Copenhagen Cystic Fibrosis Centre, Dept of Infectious Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
Copenhagen Cystic Fibrosis Centre, Dept of Infectious Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Eur Respir J. 2015 Sep;46(3):707-16. doi: 10.1183/09031936.00011815. Epub 2015 Apr 30.
Early signs of pulmonary disease with Mycobacterium abscessus complex (MABSC) can be missed in patients with cystic fibrosis (CF). A serological method could help stratify patients according to risk. The objective of this study was to test the diagnostic accuracy of a novel method for investigating IgG activity against MABSC.A prospective study of all patients attending the Copenhagen CF Centre was conducted by culturing for MABSC during a 22-month period and then screening patients with an anti-MABSC IgG ELISA. Culture-positive patients had stored serum examined for antibody kinetics before and after culture conversion.307 patients had 3480 respiratory samples cultured and were then tested with the anti-MABSC IgG ELISA. Patients with MABSC pulmonary disease had median anti-MABSC IgG levels six-fold higher than patients with no history of infection (434 versus 64 ELISA units; p<0.001). The test sensitivity was 95% (95% CI 74-99%) and the specificity was 73% (95% CI 67-78%). A diagnostic algorithm was constructed to stratify patients according to risk.The test accurately identified patients with pulmonary disease caused by MABSC and was suited to be used as a complement to mycobacterial culture.
肺疾病的早期迹象与脓肿分枝杆菌复合群（MABSC）在囊性纤维化（CF）患者中可能被忽视。血清学方法可以根据风险对患者进行分层。本研究的目的是测试一种新型方法调查针对 MABSC 的 IgG 活性的诊断准确性。通过在 22 个月的时间内培养 MABSC 对所有在哥本哈根 CF 中心就诊的患者进行了一项前瞻性研究，然后用抗 MABSC IgG ELISA 对患者进行筛查。对培养阳性的患者在培养转换前后检查了抗体动力学的储存血清。307 名患者进行了 3480 次呼吸道样本培养，然后用抗 MABSC IgG ELISA 进行了检测。患有 MABSC 肺部疾病的患者的抗 MABSC IgG 水平中位数比没有感染史的患者高六倍（434 与 64 ELISA 单位；p<0.001）。该检测的敏感性为 95%（95%CI 74-99%），特异性为 73%（95%CI 67-78%）。构建了一个诊断算法，根据风险对患者进行分层。该检测准确地识别了由 MABSC 引起的肺部疾病患者，适合作为分枝杆菌培养的补充。
