Mishra Hricha, Jain Amita, Kanta Chandra, Prakash Shantanu, Kalyan Rajkumar
Paediatrics, King George's Medical University, Lucknow, IND.
Clinical Microbiology, King George's Medical University, Lucknow, IND.
Cureus. 2025 Mar 31;17(3):e81549. doi: 10.7759/cureus.81549. eCollection 2025 Mar.
Introduction This study aims to evaluate the diagnostic performance of polymerase chain reaction (PCR), enzyme-linked immunosorbent assay (ELISA) methods, and gene sequencing in detecting , the causative agent of scrub typhus, in pediatric patients with acute encephalitis syndrome (AES). Methods The study was conducted at a tertiary care teaching hospital in northern India. In all, 264 children presenting with AES were enrolled between August 2018 and November 2019. Cerebrospinal fluid (CSF), serum, and peripheral blood mononuclear cell (PBMC) samples were analyzed using real-time PCR and ELISA to detect the presence of scrub typhus. The 56 kDa gene sequencing was performed in 15 samples. Results The ELISA for scrub typhus IgM demonstrated the highest cumulative positivity rate at 26.52%. In contrast, PCR testing of CSF and PBMC samples showed lower detection rates of 4.17% and 9.47%, respectively. The overall positivity for scrub typhus was 29.5%, highlighting the significant role of this pathogen in pediatric AES cases in endemic regions. The phylogenetic analysis of scrub typhus revealed many Gilliam-like strains. Conclusion ELISA for scrub typhus IgM has a high positivity rate in comparison to PCR for the detection of scrub typhus in children with AES.
引言 本研究旨在评估聚合酶链反应（PCR）、酶联免疫吸附测定（ELISA）方法和基因测序在检测急性脑炎综合征（AES）儿科患者中恙虫病病原体方面的诊断性能。方法 该研究在印度北部的一家三级护理教学医院进行。2018年8月至2019年11月期间，共纳入了264例患有AES的儿童。使用实时PCR和ELISA对脑脊液（CSF）、血清和外周血单核细胞（PBMC）样本进行分析，以检测恙虫病的存在。对15个样本进行了56 kDa基因测序。结果 恙虫病IgM的ELISA显示累积阳性率最高，为26.52%。相比之下，CSF和PBMC样本的PCR检测率较低，分别为4.17%和9.47%。恙虫病的总体阳性率为29.5%，突出了该病原体在流行地区儿科AES病例中的重要作用。恙虫病的系统发育分析显示出许多类似吉列姆的菌株。结论 与PCR相比，恙虫病IgM的ELISA在检测AES儿童恙虫病方面具有较高的阳性率。
