Antibodies in Melioidosis: The Role of the Indirect Hemagglutination Assay in Evaluating Patients and Exposed Populations.
Antibodies in Melioidosis: The Role of the Indirect Hemagglutination Assay in Evaluating Patients and Exposed Populations.
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DOI：
10.4269/ajtmh.17-0998
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发表时间：
2018-12
期刊：
影响因子：
--
通讯作者：
Dunachie SJ
中科院分区：
文献类型：
--
作者：
Chaichana P;Jenjaroen K;Amornchai P;Chumseng S;Langla S;Rongkard P;Sumonwiriya M;Jeeyapant A;Chantratita N;Teparrukkul P;Limmathurotsakul D;Day NPJ;Wuthiekanun V;Dunachie SJ
类鼻疽是一种被忽视的主要热带疾病，死亡率很高，由革兰氏阴性菌鼻疽伯克霍尔德氏菌 (Bp) 引起。微生物培养仍然是诊断的金标准，但非常需要一种更简单、更容易获得的测试，例如抗体测定。在这项研究中，我们对泰国东北部的献血者 (n = 1,060) 和成年类鼻疽患者 (n = 200) 进行了血清学调查，以使用间接血凝测定 (IHA) 测量对 Bp 的抗体反应。我们发现 38% 的健康成年人（17-59 岁）血清呈阳性（IHA 滴度≥1:80）。健康献血者的血清阳性与申报职业为稻农以及居住在非城市地区有关，但与性别或年龄无关。在类鼻疽队列中，18至45岁成年患者的血清阳性率（90%，37/41）高于年龄≥45岁的患者（68%，108/159，P = 0.004）。糖尿病患者的血清阳性率显着较高（P = 0.008）。在单变量分析中，血清阳性与死亡率降低相关（P = 0.005），但在根据年龄、糖尿病状况、既往肾病和中性粒细胞计数进行调整后的多变量分析中，血清阳性与死亡率降低无关。这项研究证实了流行地区存在高背景抗体，并证明了在该人群的急性类鼻疽期间使用 IHA 的局限性。
Melioidosis is a major neglected tropical disease with high mortality, caused by the Gram-negative bacterium Burkholderia pseudomallei (Bp). Microbiological culture remains the gold standard for diagnosis, but a simpler and more readily available test such as an antibody assay is highly desirable. In this study, we conducted a serological survey of blood donors (n = 1,060) and adult melioidosis patients (n = 200) in northeast Thailand to measure the antibody response to Bp using the indirect hemagglutination assay (IHA). We found that 38% of healthy adults (aged 17–59 years) have seropositivity (IHA titer ≥ 1:80). The seropositivity in healthy blood donors was associated with having a declared occupation of rice farmer and with residence in a nonurban area, but not with gender or age. In the melioidosis cohort, the seropositivity rate was higher in adult patients aged between 18 and 45 years (90%, 37/41) compared with those aged ≥ 45 years (68%, 108/159, P = 0.004). The seropositivity rate was significantly higher in people with diabetes (P = 0.008). Seropositivity was associated with decreased mortality on univariable analysis (P = 0.005), but not on multivariable analysis when adjusted for age, diabetes status, preexisting renal disease, and neutrophil count. This study confirms the presence of high background antibodies in an endemic region and demonstrates the limitations of using IHA during acute melioidosis in this population.
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影响因子：
2.5
作者：
Diefenbach-Elstob, Tanya R.;Graves, Patricia M.;Warner, Jeffrey M.
通讯作者：
Warner, Jeffrey M.
影响因子：
--
作者：
Harris, Patrick N. A.;Williams, Natasha L.;Norton, Robert E.
通讯作者：
Norton, Robert E.
影响因子：
--
作者：
Harris, Patrick N. A.;Ketheesan, Natkunam;Norton, Robert E.
通讯作者：
Norton, Robert E.
影响因子：
4.2
作者：
Brett, PJ;Deshazer, D;Woods, DE
通讯作者：
Woods, DE
影响因子：
3.8
作者：
Hantrakun V;Thaipadungpanit J;Rongkard P;Srilohasin P;Amornchai P;Langla S;Mukaka M;Chantratita N;Wuthiekanun V;Dance DAB;Day NPJ;Peacock SJ;Limmathurotsakul D
通讯作者：
Limmathurotsakul D