Qvist Tavs, Pressler Tacjana, Katzenstein Terese L, Høiby Niels, Collins Michael T
Department of Infectious Diseases, CF Center Copenhagen, University Hospital Rigshospitalet, Copenhagen, Denmark.
Department of Clinical Microbiology, CF Center Copenhagen, University Hospital Rigshospitalet, Copenhagen, Denmark.
Pediatr Pulmonol. 2017 Jan;52(1):34-40. doi: 10.1002/ppul.23608. Epub 2016 Sep 20.
The aim of this study was to test a commercial bovine enzyme-linked immunosorbent assay for investigating antibody activity against Mycobacterium avium complex.
All patients at the Copenhagen Cystic Fibrosis (CF) Center who had culture for nontuberculous mycobacteria performed were included. A commercially available antibody test used in veterinary medicine, was adjusted for human use, and applied to patient sera in a cross sectional test. The test positivity threshold was determined using a receiver operating curve (ROC). A longitudinal analysis of antibody kinetics before and after culture conversion was performed in case patients.
Out of 286 included subjects, six had clinical M. avium complex pulmonary disease at the time of sera sampling. These patients presented with higher antibody test values (P-value <0.01). A test cut point of 0.78 was chosen, corresponding to a sensitivity of 100% (54-100), specificity of 66% (60-72), a positive predictive value of 6% (2-13), and negative predictive value of 100% (98-100).
While not suited for direct diagnosis of M. avium complex due to a high number of false positive subjects, the assay proved useful at ruling out pulmonary disease. Screening sera from patients with CF could guide clinicians to focus attention on patients at higher risk of M. avium complex pulmonary disease. Pediatr Pulmonol. 2017;52:34-40. © 2016 Wiley Periodicals, Inc.
本研究的目的是测试一种用于检测抗鸟分枝杆菌复合群抗体活性的商用牛酶联免疫吸附测定法。
纳入哥本哈根囊性纤维化（CF）中心所有进行过非结核分枝杆菌培养的患者。一种用于兽医学的商用抗体检测方法经调整后用于人体，并在横断面检测中应用于患者血清。使用受试者工作特征曲线（ROC）确定检测阳性阈值。对病例患者培养转化前后的抗体动力学进行纵向分析。
在纳入的286名受试者中，有6名在血清采样时患有临床鸟分枝杆菌复合群肺部疾病。这些患者的抗体检测值更高（P值<0.01）。选择的检测切点为0.78，对应灵敏度为100%（54 - 100），特异性为66%（60 - 72），阳性预测值为6%（2 - 13），阴性预测值为100%（98 - 100）。
虽然由于假阳性受试者数量较多，该检测方法不适合直接诊断鸟分枝杆菌复合群，但在排除肺部疾病方面被证明是有用的。筛查CF患者的血清可以指导临床医生将注意力集中在患鸟分枝杆菌复合群肺部疾病风险较高的患者身上。《儿科肺科杂志》。2017年；52:34 - 40。©2016威利期刊公司。
