Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal. Manipal Academy of Higher Education, Madhav Nagar, Manipal, Karnataka, India.
Department of Immunohematology and Blood Transfusion, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India.
Transfus Clin Biol. 2022 Aug;29(3):219-223. doi: 10.1016/j.tracli.2022.04.003. Epub 2022 May 24.
Transfusion transmissible syphilis is caused by Treponema pallidum; blood donors are traditionally screened with non-treponemal antibody tests to ensure transfusion safety. Detection of specific antibodies against T. pallidum is employed in reverse algorithm screening. We aim to analyze the utility of the reverse algorithm screening strategy for T. pallidum and to determine the prevalence trends among blood donors in our centre.
The study was conducted in a Transfusion Centre catering to the 2030 bedded Tertiary Care Centre in coastal Karnataka in two timelines from 2012 to 2014, and 2019 to 2020, respectively. A fully automated Enzyme-Linked Immunosorbent Assay and Enhanced Chemiluminescence Immunoassay, which detect both IgM and IgG antibodies against T.pallidum were used in the study. Blood donor data from 2008 to 2020 were also analyzed to observe the trend in prevalence rate of syphilis among blood donors.
Among 26329 and 388 blood donors screened with ELISA and ECI, 134 (0.51%) and 9 (2.3%) were reactive to T. pallidum antibodies respectively. TPHA confirmed that 104 and 9 donors were reactive from each of the ELISA and ECI reactive donor groups. The increase in the prevalence of syphilis was observed with the use of reverse algorithm compared to the traditional strategy. The prevalence of syphilis in the present study ranged from 0.02 to 0.28%.
The reverse algorithm screening can give a better result with a positive predictive value of 77.61% and 88.9% for ELISA and ECI. respectively Our study found that the use of reverse algorithm might increase the blood discard rate slightly but adds on to safety of blood components.
输血传播性梅毒是由梅毒螺旋体引起的；传统上，献血者通过非梅毒螺旋体抗体检测来确保输血安全。检测针对梅毒螺旋体的特异性抗体用于反向算法筛查。我们旨在分析反向算法筛查策略对梅毒螺旋体的有效性，并确定我们中心献血者中的流行趋势。
该研究在 2012 年至 2014 年和 2019 年至 2020 年期间，在沿海卡纳塔克邦的一家为 2030 张病床的三级护理中心提供服务的输血中心进行。研究中使用了全自动酶联免疫吸附试验和增强化学发光免疫分析，可检测针对梅毒螺旋体的 IgM 和 IgG 抗体。还分析了 2008 年至 2020 年的献血者数据，以观察献血者中梅毒患病率的趋势。
在对 26329 名和 388 名献血者进行 ELISA 和 ECI 筛查中，分别有 134 名（0.51%）和 9 名（2.3%）对梅毒螺旋体抗体呈反应性。TPHA 证实，来自 ELISA 和 ECI 反应性供体组的每个组中，有 104 名和 9 名供体呈反应性。与传统策略相比，使用反向算法观察到梅毒的患病率增加。本研究中梅毒的患病率范围为 0.02%至 0.28%。
反向算法筛查的阳性预测值分别为 77.61%和 88.9%，可以获得更好的结果。我们的研究发现，使用反向算法可能会略微增加血液丢弃率，但会增加血液成分的安全性。
