临床特征及快速血清学检测的作用：Typhifast IgM和Enterocheck WB在伤寒热诊断中的应用
Clinical Profile and the Role of Rapid Serological Tests: Typhifast IgM and Enterocheck WB in the Diagnosis of Typhoid Fever.
作者信息
Bhume Rahul J, Babaliche Prakash
机构信息
Department of Medicine, Jawaharlal Nehru Medical College, Belagavi, Karnataka, India.
出版信息
Indian J Crit Care Med. 2020 May;24(5):307-312. doi: 10.5005/jp-journals-10071-23417.
INTRODUCTION
During identification and diagnosis, typhoid fever (TF) causes various issues such as nonspecific symptoms and nontyphoidal associated febrile diseases. Accurate identification and diagnosis are still a substantial concern. The current study was undertaken to study the clinical profile of TF and the role of Typhifast IgM and Enterocheck WB in early diagnosis.
MATERIALS AND METHODS
Clinically suspected TF patients (121) were included in the study. Patients with antibiotic history during the period of febrile illness were excluded. The diagnosis was confirmed with blood culture test. Widal test and two new rapid serological tests: Typhifast IgM and Enterocheck WB were performed. The outcomes were compared with blood culture-confirmed cases to derive the sensitivity and specificity of the diagnostic tests. The clinical characteristics were compared with diagnostic tests using Chi-square test.
RESULTS
The most common presentations of TF were fever, chills, vomiting, abdominal pain, anorexia, constipation, and diarrhea. Among the 121 clinically suspected TF patients, 67 had positive blood culture tests for . The Typhifast IgM and Enterocheck WB showed sensitivity of 97.01% and 68.52%, respectively. Specificity was also more with Typhifast IgM (85.07%) than with Enterocheck WB (62.96%). When tests were used in parallel combination, 97.01% sensitivity was attained, while the specificity dropped to 46.30%. When used in serial combination, sensitivity of 85.07% and specificity of 85.19% were observed.
CONCLUSION
Stepladder fever, abnormal serum glutamic oxaloacetic transaminase (SGOT), and abnormal albumin are associated with blood culture, Typhifast IgM, and Enterocheck WB tests. Rapid serological tests might assist in accurate and early identification of TF.
HOW TO CITE THIS ARTICLE
Bhume RJ, Babaliche P. Clinical Profile and the Role of Rapid Serological Tests: Typhifast IgM and Enterocheck WB in the Diagnosis of Typhoid Fever. Indian J Crit Care Med 2020;24(5):307-312.
引言
在伤寒热（TF）的识别与诊断过程中，会引发各种问题，如非特异性症状以及非伤寒相关的发热性疾病。准确的识别和诊断仍是一个重大问题。本研究旨在探讨伤寒热的临床特征以及Typhifast IgM和Enterocheck WB在早期诊断中的作用。
材料与方法
本研究纳入了121例临床疑似伤寒热患者。排除发热期有抗生素使用史的患者。通过血培养试验确诊。进行了肥达试验以及两种新的快速血清学检测：Typhifast IgM和Enterocheck WB。将结果与血培养确诊病例进行比较，以得出诊断检测的敏感性和特异性。使用卡方检验将临床特征与诊断检测进行比较。
结果
伤寒热最常见的表现为发热、寒战、呕吐、腹痛、厌食、便秘和腹泻。在121例临床疑似伤寒热患者中，67例血培养检测呈阳性。Typhifast IgM和Enterocheck WB的敏感性分别为97.01%和68.52%。Typhifast IgM的特异性（85.07%）也高于Enterocheck WB（62.96%）。当两种检测并行联合使用时，敏感性达到97.01%，而特异性降至46.30%。当串行联合使用时，观察到敏感性为85.07%，特异性为85.19%。
结论
阶梯热、血清谷草转氨酶（SGOT）异常和白蛋白异常与血培养、Typhifast IgM和Enterocheck WB检测相关。快速血清学检测可能有助于准确、早期识别伤寒热。
如何引用本文
Bhume RJ, Babaliche P. 临床特征及快速血清学检测：Typhifast IgM和Enterocheck WB在伤寒热诊断中的作用。《印度危重症医学杂志》2020；24(5):307 - 312。
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