Significance of Isolated Reactive Treponemal Chemiluminescence Immunoassay Results
Significance of Isolated Reactive Treponemal Chemiluminescence Immunoassay Results
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DOI：
10.1093/infdis/jis459
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发表时间：
2013-05-01
影响因子：
6.4
通讯作者：
Post, Jeffrey J.
中科院分区：
文献类型：
--
作者：
Hunter, Michael G.;Robertson, Peter W.;Post, Jeffrey J.
方法。 CIA 对血清进行筛选，反应性样本通过快速血浆反应素 (RPR)、梅毒螺旋体颗粒凝集 (TPPA) 和荧光螺旋体抗体吸收 (FTA Abs) 测定进行反射测试。仅对 CIA 起反应的样品被视为“孤立的”反应性 CIA 样品。我们对部分具有独立反应性 CIA 样本的受试者进行了详细审查。结果。在 28 261 份样本中，1171 份（4.1%）对 CIA 有反应，其中 133 份（11.3%）有单独的 CIA 反应。大多数具有分离的反应性 CIA 样本的受试者（82 名中的 66 名 [80.5%]）来自高流行人群。我们发现了 CIA、TPPA 和 FTA 抗体血清逆转的证据。分离的反应性 CIA 血清和对 FTA Abs 或 TPPA 测定有反应的血清的中位化学发光信号截止比相似 (2.19 vs 2.32; P = .15)，但低于对 FTA Abs 和 TPPA 测定有反应的血清 (12.37; P < .001) 或对 RPR 测定有反应的血清 (25.53; P < .001) .001）。在接受病历审查的 20 名分离出反应性 CIA 标本的患者中，共有 11 名患者 (55%) 先前或随后有梅毒感染的证据。结论。分离的反应性 CIA 标本可能代表真正的梅毒螺旋体感染，并且可能在传统密螺旋体检测的血清复归后发现。
Methods. Sera were screened by CIA, and reactive samples underwent reflex testing with rapid plasma reagin (RPR), Treponema pallidum particle agglutination (TPPA), and fluorescent treponemal antibody absorption (FTA Abs) assays. Samples reactive only on the CIA were deemed "isolated" reactive CIA samples. We undertook detailed review of a subset of subjects with isolated reactive CIA specimens.Results. Of 28 261 specimens, 1171 (4.1%) were reactive on CIA, of which 133 (11.3%) had isolated CIA reactivity. Most subjects (66 of 82 [80.5%]) with isolated reactive CIA specimens were from high-prevalence populations. We found evidence of CIA, TPPA, and FTA Abs seroreversion. The median chemiluminescent signal-to-cutoff ratio was similar for isolated reactive CIA sera and sera that were reactive on either FTA Abs or TPPA assays (2.19 vs 2.32; P = .15) but lower than for sera reactive on both FTA Abs and TPPA assays (12.37; P < .001) or for sera reactive on RPR assays (25.53; P < .001). A total of 11 of 20 patients (55%) with an isolated reactive CIA specimen who underwent medical record review had previous or subsequent evidence of syphilis infection.Conclusions. Isolated reactive CIA specimens may represent true T. pallidum infection and may be found after seroreversion of traditional treponemal assays.