Kusum Mayura, Boonsarthorn Naphatsawan, Biaklang Mayurachat, Sina Umaporn, Sawanpanyalert Pathom, Naigowit Pimjai
Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand.
J Med Assoc Thai. 2005 Aug;88(8):1098-102.
Blood from patients suspected of leptospirosis 148 specimens were cultured for leptospira. Twenty two specimens were positive (15%). The isolated leptospira were tested against the 24 serovars of standard antisera by Microscopic Agglutination Test (MAT). It was found that all 22 leptospira isolates reacted strongly against L. autumnalis, except 1 isolate that also reacted against serovar djasiman. The patient's sera were collected from only 14 cases. When the sera of the 14 patients were tested with the 24 reference serovars by MAT it was found that sera reacted the most against L. australis and in decreasing order against L. bratislava, L. autumnalis, L. rachmati, L. copenhageni, L. javanica. There had some cross reactions against several serovars in a single patient. The present study showed inconsistency between culture results and serum assays. Since sera showed cross reactivities against several serovars, it was not possible to determine which serovar was etiologic. Therefore, the isolation of leptospira though time consuming is specific in the identification of the serovar.
对疑似钩端螺旋体病患者的血液进行培养,共148份标本培养钩端螺旋体。22份标本呈阳性(15%)。通过显微镜凝集试验(MAT)对分离出的钩端螺旋体与24种标准抗血清血清型进行检测。结果发现,除1株分离株还与贾西曼血清型反应外,所有22株钩端螺旋体分离株均与秋季热钩端螺旋体有强烈反应。仅从14例患者中采集了血清。当用MAT对这14例患者的血清与24种参考血清型进行检测时,发现血清与澳洲钩端螺旋体反应最强,其次依次为布拉迪斯拉发钩端螺旋体、秋季热钩端螺旋体、拉赫马特钩端螺旋体、哥本哈根钩端螺旋体、爪哇钩端螺旋体。单个患者中存在针对几种血清型的交叉反应。本研究表明培养结果与血清检测结果不一致。由于血清对几种血清型有交叉反应,因此无法确定哪种血清型是病因。因此,尽管分离钩端螺旋体耗时,但在血清型鉴定方面具有特异性。