Basu Shaoli, Shetty Anjali
Department of Microbiology, PD Hinduja Hospital, Mumbai, Maharashtra, India.
Indian J Crit Care Med. 2021 May;25(Suppl 2):S122-S126. doi: 10.5005/jp-journals-10071-23813.
(1) Blood culture is the gold standard for the diagnosis of bacterial infections. (2) Bone marrow culture is more sensitive than blood culture even in patients with enteric fever receiving antibiotics. (3) Microscopic agglutination test is considered the gold standard for diagnosing leptospirosis; however, now IgM ELISA and polymerase chain reaction (PCR) are more frequently used for diagnosis. (4) Tuberculosis is diagnosed with the help of nucleic acid amplification tests like Xpert MTB/RIF Ultra which also detects rifampicin resistance. Other tests include microscopy, Lowenstein-Jensen and mycobacteria growth indicator tube culture, line probe assay. (5) Tropical rickettsial infections are diagnosed by serological reactions (Weil-Felix, ELISA for antibodies) and PCR. (6) For Brucellosis culture from blood, bone marrow or tissue specimens remain the mainstay in diagnosis. (7) Dengue, Zika, Crimean-Congo hemorrhagic fever, Ebola, hantavirus, rabies are diagnosed with reverse transcriptase-polymerase chain reaction. Serological tests like IgM ELISA or paired sera samples for IgG are also used for diagnosis.
Basu S, Shetty A. Laboratory Diagnosis of Tropical Infections. Indian J Crit Care Med 2021;25(Suppl 2):S122-S126.
(1)血培养是诊断细菌感染的金标准。(2)即使是接受抗生素治疗的伤寒患者,骨髓培养也比血培养更敏感。(3)显微镜凝集试验被认为是诊断钩端螺旋体病的金标准;然而,现在IgM酶联免疫吸附测定(ELISA)和聚合酶链反应(PCR)更常用于诊断。(4)结核病借助核酸扩增试验如Xpert MTB/RIF Ultra进行诊断,该试验还可检测利福平耐药性。其他检测包括显微镜检查、罗氏培养基培养和分枝杆菌生长指示管培养、线性探针分析。(5)热带立克次体感染通过血清学反应(外斐反应、抗体ELISA)和PCR进行诊断。(6)对于布鲁氏菌病,血液、骨髓或组织标本的培养仍然是诊断的主要方法。(7)登革热、寨卡病毒病、克里米亚-刚果出血热、埃博拉病毒病、汉坦病毒病、狂犬病通过逆转录聚合酶链反应进行诊断。血清学检测如IgM ELISA或用于IgG的双份血清样本也用于诊断。
Basu S, Shetty A. 热带感染的实验室诊断。《印度重症医学杂志》2021;25(增刊2):S122 - S126。