Accuracy of Rapid IgM-Based Immunochromatographic and Immunoblot Assays for Diagnosis of Acute Scrub Typhus and Murine Typhus Infections in Laos
Accuracy of Rapid IgM-Based Immunochromatographic and Immunoblot Assays for Diagnosis of Acute Scrub Typhus and Murine Typhus Infections in Laos
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DOI：
10.4269/ajtmh.2010.09-0534
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发表时间：
2010-08-01
影响因子：
3.3
通讯作者：
Newton, Paul N.
中科院分区：
文献类型：
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作者：
Blacksell, Stuart D.;Jenjaroen, Kemajittra;Newton, Paul N.
我们研究了诊断准确性的快速免疫层析试验（ICT）检测IgM抗恙虫病（ST ICT）和免疫印迹试验检测IgM抗鼠斑疹伤寒（MT IBT）的入院血清样本，从1,030发热患者在老挝。以恙虫病东方体IgM阳性率增加1倍为诊断标准，测定SI-ICT的敏感性和特异性为23.8%（95%可信区间[CI] = 15.9 ~ 33.3%）和86.2%（95% CI = 84.1 -88.6%），以入院IgM ≥ 1400为标准测定ST ICT的敏感性和特异性分别为39.1%（95%CI = 34.1 - 44.2%）和99.5%（95%CI = 98.7 - 99.9%），分别采用le增加4倍的标准测定MT IBT的敏感性和特异性，配对血清标本对斑疹伤寒立克次体的M分别为61 2%（95% CI = 53 7-68 3%）和86 5%（95% CI = 84 1-88 8%）。以IgM ≥ 1400为标准测定MT IBT的敏感性为54.6%（95%CI = 49.1 ~ 60.0%），特异性为94.1%（95%CI = 92.0 ~ 95.7%），两种方法均具有较好的特异性，但敏感性较低，在入院诊断中的应用价值有限
We studied the diagnostic accuracy of a rapid immunochromatographic test (ICT) for detection of IgM against scrub typhus (ST ICT) and an immunoblot test for the detection of IgM against murine typhus (MT IBT) by using admission serum samples from 1,030 febrile patients in Laos. Sensitivity and specificity for the Si ICT determined by using the diagnostic criteria of a tour-fold increase in IgM against Orientia tsutsugamusht between paned samples were 23.8% (95% confidence interval [CI] = 15 9-33 3%) and 86 2% (95% CI = 84 1-88.6%), respectively Sensitivity and specificity for the ST ICT determined by using an admission IgM titer >= 1 400 were 39.1% (95% CI = 34 1-44 2%) and 99 5% (95% CI = 98 7-99 9%), respectively Sensitivity and specificity for the MT IBT determined by using the criteria of a four-fold Increase in le,M against Rickettsia typht between paired serum samples were 61 2% (95% CI = 53 7-68 3%) and 86 5% (95% CI = 84 1-88 8%). respectively Sensitivity and specificity for the MT IBT determined by using an admission IgM titer >= 1 400 were 54 6% (95% CI = 49 1-60 0%) and 94.1% (95% CI = 92 0-95 7%), respectively Both assays had relatively good specificity but low sensitivity and thus have limited utility for admission diagnosis