Theel Elitza S, Sorenson Marisa, Rahman Crystal, Granger Dane, Vaughn Andrew, Breeher Laura
Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
J Clin Microbiol. 2020 Mar 25;58(4). doi: 10.1128/JCM.00136-20.
Immunity to measles, mumps, rubella, and varicella-zoster viruses (VZV; MMRV) is a common condition of employment for health care workers (HCWs) to ensure compliance with national standards and state laws. When documentation of complete vaccination or laboratory-confirmed infection is not available, Advisory Committee on Immunization Practices (ACIP) criteria are used to guide vaccination or anti-MMRV IgG testing. We assessed the performance of the BioPlex 2200 MMRV IgG multiplex flow immunoassay (MFI; Bio-Rad Laboratories, Hercules, CA) and matched immunofluorescence assays (IFAs; MBL Bion, Des Plaines, IL) in 220 HCWs categorized by ACIP criteria for presumptive immunity to MMRV. Among HCWs presumptively immune to measles, mumps, rubella, and VZV, the Bio-Rad MFI was positive in 77.3, 85.4, 84.3, and 91.1% of HCWs, respectively. Comparatively, the Bion IFA was positive in 92.9, 91.1, and 93.5% of HCWs presumptively immune to measles, mumps, and VZV (a rubella IFA was unavailable). Among HCWs fully vaccinated against measles, mumps, and VZV, Bio-Rad MFI/Bion IFA positivity rates were 77.4%/93%, 84.8%/90.7%, and 54.5%/90.9%, respectively. The Bio-Rad MFI was positive in 83.7% of HCWs fully vaccinated against rubella. For HCWs whose last vaccination event occurred within 15 years of enrollment, 83.3, 93.3, and 74.2% were positive by the Bio-Rad measles, mumps, and rubella IgG MFIs, respectively. We show significantly decreased Bio-Rad MFI sensitivity for detection of anti-measles and anti-mumps IgG-class antibodies in presumptively immune or fully vaccinated HCWs. Although negative results typically prompt revaccination, failure to recognize presumptive immunity in individuals unable to receive live, attenuated vaccines may have employment implications.
对麻疹、腮腺炎、风疹和水痘带状疱疹病毒（VZV；MMRV）具有免疫力是医护人员（HCWs）的一项常见就业条件，以确保符合国家标准和州法律。当无法提供完整疫苗接种记录或实验室确诊感染的文件时，免疫实践咨询委员会（ACIP）的标准用于指导疫苗接种或抗MMRV IgG检测。我们评估了BioPlex 2200 MMRV IgG多重流式免疫分析（MFI；Bio-Rad Laboratories，Hercules，加利福尼亚州）和匹配的免疫荧光分析（IFAs；MBL Bion，Des Plaines，伊利诺伊州）在220名根据ACIP标准被归类为对MMRV有推定免疫力的医护人员中的性能。在推定对麻疹、腮腺炎、风疹和VZV有免疫力的医护人员中，Bio-Rad MFI在分别77.3%、85.4%、84.3%和91.1%的医护人员中呈阳性。相比之下，Bion IFA在推定对麻疹、腮腺炎和VZV有免疫力的医护人员中分别有92.9%、91.1%和93.5%呈阳性（风疹IFA不可用）。在已完全接种麻疹、腮腺炎和VZV疫苗的医护人员中，Bio-Rad MFI/Bion IFA阳性率分别为77.4%/93%、84.8%/90.7%和54.5%/90.9%。Bio-Rad MFI在已完全接种风疹疫苗的医护人员中有83.7%呈阳性。对于最后一次疫苗接种事件发生在入组后15年内的医护人员，Bio-Rad麻疹、腮腺炎和风疹IgG MFI分别有83.3%、93.3%和74.2%呈阳性。我们发现Bio-Rad MFI在检测推定有免疫力或已完全接种疫苗的医护人员中的抗麻疹和抗腮腺炎IgG类抗体时敏感性显著降低。尽管阴性结果通常会促使再次接种疫苗，但未能识别出无法接种减毒活疫苗的个体的推定免疫力可能会对就业产生影响。
