Pôle de Biologie-Pathologie, Parasitology and Mycology Laboratory, University Hospital of Saint Etienne, Saint Etienne, France
Pôle de Biologie-Pathologie, Parasitology and Mycology Laboratory, University Hospital of Saint Etienne, Saint Etienne, France.
J Clin Microbiol. 2017 Dec;55(12):3395-3404. doi: 10.1128/JCM.01106-17. Epub 2017 Sep 27.
A study comparing the ICT (immunochromatography technology) IgG and IgM rapid diagnostic test (LDBio Diagnostics, France) with a fully automated system, Architect, was performed on samples from university hospitals of Marseille and Saint-Etienne. A total of 767 prospective sera and 235 selected sera were collected. The panels were selected to test various IgG and IgM parameters. The reference technique, IgGII Western blot analysis (LDBio Diagnostics), was used to confirm the IgG results, and commercial kits Platelia Toxo IgM (Bio-Rad) and Toxo-ISAgA (bioMérieux) were used in Saint-Etienne and Marseille, respectively, as the IgM reference techniques. Sensitivity and specificity of the ICT and the Architect IgG assays were compared using a prospective panel. Sensitivity was 100% for the ICT test and 92.1% for Architect (cutoff at 1.6 IU/ml). The low-IgG-titer serum results confirmed that ICT sensitivity was superior to that of Architect. Specificity was 98.7% (ICT) and 99.8% (Architect IgG). The ICT test is also useful for detecting IgM without IgG and is both sensitive (100%) and specific (100%), as it can distinguish nonspecific IgM from specific IgM. In comparison, IgM sensitivity and specificity on Architect are 96.1% and 99.6%, respectively (cutoff at 0.5 arbitrary units [AU]/ml). To conclude, this new test overcomes the limitations of automated screening techniques, which are not sensitive enough for IgG and lack specificity for IgM (rare IgM false-positive cases).
一项比较 ICT(免疫层析技术)IgG 和 IgM 快速诊断检测(法国 LDBio Diagnostics)与全自动系统 Architect 的研究在马赛和圣艾蒂安的大学医院的样本上进行。共收集了 767 份前瞻性血清和 235 份选定的血清。这些检测板被选中以测试各种 IgG 和 IgM 参数。参考技术, IgGII Western blot 分析(LDBio Diagnostics)用于确认 IgG 结果,而 Platelia Toxo IgM(Bio-Rad)和 Toxo-ISAgA(bioMérieux)商业试剂盒分别在圣艾蒂安和马赛被用作 IgM 参考技术。使用前瞻性检测板比较了 ICT 和 Architect IgG 检测的敏感性和特异性。ICT 检测的敏感性为 100%,Architect 为 92.1%(cutoff 为 1.6 IU/ml)。低 IgG 滴度血清结果证实 ICT 敏感性优于 Architect。特异性为 98.7%(ICT)和 99.8%(Architect IgG)。ICT 检测还可用于检测无 IgG 的 IgM,其敏感性(100%)和特异性(100%)均较高,因为它可以区分非特异性 IgM 和特异性 IgM。相比之下,Architect 上的 IgM 敏感性和特异性分别为 96.1%和 99.6%(cutoff 为 0.5 个任意单位 [AU]/ml)。总之,这项新的检测克服了自动化筛选技术的局限性,这些技术对 IgG 不够敏感,并且对 IgM 缺乏特异性(罕见的 IgM 假阳性病例)。