Diagnosis of Mediterranean spotted fever by cultivation of Rickettsia conorii from blood and skin samples using the centrifugation-shell vial technique and by detection of R-conorii in circulating endothelial cells: A 6-year follow-up
Diagnosis of Mediterranean spotted fever by cultivation of Rickettsia conorii from blood and skin samples using the centrifugation-shell vial technique and by detection of R-conorii in circulating endothelial cells: A 6-year follow-up
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DOI：
10.1128/jcm.34.11.2722-2727.1996
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发表时间：
1996-11-01
影响因子：
9.4
通讯作者：
Raoult, D
中科院分区：
文献类型：
--
作者：
LaScola, B;Raoult, D
立克次体，一种专性细胞内细菌，感染血管内皮细胞，是地中海斑疹热的病原体。我们将157例患者205例康氏弧菌血液和皮肤培养结果与41例患者循环内皮细胞（CEC）中48例康氏弧菌检测结果与相关血清学、临床和治疗数据相关联，40%的患者和29.8%的样本中培养出康氏弧菌，50%的样本（46.2%的患者）在CEC中检测到康氏弧菌。当这些计算仅限于未经治疗的患者血清转化为康氏弧菌之前的样本时，培养的灵敏度为59%，而在CEC中检测灵敏度为50%。我们还对8个阳性培养的贝壳瓶上清和43个血液样本进行了pcr检测，只有新鲜培养的非冷冻上清为阳性，本报告中描述的方法适用于所有实验室。我们的研究结果表明，对于适合培养的样品，必须在开始抗生素治疗方案之前收集，在疾病过程中尽可能早地收集，并以最小的延迟接种到贝壳瓶上，如果要成功分离出conconi。对于已接受治疗或延迟诊断的患者，在CEC中检测conconi仍有帮助。
Rickettsia conorii, an obligate intracellular bacterium that infects vascular endothelial cells, is the etiologic agent of Mediterranean spotted fever. We correlated the results of 205 R. conorii blood and skin cultures for 157 patients and the results of 48 detections of R. conorii in circulating endothelial cells (CEC) for 41 patients with relevant serological, clinical, and therapeutic data, R. conorii was cultured from 40% of patients and 29.8% of samples, R. conorii was detected in CEC in 50% of samples, representing 46.2% of patients, When these calculations were limited to the samples from untreated patients prior to their seroconversion to R. conorii, the sensitivity of culture was 59%, whereas it remained at 50% for detection in CEC, We also performed PCRs for the detection of R. conorii on eight shell vial supernatants from positive cultures and on 43 blood samples, Only nonfrozen supernatants from fresh cultures were positive, The methods described in this report are suitable for use in all laboratories, Our findings suggest that for samples to be suitable for culture they must be collected prior to the initiation of an antibiotic regimen, as early as possible in the course of the disease, and be inoculated onto shell vials with minimal delay, if R. conorii is to be successfully isolated, For patients who have been treated or who have a delayed diagnosis, detection of R. conorii in CEC remains helpful.