Pappas M G, Ballou W R, Gray M R, Takafuji E T, Miller R N, Hockmeyer W T
Am J Trop Med Hyg. 1985 Mar;34(2):346-54. doi: 10.4269/ajtmh.1985.34.346.
The dot enzyme-linked immunosorbent assay (Dot-ELISA) was compared to the microscopic agglutination test (MA test) for the diagnosis of human leptospirosis. Of 177 sera from 68 soldiers who trained in the Republic of Panama, 102 sera were positive in the MA test and 93 of these sera were positive in the IgM-specific Dot-ELISA. Incidence of infection was 50 of 68 patients with the MA test and 48 of 68 in the IgM Dot-ELISA. Five MA test-positive sera were reactive only in the IgG-specific Dot-ELISA, suggesting previous exposure. All 21 infecting serovars of Leptospira interrogans, as determined by positive reactions in the MA test or culture of blood and urine specimens, were reactive in the Dot-ELISA. Of 75 sera negative in the MA test, 61 were nonreactive in the Dot-ELISA. However, 9 of these 14 Dot-ELISA-positive/MA test-negative sera were acute samples from patients whose later sera were MA test-positive. Positive reactions in the IgM Dot-ELISA occurred in 2 of 30 control, 4 of 10 Lyme disease, 1 of 11 relapsing fever, and 1 of 8 yaws sera; 10 syphilis patient sera were nonreactive. The IgM-specific Dot-ELISA appears to be sensitive and specific for the serodiagnosis of acute leptospirosis. In addition, this rapid test is inexpensive, simple to perform, utilizes minute volumes of killed leptospiral antigen and is easily adaptable to field use.
将斑点酶联免疫吸附测定法（Dot-ELISA）与显微镜凝集试验（MA试验）用于诊断人类钩端螺旋体病进行了比较。在68名曾在巴拿马共和国接受训练的士兵的177份血清中，MA试验有102份血清呈阳性，其中93份血清在IgM特异性Dot-ELISA中呈阳性。MA试验确诊感染的有50例，IgM Dot-ELISA确诊感染的有48例。5份MA试验阳性血清仅在IgG特异性Dot-ELISA中有反应，提示既往暴露。通过MA试验或血液及尿液标本培养呈阳性反应确定的所有21种问号钩端螺旋体感染血清型，在Dot-ELISA中均有反应。MA试验阴性的75份血清中，61份在Dot-ELISA中无反应。然而，这14份Dot-ELISA阳性/MA试验阴性血清中有9份是患者的急性期样本，其后期血清MA试验呈阳性。在30份对照血清中有2份、10份莱姆病血清中有4份、11份回归热血清中有1份、8份雅司病血清中有1份在IgM Dot-ELISA中呈阳性反应；10份梅毒患者血清无反应。IgM特异性Dot-ELISA似乎对急性钩端螺旋体病的血清学诊断敏感且特异。此外，这种快速检测方法价格低廉、操作简单，使用微量的灭活钩端螺旋体抗原，且易于适应现场使用。
