印度卡纳塔克邦患者中恙虫病东方体IgM和IgG抗体的持续性
Persistence of scrub typhus IgM and IgG antibodies among patients from Karnataka, India.
作者信息
Chunduru Kiran, A R Manoj, Poornima Subhadra, Narasimhaswamy Nagalakshmi, Bairy Indira, M Mridula, Hande H Manjunatha, Shastry Shamee, Devaki Ramakrishna, M Varghese George, Saravu Kavitha
机构信息
Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Department of Genetics and Molecular Medicine, Kamineni Life Sciences, Hyderabad, Telangana, India.
出版信息
Ann Med. 2025 Dec;57(1):2468258. doi: 10.1080/07853890.2025.2468258. Epub 2025 Mar 3.
BACKGROUND
The longevity of scrub typhus IgM and IgG are not clear. A region-specific diagnostic cut-off for enzyme-linked immunosorbent assay (ELISA) is a necessity for improved diagnosis.
OBJECTIVES
To determine a region-specific optical density (OD) value cut-off for scrub typhus IgM and IgG ELISA and to study the persistence of these antibodies.
METHODS
A prospective cohort study was conducted among patients diagnosed with scrub typhus admitted to Kasturba Hospital, Manipal, Karnataka, India from August 2019 to April 2023. An equal number of scrub typhus patients and healthy volunteers were enrolled to determine region-specific scrub typhus IgM and IgG ELISA OD value cut-off. A receiver operating characteristic (ROC) curve analysis was performed to determine the OD value cut-off with an optimal combination of sensitivity and specificity. The patients were followed up prospectively at varying time points up to 18 months and scrub typhus IgM and IgG ELISA were performed in all the collected samples.
RESULTS
The ROC curve analysis of scrub typhus IgM revealed an optimal OD value cut-off of 1.309 with a sensitivity and specificity of 98.7% (95% CI: 93.1%-100%). The ROC curve analysis of scrub typhus IgG revealed an optimal OD value cut-off of 0.9 with a sensitivity of 71.7% (95% CI: 60.5%-81.4%) and specificity of 93.5% (95% CI: 85.7%-97.9%). At 18 months of follow-up, scrub typhus IgM (OD value > 1.309) and IgG (OD value > 0.9) were above the newly derived diagnostic cut-off in 17 (32%) and 40 (75.4%) patients, respectively.
CONCLUSION
Scrub typhus IgM and IgG antibodies were persistent above the newly derived regional diagnostic cut-off for up to 18 months.
背景
恙虫病免疫球蛋白M（IgM）和免疫球蛋白G（IgG）的持续时间尚不清楚。酶联免疫吸附测定（ELISA）的区域特异性诊断临界值对于改善诊断是必要的。
目的
确定恙虫病IgM和IgG ELISA的区域特异性光密度（OD）值临界值，并研究这些抗体的持续存在情况。
方法
2019年8月至2023年4月，在印度卡纳塔克邦马尼帕尔市卡斯图尔巴医院对确诊为恙虫病的患者进行了一项前瞻性队列研究。纳入数量相等的恙虫病患者和健康志愿者，以确定区域特异性恙虫病IgM和IgG ELISA OD值临界值。进行了受试者操作特征（ROC）曲线分析，以确定具有最佳敏感性和特异性组合的OD值临界值。对患者进行了长达18个月的不同时间点的前瞻性随访，并对所有采集的样本进行了恙虫病IgM和IgG ELISA检测。
结果
恙虫病IgM的ROC曲线分析显示，最佳OD值临界值为1.309，敏感性和特异性分别为98.7%（95%置信区间：93.1%-100%）。恙虫病IgG的ROC曲线分析显示，最佳OD值临界值为0.9，敏感性为71.7%（95%置信区间：60.5%-81.4%），特异性为93.5%（95%置信区间：85.7%-97.9%）。在随访18个月时，分别有17名（32%）和40名（75.4%）患者的恙虫病IgM（OD值>1.309）和IgG（OD值>0.9）高于新得出的诊断临界值。
结论
恙虫病IgM和IgG抗体在长达18个月的时间内持续高于新得出的区域诊断临界值。
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