Laboratorio Regional de Salud Pública de la Comunidad de Madrid, Madrid, Spain.
APMIS. 2010 Mar;118(3):203-9. doi: 10.1111/j.1600-0463.2009.02581.x.
The aim of the study was to compare RNA amplification using multiplex RT-PCR and IgM detection by means of indirect and capture ELISAs for the diagnosis of measles and rubella. A total of 229 cases of maculopapular rash with serum and throat swab samples were included. Specific serological IgM to measles and rubella was determined by Enzygnost (Siemens) and Platelia (Bio-Rad). Both viruses were researched using multiplex RT-PCR performed on throat samples. Criteria for inclusion of measles or rubella cases were a positive RT-PCR result for one virus and negative for the other; and/or a positive IgM result for one virus by both ELISAs and negative RT-PCR for the other virus. A total of 74 cases were classified as measles and 54 as rubella. In measles, sensitivity and specificity were 93.2% and 100% for RT-PCR, 97.3% and 98.1% for Enzygnost, and 90.5% and 95.5% for Platelia. For rubella, these values were 42.6% and 100% for RT-PCR, 100% and 97.1% for Enzygnost, and 94.4% and 98.3% for Platelia. Enzygnost and Platelia are useful techniques for detecting IgM against measles and rubella. RNA amplification by RT-PCR was both sensitive and specific for the diagnosis of measles; however, for rubella, the sensitivity of this technique must be improved.
本研究旨在比较多重 RT-PCR 进行 RNA 扩增与间接和捕获 ELISA 检测 IgM 对麻疹和风疹的诊断价值。共纳入 229 例有斑丘疹的病例,采集血清和咽拭子样本。麻疹和风疹特异性 IgM 采用 Enzygnost(西门子)和 Platelia(伯乐)酶联免疫吸附试验法检测。使用多重 RT-PCR 检测咽拭子样本中的两种病毒。麻疹或风疹病例纳入标准为一种病毒的 RT-PCR 结果阳性而另一种病毒阴性;和/或两种 ELISA 检测到一种病毒的 IgM 阳性而另一种病毒 RT-PCR 阴性。共确诊 74 例麻疹和 54 例风疹。在麻疹中,RT-PCR 的灵敏度和特异性分别为 93.2%和 100%,Enzygnost 分别为 97.3%和 98.1%,Platelia 分别为 90.5%和 95.5%。对于风疹,RT-PCR 的灵敏度和特异性分别为 42.6%和 100%,Enzygnost 分别为 100%和 97.1%,Platelia 分别为 94.4%和 98.3%。Enzygnost 和 Platelia 是检测麻疹和风疹 IgM 的有用技术。RT-PCR 进行 RNA 扩增对麻疹的诊断既敏感又特异;然而,对于风疹,必须提高该技术的灵敏度。