Evaluation of an immunoglobulin G enzyme-linked immunosorbent assay for pertussis toxin and filamentous hemagglutinin in diagnosis of pertussis in Senegal
Evaluation of an immunoglobulin G enzyme-linked immunosorbent assay for pertussis toxin and filamentous hemagglutinin in diagnosis of pertussis in Senegal
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DOI：
10.1128/cdli.5.2.130-134.1998
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发表时间：
1998-03-01
期刊：
影响因子：
--
通讯作者：
Guiso, N
中科院分区：
文献类型：
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作者：
Simondon, F;Iteman, I;Guiso, N
酶联免疫吸附测定广泛用于百日咳的血清学诊断，一般得出的结论是，配对血清中针对百日咳毒素（PT）或丝状血凝素（FHA）的特异性免疫球蛋白G（IgG）或IgA显着增加与百日咳博德特氏菌感染相关。然而，这种类型的百日咳诊断主要适用于未接种疫苗的儿童，需要及时采集急性期和恢复期血清，在目前的实践和流行病学研究中，并不总是满足这样的标准。本研究的目的是分析在疑似百日咳感染病例中观察到的配对血清中针对 PT 和 FHA 的 Ige 抗体滴度下降的意义，获得了 460 名至少经历过百日咳感染的儿童的配对血清的血清学结果咳嗽第 8 天，25% 的儿童观察到抗 PT IgG 下降，比抗 FHA IgG 下降更常见。在培养确诊感染的儿童中观察到 14% 的血清学下降，根据世界卫生组织建议，在符合确诊标准的儿童中观察到 59% 的血清学下降。大多数下降是在按照标准推荐时间表收集血清样本时观察到的，接种疫苗的儿童比未接种疫苗的儿童更容易观察到血清学下降，这种差异非常显着（P < 0.00001），可以通过接种疫苗和未接种疫苗的儿童之间抗体反应的不同动力学来解释。早期建议应将 PT 或 FHA 显着降低添加到百日咳的诊断标准中。
The enzyme-linked immunosorbent assay is widely employed for the serological diagnosis of pertussis, It is generally concluded that a significant increase in specific immunoglobulin G (IgG) or IgA against the pertussis toxin (PT) or against filamentous hemagglutinin (FHA) in paired sera correlates with Bordetella pertussis infection. However, this type of diagnosis of pertussis has mainly been applied to unvaccinated children, with timely sampling of acute- and convalescent-phase sera, In current practice and in epidemiological studies, such criteria are not always fulfilled, The aim of this study was to analyze the significance of decreases in Ige antibody titers against PT and FHA between paired sera observed in suspected cases of pertussis infection, Serological results from paired sera were available for 460 children experiencing at least 8 days of cough, An anti-PT IgG decrease was observed in 25% of the children, more frequently than the anti-FHA IgG decrease, Fourteen percent of the serologic decreases were observed in children with culture-confirmed infection, and 59% of the decreases were observed in children with confirmation criteria according to World Health Organization recommendations. Most of the decreases were observed when serum samples were collected according to a standard recommended schedule, Serologic decreases were observed more frequently among vaccinated children than among unvaccinated children, This difference, which was highly significant (P < 0.00001), was explained by the different kinetics of the antibody responses between vaccinated and unvaccinated children, The importance of the antibody response for the evaluation of vaccine efficacy, namely a bias toward higher absolute vaccine efficacy when this response is not taken into account, is discussed, This study supports an earlier recommendation that a significant decrease in PT or FHA should be added to the diagnostic criteria for pertussis.