Jager Mischa M, Weers-Pothoff Gezina, Hermans Mirjam H A, Meekelenkamp Jamie C E, Schellekens Jeroen J A, Renders Nicole H M, Leenders Alexander C A P, Schneeberger Peter M, Wever Peter C
Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 5200 ME 's-Hertogenbosch, Netherlands.
Clin Vaccine Immunol. 2011 Jun;18(6):963-8. doi: 10.1128/CVI.00009-11. Epub 2011 Apr 20.
In the peak of the 2009 Q fever outbreak in the Netherlands, we introduced a diagnostic algorithm for acute Q fever with an enzyme-linked immunosorbent assay for immunoglobulin M antibodies to Coxiella burnetii phase II antigens (MII screen) as an initial step. Subsequently, an immunofluorescence assay or PCR was performed depending on the MII screen outcome, date of onset of disease, and inpatient or outpatient setting. The impact of MII screen on the number of immunofluorescence assays performed and the contribution of PCR to diagnosis were retrospectively evaluated in 825 patients referred in a 17-day period. Acute Q fever was diagnosed in 256 patients. The introduction of MII screen reduced the number of immunofluorescence assays performed by more than 80%. In 103 patients, PCR analysis contributed to the diagnosis of acute Q fever. Q fever diagnostics were hampered by the fact that for a high number of patients the date of onset of disease was not provided and the requested follow-up serum samples were not received.
在荷兰2009年Q热疫情高峰期，我们引入了一种急性Q热诊断算法，第一步是采用酶联免疫吸附试验检测抗伯纳特柯克斯体II期抗原的免疫球蛋白M抗体（MII筛查）。随后，根据MII筛查结果、疾病发病日期以及住院或门诊情况，进行免疫荧光试验或聚合酶链反应。我们回顾性评估了在17天内转诊的825例患者中，MII筛查对所进行免疫荧光试验数量的影响以及聚合酶链反应对诊断的贡献。256例患者被诊断为急性Q热。MII筛查的引入使所进行的免疫荧光试验数量减少了80%以上。在103例患者中，聚合酶链反应分析有助于急性Q热的诊断。由于大量患者未提供疾病发病日期且未收到要求的后续血清样本，Q热诊断受到了阻碍。
