Kunakorn M, Boonma P, Khupulsup K, Petchclai B
Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Clin Microbiol. 1990 Jun;28(6):1249-53. doi: 10.1128/jcm.28.6.1249-1253.1990.
Indirect hemagglutination (IHA) is commonly used for serodiagnosis of melioidosis. However, in endemic areas, high background titers in normal populations and occasional low titers in patients with septicemic melioidosis prompted a search for a more sensitive and more specific method of serodiagnosis. An indirect fluorescent-antibody test for immunoglobulin M (IgM) specific antibody to Pseudomonas pseudomallei was more sensitive and more specific, but fluorescence microscopes are rarely available in the endemic areas. An enzyme-linked immunosorbent assay (ELISA) for IgM antibody is an attractive alternative. An indirect ELISA for IgM antibody (IgM ELISA) and an IgM antibody capture ELISA for melioidosis were developed. Both tests, together with IHA, were evaluated for 153 serum specimens from blood donors and 16 serum specimens from 16 melioidosis patients. It was found that IHA, the IgM ELISA, and the IgM antibody capture ELISA had sensitivities of 88, 88, and 75%, respectively, with specificities of 97.4, 92.2, and 91.5%, respectively. When IHA was combined with IgM ELISA, a sensitivity of 100% and a specificity of 95.4% were obtained. The IgM ELISA and IHA should be used in combination for serodiagnosis of melioidosis.
间接血凝试验（IHA）常用于类鼻疽的血清学诊断。然而，在流行地区，正常人群的背景滴度较高，而败血症型类鼻疽患者偶尔出现低滴度，这促使人们寻找一种更敏感、更特异的血清学诊断方法。检测针对类鼻疽杆菌的免疫球蛋白M（IgM）特异性抗体的间接荧光抗体试验更敏感、更特异，但荧光显微镜在流行地区很少见。检测IgM抗体的酶联免疫吸附测定（ELISA）是一种有吸引力的替代方法。开发了用于类鼻疽的IgM抗体间接ELISA（IgM ELISA）和IgM抗体捕获ELISA。对153份献血者血清标本和16份类鼻疽患者的16份血清标本进行了IHA、这两种ELISA检测。结果发现，IHA、IgM ELISA和IgM抗体捕获ELISA的敏感性分别为88%、88%和75%，特异性分别为97.4%、92.2%和91.5%。当IHA与IgM ELISA联合使用时，敏感性为100%，特异性为95.4%。IgM ELISA和IHA应联合用于类鼻疽的血清学诊断。
