Waag D, Chulay J, Marrie T, England M, Williams J
Pathogenesis and Immunology Branch, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland 21702-5011, USA.
Eur J Clin Microbiol Infect Dis. 1995 May;14(5):421-7. doi: 10.1007/BF02114898.
An enzyme immunoassay was validated for the serodiagnosis of acute Q fever. Minimum positive tests were determined for both serial dilutions and a single dilution of patient sera. To establish the specificity of the test, 152 serum samples were tested from individuals with no evidence of past Coxiella burnetii infection. Diagnostic titers were set at > or = 128 for the IgM and IgG responses to phase I, at > or = 512 for the IgM response to phase II and at > or = 1,024 for the IgG response to phase II Coxiella burnetii. These titers gave a false-positive rate of < or = 1%. Alternatively, testing a single dilution of sera (1:128) gave specificities ranging from 97.3 to 98.7%. Tests with the greatest sensitivities, using serially diluted early convalescent-phase sera, were the IgM (84%) and IgG (80%) responses to phase II Coxiella burnetii. At a single serum dilution, 92% of early convalescent sera had a positive IgG response to phase II Coxiella burnetii. With a high specificity and good sensitivity, the EIA can be used to diagnose acute Q fever with a single convalescent serum specimen. The duration of a positive response was greater than five years.
一种酶免疫测定法已被验证可用于急性Q热的血清学诊断。对患者血清的系列稀释液和单一稀释液均确定了最低阳性检测结果。为确定该检测方法的特异性，对152份无既往伯氏考克斯体感染证据的个体血清样本进行了检测。针对对I期的IgM和IgG反应，诊断滴度设定为≥128；针对对II期的IgM反应，诊断滴度设定为≥512；针对对II期伯氏考克斯体的IgG反应，诊断滴度设定为≥1024。这些滴度产生的假阳性率≤1%。或者，检测血清的单一稀释液（1:128）时，特异性范围为97.3%至98.7%。使用系列稀释的恢复期早期血清进行检测时，敏感性最高的是对II期伯氏考克斯体的IgM（84%）和IgG（80%）反应。在单一血清稀释度下，92%的恢复期早期血清对II期伯氏考克斯体有阳性IgG反应。该酶免疫测定法具有高特异性和良好的敏感性，可用于用单一恢复期血清标本诊断急性Q热。阳性反应的持续时间超过五年。
