Assessment of the efficacy of an IgM-elisa and microscopic agglutination test (MAT) in the diagnosis of acute leptospirosis
Assessment of the efficacy of an IgM-elisa and microscopic agglutination test (MAT) in the diagnosis of acute leptospirosis
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DOI：
10.4269/ajtmh.1999.61.731
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发表时间：
1999-11-01
影响因子：
3.3
通讯作者：
Levett, PN
中科院分区：
文献类型：
--
作者：
Cumberland, P;Everard, COR;Levett, PN
1979年至1989年在巴巴多斯进行的一项前瞻性研究中，在638名有钩端螺旋体病症状的住院患者中诊断出321例。初步诊断是基于患者的病史和特征性体征和症状。在92例病例（29%）中，通过从血液、尿液或透析液中分离出微生物来确诊;在其余229例病例（71%）中，仅通过血清学确诊。IgM-ELISA和显微镜凝集试验（MAT）的结果与分离株的情况下，在非钩端螺旋体病的情况下，被用来评估的敏感性和特异性的测试。ELISA检测IgM的敏感性在第一次急性期标本中为52%，在第二次急性期和恢复期标本中分别提高到89%和93%。IgM-ELISA的特异性高（大于或等于94%），在所有标本。MAT的灵敏度低（30%），在第一个急性期标本，增加到63%，在第二个急性期标本和76%的恢复期标本。所有标本的MAT特异性均大于或等于97%。
In a prospective study in Barbados between 1979 and 1989, 321 cases were diagnosed in 638 patients presenting at a hospital with symptoms of leptospirosis. Initial diagnosis was based on patient history and characteristic signs and symptoms. In 92 cases (29%), diagnosis was confirmed by isolation of organisms from the blood, urine, or dialysate fluid; in the remaining 229 cases (71%) diagnosis was confirmed by serology alone. Results of an IgM-ELISA and microscopic agglutination test (MAT) in cases with isolates and in non-leptospirosis cases were used to assess the sensitivity and specificity of the tests. The sensitivity of IgM detection by ELISA was 52% in the first acute-phase specimen, increasing to 89% and 93% in the second acute-phase and convalescent specimens, respectively. The specificity of the IgM-ELISA was high (greater than or equal to 94%) in all specimens. The sensitivity of the MAT was low (30%) in the first acute-phase specimen, increasing to 63% in the second acute-phase specimen and 76% in the convalescent specimen. The specificity of the MAT was greater than or equal to 97% in all specimens.