Katz Alan R, Effler Paul V, Ansdell Vernon E
Department of Public Health Sciences and Epidemiology, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI 96822, USA.
Trop Med Int Health. 2003 Jul;8(7):639-42. doi: 10.1046/j.1365-3156.2003.01071.x.
Laboratory confirmation of leptospirosis is usually accomplished serologically, without isolates, using the microscopic agglutination test (MAT). However, optimal performance of the MAT is dependent on the knowledge of enzootic serogroups and serovars so that an appropriate MAT antigen testing battery can be established. Infecting leptospiral serogroups can be identified serologically without isolates, using the MAT, or by serogrouping of isolates, but little information is available regarding the correlation between these methods. The identification of infecting serogroups for 53 culture-confirmed leptospirosis cases, diagnosed in Hawaii between 1979 and 1998, using serology and culture isolates were compared. The overall agreement between the two methods was good (kappa = 0.71, 95% CI: 0.56, 0.86). However, the agreement varied between serogroups from 0 to 100%. In establishing the prevalence of serogroups, results obtained via MAT serology (in the absence of serogrouped isolates) should be considered presumptive rather than definitive.
钩端螺旋体病的实验室确诊通常通过血清学方法完成，无需分离菌株，采用显微镜凝集试验（MAT）。然而，MAT的最佳性能取决于对动物疫源血清群和血清型的了解，以便能够建立合适的MAT抗原检测组合。感染的钩端螺旋体血清群可以通过MAT在不分离菌株的情况下进行血清学鉴定，或通过对分离菌株进行血清群分类来鉴定，但关于这些方法之间的相关性信息很少。对1979年至1998年在夏威夷诊断的53例经培养确诊的钩端螺旋体病病例，比较了使用血清学和培养分离菌株来鉴定感染血清群的情况。两种方法之间的总体一致性良好（kappa = 0.71，95% CI：0.56，0.86）。然而，血清群之间的一致性在0%至100%之间变化。在确定血清群的流行率时，通过MAT血清学（在没有血清群分类分离菌株的情况下）获得的结果应被视为推测性的而非确定性的。
