Jaiswal Virendra, Ghoshal Ujjala, Baijal Sanjay S, Mittal Balraj, Dhole Tapan N, Ghoshal Uday C
Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India.
BMC Res Notes. 2012 Aug 7;5:416. doi: 10.1186/1756-0500-5-416.
Diagnosis of amoebic liver abscess (ALA) in patients on anti-amoebic drugs is difficult. There is scanty data on this issue using Entamoeba histolytica (E. histolytica) lectin antigen and polymerase chain reaction (PCR). We studied utility of lectin antigen, PCR, and IgG antibody in diagnosis of liver abscess in patients on anti-amoebic treatment. Liver aspirate of 200 patients, of which 170 had anti-amoebic drug prior to drainage, was tested for E. histolytica lectin antigen by (ELISA), PCR, bacterial culture, and serum IgG antibody by (ELISA). Classification of abscesses was based on result of anti-amoebic IgG antibody and bacterial culture, E. histolytica PCR and bacterial culture, and E. histolytica lectin antigen and bacterial culture.
Using anti-amoebic IgG antibody and bacterial culture, 136/200 (68.0%) were classified as ALA, 12/200 (6.0%) as pyogenic liver abscess (PLA), 29/200 (14.5%) as mixed infection, and 23/200 (11.5%) remained unclassified. Using amoebic PCR and bacterial culture 151/200 (75.5%) were classified as ALA, 25/200 (12.5%) as PLA, 16/200 (8.0%) as mixed infection, and 8/200 (4.0%) remained unclassified. With E. histolytica lectin antigen and bacterial culture, 22/200 (11.0%) patients were classified as ALA, 39/200 (19.5%) as PLA, 2/200 (1.0%) as mixed infection, and 137/200 (68.5%) remained unclassified.
E. histolytica lectin antigen was not suitable for classification of ALA patients who had prior anti-amoebic treatment. However, PCR may be used as alternative test to anti-amoebic antibody in diagnosis of ALA.
对于正在接受抗阿米巴药物治疗的患者，诊断阿米巴肝脓肿（ALA）存在困难。关于使用溶组织内阿米巴（E. histolytica）凝集素抗原和聚合酶链反应（PCR）诊断该疾病的相关数据较少。我们研究了凝集素抗原、PCR和IgG抗体在抗阿米巴治疗患者肝脓肿诊断中的应用。对200例患者的肝穿刺液进行检测，其中170例在引流前接受过抗阿米巴药物治疗，采用酶联免疫吸附测定（ELISA）检测E. histolytica凝集素抗原、PCR、细菌培养，并采用ELISA检测血清IgG抗体。根据抗阿米巴IgG抗体和细菌培养结果、E. histolytica PCR和细菌培养结果以及E. histolytica凝集素抗原和细菌培养结果对脓肿进行分类。
根据抗阿米巴IgG抗体和细菌培养结果，200例患者中136例（68.0%）被分类为ALA，12例（6.0%）为化脓性肝脓肿（PLA），29例（14.5%）为混合感染，23例（11.5%）仍无法分类。根据阿米巴PCR和细菌培养结果，200例患者中151例（75.5%）被分类为ALA，25例（12.5%）为PLA，16例（8.0%）为混合感染，8例（4.0%）仍无法分类。根据E. histolytica凝集素抗原和细菌培养结果，200例患者中22例（11.0%）被分类为ALA，39例（19.5%）为PLA，2例（1.0%）为混合感染，137例（68.5%）仍无法分类。
E. histolytica凝集素抗原不适用于对曾接受抗阿米巴治疗的ALA患者进行分类。然而，在ALA的诊断中，PCR可作为抗阿米巴抗体的替代检测方法。
