de Ory Fernando, Minguito Teodora
Servicio de Microbiología Diagnóstica, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, España.
Enferm Infecc Microbiol Clin. 2009 Feb;27(2):81-4. doi: 10.1016/j.eimc.2008.03.002. Epub 2009 Feb 5.
Antigenuria detection is the main approach for diagnosing Legionella infections. The aim of this study was to compare 5 commercially available methods for detecting Legionella pneumophila soluble antigens in urine.
Seventy-one urine samples were tested, 62 from patients with bacterial infection and 9 from patients with respiratory syncytial virus infection. All samples were assayed for the presence of L. pneumophila by immunoenzymatic (ELISA) (Binax and Bartels), and immunochromatographic (IC) (Binax, SAS and Uni-Gold) methods.
Identical results (35 positive and 17 negative) were obtained by the 5 assays in 52 samples (73.2%). Samples showing discrepant results were classified by the majority criterion, and/or other laboratory results (serology), and/or epidemiological findings. On this basis, 51 samples were ultimately classified as positive, and 20 as negative. Sensitivity values of ELISA-Binax, ELISA-Bartels, IC-Binax, IC-SAS and IC-Uni-Gold were 80.4, 100, 82.4, 86.3, and 70.6%, respectively. Corresponding values for specificity were 90, 95, 100, 95 and 100%.
The results indicate that the methods compared are all adequate for diagnosing Legionella infection, although some have certain limitations regarding sensitivity.
抗原尿检测是诊断军团菌感染的主要方法。本研究旨在比较5种市售检测尿液中嗜肺军团菌可溶性抗原的方法。
检测了71份尿液样本，其中62份来自细菌感染患者，9份来自呼吸道合胞病毒感染患者。所有样本均采用免疫酶法（ELISA）（Binax和Bartels）和免疫层析法（IC）（Binax、SAS和Uni-Gold）检测嗜肺军团菌的存在情况。
5种检测方法在52份样本（73.2%）中得到了相同的结果（35份阳性和17份阴性）。对结果不一致的样本，根据多数标准、和/或其他实验室结果（血清学）、和/或流行病学调查结果进行分类。在此基础上，最终将51份样本分类为阳性，20份为阴性。ELISA-Binax、ELISA-Bartels、IC-Binax、IC-SAS和IC-Uni-Gold的灵敏度值分别为80.4%、100%、82.4%、86.3%和70.6%。相应的特异性值分别为90%、95%、100%、95%和100%。
结果表明，尽管某些方法在灵敏度方面存在一定局限性，但所比较的这些方法均适用于诊断军团菌感染。
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