Detection of anti-pertussis toxin IgG in oral fluids for use in diagnosis and surveillance of Bordetella pertussis infection in children and young adults
Detection of anti-pertussis toxin IgG in oral fluids for use in diagnosis and surveillance of Bordetella pertussis infection in children and young adults
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DOI：
10.1099/jmm.0.46543-0
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发表时间：
2006-09-01
影响因子：
3
通讯作者：
Harrison, Timothy G.
中科院分区：
文献类型：
--
作者：
Litt, David J.;Samuel, Dhanraj;Harrison, Timothy G.
百日咳杆菌感染越来越被认为是儿童和年轻人长期令人痛苦的咳嗽（无百日咳症状）的原因。在这一人群中诊断感染对于治疗和监测非常重要，也可能有助于减少向未接种疫苗的婴儿的传播，因为对这些婴儿来说，疾病可能是致命的。抗百日咳毒素（PT）的血清IgG滴度通常用作近期或持续存在B的标志物。百日咳感染然而，从幼儿中收集血清很困难，而且这些受试者提供样本的依从性很低。为了避免这些问题，IgG捕获ELISA能够检测口腔液中的抗PT IgG。通过与血清ELISA进行比较，使用来自具有长期咳嗽史的儿童（年龄5-16岁）的187份匹配血清和口腔液样本对该测定进行评价，其血清抗PT滴度已经测定（69份血清阳性，118份血清阴性）。结果显示，使用70个任意单位（Au）的临界值，口腔液检测检测血清阳性受试者的灵敏度为79（.）7% [95%置信区间（CI）68（.）3-88（.）4]特异性为96（.）6%（95% CI 91（.）5-99（.）1）。因此，口服液滴度>= 70 Au将具有阳性预测值76（.）2-93（.）当用作血清ELISA的替代物时，慢性咳嗽儿童中百日咳为2%（假设疾病患病率为12-37%）。这种口服液ELISA将大大有助于B的方便。百日咳疾病的诊断和监测。
Bordetella pertussis infection is being increasingly recognized as a cause of prolonged, distressing cough (without whooping symptoms) in children and young adults. Diagnosis of infection in this population is important for treatment and surveillance purposes, and may also prove useful in reducing transmission to unvaccinated babies, for whom disease can be fatal. Serum IgG titres against pertussis toxin (PT) are routinely used as a marker of recent or persisting B. pertussis infection. However, collection of serum from young children is difficult, and compliance amongst these subjects to give samples is low. To circumvent these problems, an IgG-capture ELISA capable of detecting anti-PT IgG in oral fluid was devised. The assay was evaluated by comparison to a serum ELISA, using 187 matched serum and oral fluid samples from children (aged 5-16 years) with a history of prolonged coughing, whose serum anti-PT titre had already been determined (69 seropositive, 118 seronegative). The results showed that, using a cutoff of 70 arbitrary units (AU), the oral fluid assay detected seropositive subjects with a sensitivity of 79(.)7% [95% confidence interval (CI) 68(.)3-88(.)4] and a specificity of 96(.)6% (95% CI 91(.)5-99(.)1). Thus, oral fluid titres of >= 70 AU would possess a positive predictive value of 76(.)2-93(.)2% for pertussis amongst children with chronic coughs when used as a surrogate for the serum ELISA (assuming disease prevalence of 12-37%). This oral fluid ELISA will greatly assist in the convenience of B. pertussis disease diagnosis and surveillance.