Babalis T, Dupont H T, Tselentis Y, Chatzichristodoulou C, Raoult D
Microbiological Department, Faculty of Medicine, University of Crete, Heraklion, Greece.
Am J Trop Med Hyg. 1993 Jun;48(6):784-92. doi: 10.4269/ajtmh.1993.48.784.
Since 1972, there have been no reports of Mediterranean spotted fever (MSF) in Greece. In 1991, a seroepidemiologic survey was conducted in three rural villages in the Province of Fokida in central Greece, using both an immunofluorescence assay (IFA) and Western blot to evaluate the prevalence of specific IgG and IgM antibodies to Rickettsia conorii, and to compare these two techniques. Of 254 sera tested by IFA, 148 (58.3%) were positive for IgG at a titer > or = 32 and 117 (46.1%) at a titer > or = 64. Two sera were positive for IgM at a titer > or = 32. Among the IFA-positive sera, 115 reacted against the specific protein antigen (SPA) using Western blotting and were considered as confirmed positive results, indicating a seroprevalence of 45.3%. Using the SPA reaction as a reference, the IFA diagnostic value of a single serum is poor in such an endemic area, suggesting the need for more specific tests. The results of this study have led us to conclude that for seroepidemiologic use, the IFA is not specific for MSF. Thus, the IFA is useful for sero-epidemiologic analysis only in areas where the true prevalence of MSF has been estimated using Western blotting.
自1972年以来，希腊没有地中海斑疹热（MSF）的报告。1991年，在希腊中部福基达省的三个乡村进行了一项血清流行病学调查，使用免疫荧光测定法（IFA）和蛋白质印迹法来评估抗康氏立克次体特异性IgG和IgM抗体的流行率，并比较这两种技术。在通过IFA检测的254份血清中，148份（58.3%）IgG滴度≥32呈阳性，117份（46.1%）滴度≥64呈阳性。两份血清IgM滴度≥32呈阳性。在IFA阳性血清中，115份使用蛋白质印迹法与特异性蛋白抗原（SPA）发生反应，被视为确诊阳性结果，表明血清阳性率为45.3%。以SPA反应作为参考，在这样一个流行地区，单一血清的IFA诊断价值较差，这表明需要更特异的检测方法。本研究结果使我们得出结论，对于血清流行病学用途，IFA对MSF不具有特异性。因此，IFA仅在使用蛋白质印迹法估计了MSF真实流行率的地区用于血清流行病学分析才有用。
