Mackenzie A M, Lebel P, Orrbine E, Rowe P C, Hyde L, Chan F, Johnson W, McLaine P N
Division of Microbiology, Ottawa Civic Hospital, Ontario, Canada.
J Clin Microbiol. 1998 Jun;36(6):1608-11. doi: 10.1128/JCM.36.6.1608-1611.1998.
This study describes the performance of two rapid enzyme immunoassays, Premier E. coli O157 and Premier EHEC (Meridian Diagnostics Inc., Cincinnati, Ohio) for the detection in stools of Escherichia coli O157 and verotoxins (Shiga-like toxins), respectively. Both tests were performed on stools from 876 children presenting to eight emergency departments with diarrhea. Standard culture, including E. coli O157:H7 isolation, was performed, and paired sera were taken for anti-O157-lipopolysaccharide antibody determination. Stools from patients enrolled in the study, and those yielding discordant results, were sent to a reference laboratory for repeat testing and further investigation, including cytotoxicity and non-O157 verotoxin-producing E. coli culture. Results were classified as field results (obtained in the eight site laboratories) and resolved results (obtained after repeat testing in the central laboratory). The "gold standard" for sensitivity of both tests and for specificity of Premier E. coli O157 was isolation of E. coli O157:H7 or a fourfold anti-O157 antibody rise. Specimens positive by the Premier EHEC test and negative for E. coli O157 culture were examined for non-O157 verotoxin-producing E. coli. The field sensitivity of Premier E. coli O157 was 86%, that of Premier EHEC was 89%, and the specificity of Premier E. coli O157 was 98%. Ten of 13 discordant Premier E. coli O157 results were reassigned as true results after repeat testing. Ten non-O157 verotoxin-producing E. coli isolates were recovered from Premier EHEC-positive, E. coli O157 culture-negative stools. Only one specimen gave an unequivocally false-positive Premier EHEC result. Both tests are highly sensitive and are specific if correctly performed. The Premier EHEC test will be particularly valuable as a practical routine test for the detection of non-O157 verotoxin-producing E. coli.
本研究描述了两种快速酶免疫测定法，即 Premier E. coli O157 和 Premier EHEC（Meridian Diagnostics Inc.，俄亥俄州辛辛那提）分别用于检测粪便中大肠杆菌 O157 和维罗毒素（志贺样毒素）的性能。这两种检测均在 876 名因腹泻前往 8 个急诊科就诊的儿童的粪便上进行。进行了标准培养，包括分离大肠杆菌 O157:H7，并采集配对血清用于抗 O157 脂多糖抗体测定。研究纳入患者的粪便以及产生不一致结果的粪便被送至参考实验室进行重复检测和进一步调查，包括细胞毒性检测和非 O157 产维罗毒素大肠杆菌培养。结果分为现场结果（在 8 个现场实验室获得）和解决结果（在中心实验室重复检测后获得）。两种检测的敏感性以及 Premier E. coli O157 的特异性的“金标准”是分离出大肠杆菌 O157:H7 或抗 O157 抗体升高四倍。对 Premier EHEC 检测呈阳性且大肠杆菌 O157 培养阴性的标本检测其非 O157 产维罗毒素大肠杆菌。Premier E. coli O157 的现场敏感性为 86%，Premier EHEC 的为 89%，Premier E. coli O157 的特异性为 98%。13 个不一致的 Premier E. coli O157 结果中有 10 个在重复检测后被重新认定为真实结果。从 Premier EHEC 阳性、大肠杆菌 O157 培养阴性的粪便中分离出 10 株非 O157 产维罗毒素大肠杆菌。只有 1 份标本给出了明确的 Premier EHEC 假阳性结果。如果操作正确，两种检测均具有高敏感性和特异性。Premier EHEC 检测作为检测非 O157 产维罗毒素大肠杆菌的实用常规检测将特别有价值。
