梅毒螺旋体特异性IgM酶免疫测定及梅毒螺旋体免疫印迹抗体检测在孕产妇及先天性梅毒诊断中的评估
Evaluation of a Treponema pallidum-specific IgM enzyme immunoassay and Treponema pallidum western blot antibody detection in the diagnosis of maternal and congenital syphilis.
作者信息
Rawstron Sarah A, Mehta Swati, Bromberg Kenneth
机构信息
Division of Pediatric Infectious Diseases, Department of Pediatrics, Children's Medical Center of Brooklyn (Kings County Hospital Center and SUNY Downstate), Brooklyn, New York 11203-2098, USA.
出版信息
Sex Transm Dis. 2004 Feb;31(2):123-6. doi: 10.1097/01.OLQ.0000109941.60065.65.
BACKGROUND
Congenital syphilis (CS) is a result of untreated or inadequately treated maternal syphilis. CS is more likely with early stages of maternal syphilis, but most mothers lack signs or symptoms and the risk of CS is unclear.
GOAL
The goal of this study was to evaluate Treponema pallidum IgM Western blot (TP IgM WB) and a T. pallidum IgM enzyme immunoassay (TP IgM ELISA) in mothers with syphilis to determine if positive tests better indicate a risk of CS than a rapid plasma reagin titer >/=1:16.
STUDY DESIGN
Ninety-seven mother-baby pairs with reactive syphilis serology were evaluated.
RESULTS
TP IgM WB tests were positive in 18 pregnancies (7 of 18 babies had CS) and negative in 79 pregnancies (7 of 82 babies had CS). Thirty-two mothers had titers >/=1:16 (6 babies with CS) and 65 mothers had titers </=1:8 (8 babies with CS).
CONCLUSION
TP IgM tests better identify mothers at risk of delivering babies with CS than maternal titer >/=1:16.
背景
先天性梅毒（CS）是母亲梅毒未治疗或治疗不充分的结果。母亲梅毒处于早期时，发生先天性梅毒的可能性更大，但大多数母亲没有体征或症状，先天性梅毒的风险尚不清楚。
目的
本研究的目的是评估梅毒螺旋体IgM免疫印迹法（TP IgM WB）和梅毒螺旋体IgM酶免疫测定法（TP IgM ELISA）在梅毒母亲中的应用，以确定阳性检测结果是否比快速血浆反应素滴度≥1:16更能提示先天性梅毒的风险。
研究设计
对97对梅毒血清学反应阳性的母婴进行了评估。
结果
18例妊娠的TP IgM WB检测呈阳性（18例婴儿中有7例患先天性梅毒），79例妊娠呈阴性（82例婴儿中有7例患先天性梅毒）。32位母亲的滴度≥1:16（6例婴儿患先天性梅毒），65位母亲的滴度≤1:8（8例婴儿患先天性梅毒）。
结论
与母亲滴度≥1:16相比，TP IgM检测能更好地识别有分娩先天性梅毒婴儿风险的母亲。
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