33(2):314-20.

Abstract

The indirect immunoperoxidase (HP) test has been used extensively in most government hospitals in Malaysia for the serodiagnosis of scrub typhus, murine typhus and tick typhus during the 1990s. The test was used to determine the IgG and IgM antibody titers in patients' sera for three rickettsial species, ie Orientia tsutsugamushi OT; the causative agent of scrub typhus), Rickettsia typhi (RT; the causative agent of murine typhus), and TT118 spotted fever group rickettsiae (TT; the causative agent of tick typhus). The serological findings obtained from Malaysian hospitals using the IIP test (1994-1999) were analyzed. During the six-year period, a total of 61,501 patients' sera were tested, of which 9.6%, 10.5%, and 12.9% had antibody (IgG and/or IgM of > or = 1:50) for OT, RT and TT respectively. A total of 8.6%, 9.8%, and 9.7% of sera had IgG antibody of > or = 1:50 for OT, RT, and TT respectively, indicating past infection. A total of 3.4%, 3.8%, and 6.4 % of sera had IgM antibody of > or = 1:50 for OT, RT, and TT respectively, indicating recent infection. A total of 2,986 (4.9%), 1,882 (3.1%), and 1,574 (2.6%) of sera had IgG and/or IgM antibody titers of > or = 1:400 for OT, RT, and TT respectively, suggesting active rickettsial infection. The seropositivity rates of OT, RT and TT varied according to geographical locations. While the seropositivity of OT remained constant during the six-year period, a reduction in the seropositivity of both RT and TT was noted during recent years. The serological findings reflect the endemicity of rickettsial diseases, including tick typhus, and endemic typhus in various parts of Malaysia. Awareness of these diseases by health and medical staff and by the general public is important if the mortality and morbidity associated with scrub typhus, tick typhus, and murine typhus in Malaysia, are to be reduced.

摘要

20世纪90年代,间接免疫过氧化物酶(HP)试验在马来西亚的大多数政府医院被广泛用于恙虫病、鼠型斑疹伤寒和蜱传斑疹伤寒的血清学诊断。该试验用于测定患者血清中针对三种立克次体的IgG和IgM抗体滴度,即恙虫病东方体(OT;恙虫病的病原体)、伤寒立克次体(RT;鼠型斑疹伤寒的病原体)和TT118斑点热群立克次体(TT;蜱传斑疹伤寒的病原体)。对马来西亚医院使用IIP试验(1994 - 1999年)获得的血清学结果进行了分析。在这六年期间,共检测了61501份患者血清,其中分别有9.6%、10.5%和12.9%的血清针对OT、RT和TT有抗体(IgG和/或IgM≥1:50)。分别有8.6%、9.8%和9.7%的血清针对OT、RT和TT有IgG抗体≥1:50,表明既往感染。分别有3.4%、3.8%和6.4%的血清针对OT、RT和TT有IgM抗体≥1:50,表明近期感染。分别有2986份(4.9%)、1882份(3.1%)和1574份(2.6%)的血清针对OT、RT和TT的IgG和/或IgM抗体滴度≥1:400,提示存在活动性立克次体感染。OT、RT和TT的血清阳性率因地理位置而异。虽然OT的血清阳性率在六年期间保持稳定,但近年来RT和TT的血清阳性率均有所下降。血清学结果反映了包括蜱传斑疹伤寒和地方性斑疹伤寒在内的立克次体病在马来西亚各地的流行情况。如果要降低马来西亚与恙虫病、蜱传斑疹伤寒和鼠型斑疹伤寒相关的死亡率和发病率,卫生和医务人员以及公众对这些疾病的认识很重要。

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