全细胞抗原与重组溶血共调节蛋白1酶联免疫吸附试验联合检测在越南类鼻疽诊断中的临床应用：揭示未被诊断的病例
Clinical Utility of Combined Whole-cell Antigen and Recombinant Hemolysis Co-regulated Protein 1-Enzyme-linked Immunosorbent Assays Reveals Underdiagnosed Cases of Melioidosis in Vietnam.
作者信息
Tran Quyen T L, Nguyen Ha V, Pham Huyen T, Mai Tuan V, Nguyen Quyen H M, Le Dzung V, Bui Linh N H, Hoang Lan T H, Hoang Trung Q, Trinh Trung T
机构信息
VNU-Institute of Microbiology and Biotechnology, Vietnam National University, Hanoi, Vietnam.
General Hospital of Ha Tinh Province, Ha Tinh, Vietnam.
出版信息
Am J Trop Med Hyg. 2022 Jul 25;107(3):585-91. doi: 10.4269/ajtmh.21-1143.
Melioidosis is a fatal infectious disease in the tropics and subtropics. Currently, bacterial culture is the gold standard for diagnosis of the disease, but its sensitivity is relatively low. In this study, we evaluated four ELISAs using sera collected from culture-confirmed cases of melioidosis (n = 63), cases with other bacterial infections (n = 62), and healthy donors (n = 60). Antigens used for ELISAs were the whole-cell (WC) antigens and recombinant proteins of hemolysis co-regulated protein 1 (Hcp1), GroEL1, and alkyl hydroperoxide reductase subunit C (AhpC). Using the cutoff values for optical density at 490 nm defined at a specificity of > 95%, the sensitivity of the WC, Hcp1, GroEL1, and AhpC ELISAs was 93.7%, 87.3%, 61.9%, and 57.1%, respectively. The combined WC/Hcp1 ELISA showed the greatest sensitivity and specificity of 98.4% and 95.1%, respectively. Of 511 and 500 sera collected from clinically suspected febrile patients admitted to the General Hospital of Ha Tinh Province and the Hue Central Hospital, respectively, combined WC/Hcp1 ELISAs showed 52 (10.2%) and 41 (8.2%) patients positive for melioidosis, respectively. The assay detected 14 of 14 (100%) and 21 of 23 (91.3%) culture-confirmed cases of melioidosis at Ha Tinh and Hue, respectively. A follow-up study of 38 patients positive for melioidosis by combined WC/Hcp1 ELISAs but negative for Burkholderia pseudomallei by culture method or not assigned to examine for bacterial culture resulted in 2 (5.3%) culture-reconfirmed patients with melioidosis, 9 (23.7%) deaths, 17 (44.7%) unhealthy patients, and 10 (26.3%) healthy persons. Combined WC/Hcp1 ELISA was a reliable serological method to detect underdiagnosed cases of melioidosis. Further investigations are needed to estimate the true sensitivity and specificity of the assay and the true number of cases of melioidosis.
类鼻疽是热带和亚热带地区的一种致命性传染病。目前，细菌培养是该疾病诊断的金标准，但其敏感性相对较低。在本研究中，我们使用从类鼻疽培养确诊病例（n = 63）、其他细菌感染病例（n = 62）和健康供者（n = 60）采集的血清评估了四种酶联免疫吸附测定（ELISA）。用于ELISA的抗原是全细胞（WC）抗原以及溶血共调节蛋白1（Hcp1）、GroEL1和烷基过氧化氢还原酶亚基C（AhpC）的重组蛋白。使用在特异性> 95%时定义的490 nm处光密度的临界值，WC、Hcp1、GroEL1和AhpC ELISA的敏感性分别为93.7%、87.3%、61.9%和57.1%。联合WC/Hcp1 ELISA显示出最高的敏感性和特异性，分别为98.4%和95.1%。分别从平定省总医院和顺化中心医院收治的临床疑似发热患者中采集的511份和500份血清，联合WC/Hcp1 ELISA检测出类鼻疽阳性患者分别为52例（10.2%）和41例（8.2%）。该检测分别在平定和顺化检测出14例中的14例（100%）和23例中的21例（91.3%）培养确诊的类鼻疽病例。对38例联合WC/Hcp1 ELISA检测类鼻疽阳性但通过培养方法检测伯克霍尔德菌假鼻疽阴性或未进行细菌培养检查的患者进行随访研究，结果显示有2例（5.
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