German National Reference Laboratory for Tularemia, Bundeswehr Institute of Microbiology, Department of Immunology, Neuherbergstrasse 11, 80937 Munich, Germany.
J Clin Microbiol. 2010 May;48(5):1629-34. doi: 10.1128/JCM.01475-09. Epub 2010 Mar 10.
Tularemia is a highly contagious infectious zoonosis caused by the bacterial agent Francisella tularensis. Serology is still considered to be a cornerstone in tularemia diagnosis due to the low sensitivity of bacterial culture and the lack of standardization in PCR methodology for the direct identification of the pathogen. We developed a novel immunochromatographic test (ICT) to efficiently detect F. tularensis-specific antibodies in sera from humans and other mammalian species (nonhuman primate, pig, and rabbit). This new tool requires none or minimal laboratory equipment, and the results are obtained within 15 min. When compared to the method of microagglutination, which was shown to be more specific than the enzyme-linked immunosorbent assay, the ICT had a sensitivity of 98.3% (58 positive sera were tested) and a specificity of 96.5% (58 negative sera were tested) on human sera. On animal sera, the overall sensitivity was 100% (22 positive sera were tested) and specificity was also 100% (70 negative sera were tested). This rapid test preferentially detects IgG antibodies that may occur early in the course of human tularemia, but further evaluation with human sera is important to prove that the ICT can be a valuable field test to support a presumptive diagnosis of tularemia. The ICT can also be a useful tool to monitor successful vaccination with subunit vaccines or live vaccine strains containing lipopolysaccharide (e.g., LVS) and to detect seropositive individuals or animals in outbreak situations or in the context of epidemiologic surveillance programs in areas of endemicity as recently recommended by the World Health Organization.
兔热病是一种由弗朗西斯菌引起的高度传染性人畜共患传染病。由于细菌培养的敏感性低,以及直接鉴定病原体的 PCR 方法缺乏标准化,血清学仍然被认为是兔热病诊断的基石。我们开发了一种新的免疫层析检测(ICT)方法,用于有效检测人类和其他哺乳动物(非人灵长类动物、猪和兔)血清中的 F. tularensis 特异性抗体。这种新工具不需要或仅需要最小的实验室设备,并且可以在 15 分钟内获得结果。与微凝集法相比,后者被证明比酶联免疫吸附测定法更具特异性,ICT 在人类血清中的灵敏度为 98.3%(测试了 58 份阳性血清),特异性为 96.5%(测试了 58 份阴性血清)。在动物血清中,总体灵敏度为 100%(测试了 22 份阳性血清),特异性也为 100%(测试了 70 份阴性血清)。该快速检测方法优先检测 IgG 抗体,这些抗体可能在人类兔热病的早期出现,但需要进一步用人类血清进行评估,以证明 ICT 可以成为支持兔热病疑似诊断的有价值的现场检测方法。ICT 还可以作为监测亚单位疫苗或含有脂多糖(例如 LVS)的活疫苗菌株接种成功的有用工具,并在爆发情况下或在世界卫生组织最近建议的流行地区的流行病学监测计划中,检测血清阳性个体或动物。