Haddar C, Begaud E, Maslin J, Germani Y
BioSpeedia, Institut Pasteur, 25 rue du Docteur-Roux, 75724, Paris cedex 15, France.
Centre de ressources biologiques, Institut Pasteur, 25-28 rue du Docteur-Roux, 75724, Paris cedex 15, France.
Bull Soc Pathol Exot. 2017 Feb;110(1):1-8. doi: 10.1007/s13149-016-0538-6. Epub 2017 Jan 23.
Worldwide, it is estimated that 140 million people suffer from shigellosis annually. The traditional identification of Shigella spp. by culture lacks sensitivity. Rapid diagnosis of shigellosis is important because it allows to engage appropriate antimicrobial treatment that shortens the duration and severity of the illness and reduces microbial carriage, thus the spread of infection in the community. Onestep immunochromatographic dipstick tests have been successfully developed at Institut Pasteur for Shigella spp., Shigella flexneri 2a, Shigella sonnei, and Shigella dysenteriae 1. The present work describes the evaluation of these four rapid diagnostic tests (RDT) that addressed the issue of rapid diagnosis of Shigella diarrhea and dysentery testing from bacterial cultures, stools, and rectal swabs which is usually how the specimen is often collected or received from the field or from remote settings. The evaluations have been performed in Chile, Democratic Republic of Congo, Senegal, Djibouti, Vietnam, India, and France, in dispensaries, in emergency room, on the field, in public health laboratories, and by the French Army. The dipstick method used requires minimal technical skill, and the test can be read between 5 and 15 minutes. Stool cultures and the immunochromatographic test showed concordant results in the comparative studies when RDT for S. sonnei was tested in Chile, Vietnam, India, and France; specificity (Sp) was 96% and sensitivity (Se) was 100%. When RDT for S. flexneri 2a was tested in Vietnam, Se was 91.5% and Sp was 99.2%. In Chile, Se was 83.3% and Sp was 100%. When RDT for S. dysenteriae 1 was tested in India, Vietnam, Senegal, and France by laboratory technicians and in Democratic Republic of Congo by a field technician, the Sp was 98.7% and the Se was 91.7%. In Chile, the initial finding for a simple RDT to diagnose Shigella spp. demonstrates its promising potential to become a powerful tool for case management and epidemiological surveys. Additionally, the dipsticks can be stored at room temperature in a humidity-proof plastic bag, making them easily transportable. Considering the potential impact these RDT have for the clinical management of the disease and for epidemiological studies, industrialization of these tests is in progress.
据估计，全球每年有1.4亿人感染志贺氏菌病。传统的通过培养来鉴定志贺氏菌属的方法缺乏敏感性。志贺氏菌病的快速诊断很重要，因为它能使患者接受适当的抗菌治疗，从而缩短病程、减轻病情严重程度并减少微生物携带，进而减少社区内感染的传播。巴斯德研究所已成功开发出用于检测志贺氏菌属、福氏志贺氏菌2a、宋内志贺氏菌和痢疾志贺氏菌1型的一步免疫层析试纸条检测法。本研究描述了对这四种快速诊断检测方法（RDT）的评估，这些评估解决了从细菌培养物、粪便和直肠拭子中快速诊断志贺氏菌腹泻和痢疾的问题，而这些样本通常是从现场或偏远地区采集或接收的。评估在智利、刚果民主共和国、塞内加尔、吉布提、越南、印度和法国的诊所、急诊室、现场、公共卫生实验室以及法国军队中进行。所使用的试纸条方法所需技术技能极少，检测结果可在5至15分钟内读取。在智利、越南、印度和法国对宋内志贺氏菌的RDT进行比较研究时，粪便培养和免疫层析检测结果一致；特异性（Sp）为96%，敏感性（Se）为100%。在越南对福氏志贺氏菌2a的RDT进行检测时，敏感性为91.5%，特异性为99.2%。在智利，敏感性为83.3%，特异性为100%。在印度、越南、塞内加尔和法国由实验室技术人员对痢疾志贺氏菌1型的RDT进行检测，在刚果民主共和国由现场技术人员进行检测时，特异性为98.7%，敏感性为91.7%。在智利，用于诊断志贺氏菌属的一种简单RDT的初步研究结果表明，它有潜力成为病例管理和流行病学调查的有力工具。此外，试纸条可室温保存在防潮塑料袋中，便于运输。考虑到这些RDT对该疾病临床管理和流行病学研究的潜在影响，这些检测方法的产业化正在进行中。
