用于诊断北印度温带地区常见立克次体病的血清学检测方法的比较评估。

Comparative evaluation of serological tests used for the diagnosis of rickettsial diseases prevalent in the temperate region of North India.

机构信息

Department of Microbiology, Sher- I- Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu and Kashmir, India.

出版信息

Indian J Med Microbiol. 2022 Apr-Jun;40(2):294-298. doi: 10.1016/j.ijmmb.2021.12.004. Epub 2021 Dec 31.

DOI:10.1016/j.ijmmb.2021.12.004

PMID:34980488

Abstract

PURPOSE

The clinical manifestations of rickettsial diseases mimic other endemic infections with similar presentations thus posing a serious challenge to clinicians for their diagnosis. For the diagnosis of rickettsial disease serological tests like Weil Felix, ELISA and IFA are used. There are limited studies that have evaluated different serological tests for the diagnosis of rickettsial diseases. Therefore, the present study was undertaken to evaluate the ELISA and Weil Felix test for the diagnosis of rickettsial diseases prevalent in this region.

METHODS

Samples from 281 patients clinically suspected of rickettsial diseases were tested for spotted fever group (SFG), typhus group (TG) and scrub typhus group (STG) by Weil Felix, ELISA and IFA was taken as the gold standard. Baseline titers and cut-off ODs were calculated by taking samples from healthy blood donors.

RESULTS

The sensitivity, specificity, positive and negative predictive value of Weil Felix test ranged from 30% to 44%, 83.46%-97.86%, 9%-77%, 92-96% respectively. The sensitivity and specificity, positive and negative predictive value of ELISA ranged from 80.77% to 96.15%, 96.33%-98.43%, 70.21%-88.64%, 92.89%-99.60% respectively. Maximum cross-reactions were observed between SFG and STG by the Weil Felix test and between STG and TG by ELISA.

CONCLUSIONS

ELISA was found to be sensitive and specific for the diagnosis of rickettsial diseases. It is easy to perform, does not require a technical expert for result interpretation and a large number of samples can be processed at a time.

摘要

目的

立克次体病的临床表现类似于其他具有相似表现的地方性感染，这给临床医生的诊断带来了严重挑战。为了诊断立克次体病，通常使用血清学检测方法，如 Weil-Felix、ELISA 和 IFA。目前，仅有少数研究评估了不同的血清学检测方法对立克次体病的诊断价值。因此，本研究旨在评估 ELISA 和 Weil-Felix 检测方法对立克次体病的诊断价值。

方法

采用 Weil-Felix、ELISA 和 IFA 检测 281 例临床疑似立克次体病患者的斑点热群（SFG）、斑疹伤寒群（TG）和恙虫病群（STG）。以健康献血者的样本作为金标准，计算基线滴度和截断 OD 值。

结果

Weil-Felix 检测的敏感性、特异性、阳性预测值和阴性预测值分别为 30%-44%、83.46%-97.86%、9%-77%和 92%-96%。ELISA 的敏感性、特异性、阳性预测值和阴性预测值分别为 80.77%-96.15%、96.33%-98.43%、70.21%-88.64%和 92.89%-99.60%。Weil-Felix 检测显示 SFG 和 STG 之间存在最大交叉反应，ELISA 检测显示 STG 和 TG 之间存在最大交叉反应。