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评估对莱姆病和有蜱叮咬史的发热患者的常规临床实验室样本进行多重和多功能蜱传疾病检测的必要性。

Assessing the Need for Multiplex and Multifunctional Tick-Borne Disease Test in Routine Clinical Laboratory Samples from Lyme Disease and Febrile Patients with a History of a Tick Bite.

作者信息

Garg Kunal, Jokiranta T Sakari, Filén Sanna, Gilbert Leona

机构信息

Tezted Ltd., Mattilaniemi 6-8, 40100 Jyväskylä, Finland.

United Medix Laboratories, Kivihaantie 7, 00310 Helsinki, Finland.

出版信息

Trop Med Infect Dis. 2021 Mar 17;6(1):38. doi: 10.3390/tropicalmed6010038.

Abstract

Human polymicrobial infections in tick-borne disease (TBD) patients is an emerging public health theme. However, the requirement for holistic TBD tests in routine clinical laboratories is ambiguous. TICKPLEX PLUS is a holistic TBD test utilized herein to assess the need for multiplex and multifunctional diagnostic tools in a routine clinical laboratory. The study involved 150 specimens categorized into Lyme disease (LD)-positive ( = 48), LD-negative ( = 30), and febrile patients from whom borrelia serology was requested ( = 72, later "febrile patients") based on reference test results from United Medix, Finland. Reference tests from DiaSorin, Immunetics, and Mikrogen Diagnostik followed the two-tier LD testing system. A comparison between the reference tests and TICKPLEX PLUS produced 86%, 88%, and 87% positive, negative, and overall agreement, respectively. Additionally, up to 15% of LD and 11% of febrile patients responded to TBD related coinfections and opportunistic microbes. The results demonstrated that one (TICKPLEX PLUS) test can aid in a LD diagnosis instead of four tests. Moreover, TBD is not limited to just LD, as the specimens produced immune responses to several TBD microbes. Lastly, the study indicated that the screening of febrile patients for TBDs could be a missed opportunity at reducing unreported patient cases.

摘要

蜱传疾病(TBD)患者的人类多微生物感染是一个新出现的公共卫生问题。然而,常规临床实验室对全面的TBD检测的需求并不明确。TICKPLEX PLUS是一种在此使用的全面TBD检测方法,用于评估常规临床实验室对多重和多功能诊断工具的需求。该研究涉及150份标本,根据芬兰联合医疗公司的参考检测结果,分为莱姆病(LD)阳性(=48)、LD阴性(=30)以及被要求进行疏螺旋体血清学检测的发热患者(=72,以下简称“发热患者”)。来自DiaSorin、Immunetics和Mikrogen Diagnostik的参考检测遵循两层LD检测系统。参考检测与TICKPLEX PLUS之间的比较分别产生了86%、88%和87%的阳性、阴性和总体一致性。此外,高达15%的LD患者和11%的发热患者对TBD相关的合并感染和机会性微生物有反应。结果表明,一项检测(TICKPLEX PLUS)就可以辅助LD诊断,而无需四项检测。此外,TBD不仅限于LD,因为这些标本对几种TBD微生物产生了免疫反应。最后,该研究表明,对发热患者进行TBD筛查可能是减少未报告患者病例的一个错失的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3319/8005980/a69cf2454362/tropicalmed-06-00038-g001.jpg

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