Mathur Meenakshi, De Anuradha, Turbadkar Dilip
Department of Microbiology, LTM Medical College and General Hospital, Sion, Mumbai, India.
Indian J Med Microbiol. 2009 Apr-Jun;27(2):153-5. doi: 10.4103/0255-0857.49431.
Nine hundred and forty two serum samples from clinically suspected cases of leptospirosis admitted in Lokmanya Tilak Municipal General Hospital, Mumbai during July-September 2005 were tested by LeptoTek Dri-dot/Leptocheck. One hundred and sixty five positive sera by these tests were sent to I.R.R., Mumbai, for detection of leptospira IgM antibodies by ELISA (PanBio). Eighty seven positive sera were also sent to B.J. Medical College, Pune, for microscopic agglutination test (MAT) for serovar identification. Seropositivity with LeptoTek Dri-dot/Leptocheck was 34.3%. Adults and males predominated. All patients were febrile. The commonest presentation in adults was jaundice (81.4%), followed by oliguria (37.6%). In children, myalgia was commonest (75.6%), followed by conjunctival suffusion (54.7%). IgM ELISA positivity was 69.1% and MAT positivity was 29.9%. Commonest serovar detected in this geographical area was Leptospira icterohaemorrhagiae (42.9%), followed by L. bataviae, L. tarassovi, and L. pomona . Considering at least two of the above three serological tests positive, 127 cases could be diagnosed and only 89.8% of them could be diagnosed by ELISA and rapid test. Therefore, along with rapid serological tests, IgM ELISA should be routinely done for laboratory diagnosis of leptospirosis.
2005年7月至9月期间，在孟买的洛卡曼亚·蒂拉克市立综合医院收治的942份临床疑似钩端螺旋体病病例的血清样本，采用LeptoTek Dri-dot/Leptocheck进行检测。这些检测呈阳性的165份血清样本被送往孟买的I.R.R.，采用酶联免疫吸附测定法（PanBio）检测钩端螺旋体IgM抗体。87份阳性血清样本还被送往浦那的B.J.医学院，进行显微镜凝集试验（MAT）以鉴定血清型。LeptoTek Dri-dot/Leptocheck的血清阳性率为34.3%。成年人和男性占多数。所有患者均发热。成年人中最常见的表现是黄疸（81.4%），其次是少尿（37.6%）。儿童中最常见的是肌痛（75.6%），其次是结膜充血（54.7%）。IgM酶联免疫吸附测定法阳性率为69.1%，显微镜凝集试验阳性率为29.9%。该地理区域检测到的最常见血清型是出血性黄疸钩端螺旋体（42.9%），其次是巴达维亚钩端螺旋体、塔拉索夫钩端螺旋体和波摩那钩端螺旋体。考虑到上述三种血清学检测中至少两种呈阳性，可诊断出127例病例，其中仅89.8%可通过酶联免疫吸附测定法和快速检测诊断。因此，除快速血清学检测外，应常规进行IgM酶联免疫吸附测定法用于钩端螺旋体病的实验室诊断。
