Clinical and serologic evaluation of neonates for congenital syphilis: a continuing diagnostic dilemma.
Clinical and serologic evaluation of neonates for congenital syphilis: a continuing diagnostic dilemma.
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新生儿先天性梅毒的临床和血清学评估：持续的诊断困境。
DOI：
10.1093/infdis/167.5.1093
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发表时间：
1993
期刊：
影响因子：
--
通讯作者：
Nahmias,AJ
中科院分区：
文献类型：
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作者：
Stoll,BJ;Lee,FK;Larsen,S;Hale,E;Schwartz,D;Rice,RJ;Ashby,R;Holmes,R;Nahmias,AJ
新生儿出生的妇女与反应性梅毒血清学试验进行了研究，共116人，其中包括18人有症状，60无症状，但可能感染，38无症状，可能未感染。评价了荧光密螺旋体抗体吸收（FTA-ABS）19 S IgM试验和梅毒螺旋体IgM捕获ELISA（两种密螺旋体特异性试验）以及反向酶联免疫斑点（RELISPOT）（可检测免疫球蛋白分泌细胞，是感染的非特异性指标）。有症状新生儿的敏感性分别为88%（IgM ELISA）、73%（FT A-ABS）和78%（RELISPOT）。特异性范围为97%至100%。一个主要问题是无法确定哪些无症状但可能感染的新生儿实际上未感染。在41名进行了所有三项测试的婴儿中，93%的人都是阴性的，这表明他们没有感染或最近感染过。准确识别真正未感染的无症状新生儿的策略将防止所有高危婴儿不必要的住院治疗，从而提高护理质量并降低成本。
Neonates born to women with reactive serologic tests for syphilis were studied; the total of 116 included 18 who were symptomatic, 60 asymptomatic but possibly infected, and 38 asymptomatic and probably uninfected. The fluorescent treponemal antibody-absorption (FTA-ABS) 19S IgM test and an IgM capture ELISA forTreponema pallidum, both treponema-specific assays, and the reverse enzyme-linked immunospot (RELISPOT), which detects immunoglobulin-secreting cells and is a nonspecific indicator of infection, were evaluated. Sensitivities among symptomatic neonates were 88% (IgM ELISA), 73% (FT A-ABS), and 78% (RELISPOT). Specificities ranged from 97% to 100%. A major problem has been the inability to identify which asymptomatic but possibly infected neonate is really uninfected. Among 41 such babies who had all three tests done, 93% were negative by all assays, suggesting they were un infected or recently infected. Strategies to accurately identify the truly uninfected asymptomatic newborn would prevent the unnecessary hospitalization of all at-risk infants, resulting in improved quality ofcare and reduced costs.