EVALUATION OF SEROLOGIC TESTS FOR DIAGNOSIS OF ANTHRAX AFTER AN OUTBREAK OF CUTANEOUS ANTHRAX IN PARAGUAY
EVALUATION OF SEROLOGIC TESTS FOR DIAGNOSIS OF ANTHRAX AFTER AN OUTBREAK OF CUTANEOUS ANTHRAX IN PARAGUAY
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DOI：
10.1093/infdis/160.4.706
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发表时间：
1989-10-01
影响因子：
6.4
通讯作者：
KAUFMANN, AF
中科院分区：
文献类型：
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作者：
HARRISON, LH;EZZELL, JW;KAUFMANN, AF
巴拉圭农村地区爆发至少21例皮肤炭疽热。一项病例对照研究显示，疾病与接触患病奶牛的生肉有关(优势比=16.5，P=0.02)。对发病后6周的12例患者、16例非集落对照和2例非集落对照的血清进行免疫印迹分析(EITB)，检测血清中抗炭疽毒素保护性抗原(PA)和致死因子成分的抗体。采用酶联免疫吸附试验(ELISA)检测血清中抗D-聚D-谷氨酸胶囊抗体。在12例患者中，11例PA筛查阳性，其敏感性为91.7%(76.1%~100%，95%可信区间[CI])，而18例对照中无一例特异性为100%(84.8%，单侧二项95%可信区间)。12例(21.7%~78.3%，95%可信区间)中仅6例(50%)致死因子滴度为阳性，对照组均为阴性。在.gtoreq的分界处。1：32囊膜抗体阳性11例(91.7%)，阴性16例(88.9%)。提示检测PA抗体的EITB法和检测抗囊抗体的EITB法对炭疽病的回顾性诊断都是敏感的。这两种检测都是特异的，但EITB可能比ELISA更具特异性。
An outbreak of at least 21 cases of cutaneous anthrax occurred in rural Paraguay. A case-control study revealed that disease was associated with touching the raw meat of an ill cow (odds ration = 16.5, P = .02). Serum drawn from 12 cases and 16 colony and 2 noncolony controls 6 w after the outbreak were analyzed by electrophoretic-immunotransblots (EITB) to detect serum antibodies to the protective antigen (PA) and lethal factor components of anthrax toxin. Serum was also tested by enzyme-linked immunsorbent assay (ELISA) for the presence of antibodies to poly-D-glutamic acid capsule. Of 12 cases, 11 had a positive PA screen, for a sensitivity of 91.7% (76.1%-100%, 95% confidence interval [CI]) whereas none of the 18 controls was positive for a specificity of 100% (84.8%, one-sided binomial 95% CI). Only 6 (50%) of 12 cases (21.7%-78.3%, 95% CI) had positive lethal factor titers; all controls were negative. At a cutoff of .gtoreq. 1:32 for antibodies to capsule, 11 (91.7%) of 12 (76.1%-100%, 95% CI) were positive; 16 (88.9%) of 18 controls (74.5%-100%, 95% CI) were negative. These data suggest that the EITB for detection of antibody to PA, and ELISA for detection of anticapsule antibodies are both sensitive for the retrospective diagnosis of anthrax. Both tests were specific, but EITB may be more so than ELISA.