Lupidi R, Cinco M, Balanzin D, Delprete E, Varaldo P E
Institute of Microbiology, University of Ancona Medical School, Italy.
J Clin Microbiol. 1991 Apr;29(4):805-9. doi: 10.1128/jcm.29.4.805-809.1991.
Eighteen patients involved in a localized outbreak of leptospirosis were subjected to a serological follow-up study over a 5-year period. Four distinct sets of sera from all patients and a fifth sample obtained from 10 of them were examined by the microscopic agglutination test (MAT) for demonstration of leptospiral antibodies. The test was carried out by using live leptospires from reference strains of 17 Leptospira interrogans serovars known to occur in Italy. In all cases, the highest titers of agglutinins were recorded against one or more of the three Australis group serovars tested (australis, bratislava, and lora). The highest antibody levels were reached soon after the acute phase of infection in some patients but only after some months in others. Titers then tended to recede with varying rapidity, but titers against the Australis group serovars were still detectable in some patients after 5 years. Coagglutinins against serovars of other serogroups were detected, generally at low levels, in the early sets of sera of most patients, but tended to disappear in the late-set sera. Specific immunoglobulin M (IgM) and IgG against the three Australis group serovars were determined in most serum samples from 16 patients by solid-phase enzyme immunoassay (EIA). In general, EIA titers were considerably lower than MAT titers, but there was a certain patient-to-patient variability in both the IgM/IgG ratio and the evolution and persistence of the two immunoglobulin classes. Since all the evidence indicated that the initial outbreak from a single source, the observed patient-to-patient variability in the progress of both MAT and EIA titers appeared to be attributable to factors inherent in the individual patients. Cross agglutination absorption tests, aimed at retrospectively determining to which of the Australis group serovars the outbreak-specific infecting strain belonged, were performed with six serum samples from different patients. Most absorbed sera seemed to originate from an australis or lora infection, but it was not possible to discriminate conclusively between the two serovars.
18名参与钩端螺旋体病局部暴发的患者接受了为期5年的血清学随访研究。对所有患者的四组不同血清以及其中10名患者的第五份样本进行显微镜凝集试验（MAT），以检测钩端螺旋体抗体。该试验使用来自已知在意大利出现的17种问号钩端螺旋体血清型参考菌株的活钩端螺旋体进行。在所有病例中，凝集素的最高滴度是针对所检测的三种澳洲群血清型中的一种或多种（澳洲型、布拉迪斯拉发型和洛拉型）记录的。一些患者在感染急性期后不久就达到了最高抗体水平，而另一些患者则在几个月后才达到。然后滴度往往以不同的速度下降，但5年后仍有一些患者可检测到针对澳洲群血清型的滴度。在大多数患者早期的血清样本中检测到了针对其他血清群血清型的协同凝集素，一般水平较低，但在后期血清中往往会消失。通过固相酶免疫测定（EIA）在16名患者的大多数血清样本中测定了针对三种澳洲群血清型的特异性免疫球蛋白M（IgM）和IgG。一般来说，EIA滴度远低于MAT滴度，但在IgM/I IgG比值以及两种免疫球蛋白类别的演变和持续存在方面，患者之间存在一定差异。由于所有证据表明最初的暴发源于单一来源，因此观察到的患者之间MAT和EIA滴度变化的差异似乎归因于个体患者固有的因素。对来自不同患者的六份血清样本进行了交叉凝集吸收试验，旨在回顾性确定暴发特异性感染菌株属于澳洲群血清型中的哪一种。大多数吸收后的血清似乎源于澳洲型或洛拉型感染，但无法在这两种血清型之间做出明确区分。
