Blacksell Stuart D, Mammen Mammen P, Thongpaseuth Soulignasack, Gibbons Robert V, Jarman Richard G, Jenjaroen Kemajittra, Nisalak Ananda, Phetsouvanh Rattanaphone, Newton Paul N, Day Nicholas P J
Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR.
Diagn Microbiol Infect Dis. 2008 Jan;60(1):43-9. doi: 10.1016/j.diagmicrobio.2007.07.011. Epub 2007 Sep 24.
We evaluated 2 commercial enzyme-linked immunosorbent assays (ELISAs) for the diagnosis of dengue infection; one a serologic test for immunoglobulin M (IgM) antibodies, the other based on detection of dengue virus nonstructural 1 (NS1) antigen. Using gold standard reference serology on paired sera, 41% (38/92 patients) were dengue confirmed, with 4 (11%) acute primary and 33 (87%) acute secondary infections (1 was of indeterminate status). Sensitivity of the NS1-ELISA was 63% (95% confidence interval [CI], 53-73) on admission samples but was much less sensitive (5%; 95% CI, 1-10) on convalescent samples. The IgM capture ELISA had a lower but statistically equivalent sensitivity compared with the NS1-ELISA for admission samples (45%; 95% CI, 35-55) but was more sensitive on convalescent samples (58%; 95% CI, 48-68). The results of the NS1 and IgM capture ELISAs were combined using a logical OR operator, increasing the sensitivity for admission samples (79%; 95% CI, 71-87), convalescent samples (63%; 95% CI, 53-73), and all samples (71%; 95% CI, 65-78).
我们评估了两种用于诊断登革热感染的商用酶联免疫吸附测定（ELISA）；一种是检测免疫球蛋白M（IgM）抗体的血清学检测，另一种是基于检测登革热病毒非结构1（NS1）抗原。使用配对血清的金标准参考血清学方法，41%（92例患者中的38例）被确诊为登革热，其中4例（11%）为急性初次感染，33例（87%）为急性二次感染（1例状态不确定）。NS1-ELISA在入院样本上的敏感性为63%（95%置信区间[CI]，53 - 73），但在恢复期样本上敏感性低得多（5%；95% CI，1 - 10）。IgM捕获ELISA与NS1-ELISA相比，入院样本的敏感性较低但在统计学上相当（45%；95% CI，35 - 55），但在恢复期样本上更敏感（58%；95% CI，48 - 68）。NS1和IgM捕获ELISA的结果使用逻辑或运算符进行合并，提高了入院样本（79%；95% CI，71 - 87）、恢复期样本（63%；95% CI，53 - 73）和所有样本（71%；95% CI，65 - 78）的敏感性。
