血清学和分子方法在印度北部一家三级医院诊断钩端螺旋体病的十年研究。
Serological & molecular approaches for diagnosis of leptospirosis in a tertiary care hospital in north India: a 10-year study.
机构信息
Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
出版信息
Indian J Med Res. 2013 Apr;137(4):785-90.
BACKGROUND & OBJECTIVES: Leptospirosis, a spirochetal zoonosis, is underreported from the northern States of India. This study reports results of a 10-year retrospective sero-epidemiological survey of leptospirosis conducted in a tertiary care hospital in New Delhi, India.
METHOD
A total of 1453 patients clinically suspected for leptospirosis were included and investigated initially by IgM ELISA. A proportion of these were subjected to culture, microscopic agglutination test (MAT) and polymerase chain reaction (PCR).
RESULTS
Of the 1453 patients, 391 (26.90%) were positive serologically by IgM ELISA. Seropositive and seronegative patients revealed no significant difference in clinical features and laboratory parameters. Amongst the IgM seropositive cases, culture for leptospires was positive in 5 of 192 (2.6%), MAT in 50 of 138 (36.23%), PCR from blood and urine in 10 of 115 (8.7%) and 10 of 38 (26.31%) cases, respectively. In Leptospira spp. positive patients co-infections with viral hepatitis E, malaria and dengue fever were diagnosed in 27 cases.
INTERPRETATION & CONCLUSIONS: The overall seropositivity for leptospirosis was 26.9 per cent in our study. A decreasing trend in seropositivity was observed in recent years. Co-infections with malaria, dengue, hepatitis A and E were also seen. Since leptospirosis is a treatable disease, correct and rapid diagnosis may help in effective management of patients.
背景与目的
钩端螺旋体病是一种螺旋体动物传染病，在印度北部各州的报告较少。本研究报告了在印度新德里一家三级保健医院进行的为期 10 年的钩端螺旋体病血清流行病学回顾性调查结果。
方法
共纳入 1453 例临床疑似钩端螺旋体病患者，最初采用 IgM ELISA 进行检测。其中一部分患者进行了培养、显微镜凝集试验（MAT）和聚合酶链反应（PCR）。
结果
在 1453 例患者中，391 例（26.90%）通过 IgM ELISA 血清学检测呈阳性。血清阳性和血清阴性患者在临床特征和实验室参数方面无显著差异。在 IgM 血清阳性病例中，5 例（2.6%）从 192 例培养物中分离出钩端螺旋体，50 例（36.23%）从 138 例 MAT 中分离出钩端螺旋体，10 例（8.7%）和 10 例（26.31%）从血液和尿液的 PCR 中分离出钩端螺旋体。在钩端螺旋体阳性患者中，共诊断出 27 例合并戊型肝炎病毒、疟疾和登革热感染。
解释与结论
在我们的研究中，钩端螺旋体病的总体血清阳性率为 26.9%。近年来，血清阳性率呈下降趋势。还发现与疟疾、登革热、甲型和戊型肝炎的合并感染。由于钩端螺旋体病是一种可治疗的疾病，正确和快速的诊断可能有助于有效管理患者。
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