Persistence of anti-leptospiral IgM, IgG and agglutinating antibodies in patients presenting with acute febrile illness in Barbados 1979-1989
Persistence of anti-leptospiral IgM, IgG and agglutinating antibodies in patients presenting with acute febrile illness in Barbados 1979-1989
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DOI：
10.1023/a:1015509105668
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发表时间：
2001-01-01
影响因子：
13.6
通讯作者：
Levett, PN
中科院分区：
文献类型：
--
作者：
Cumberland, P;Everard, COR;Levett, PN
在血清学确诊的严重钩端螺旋体病病例中，研究了急性疾病期间和恢复后数年内抗钩端螺旋体IgM和IgG抗体以及凝集抗体的持续性。在同一段时间内，非端螺旋体病患者因类似症状到医院就诊的抗体反应，被用来估计社区中端螺旋体病的背景抗体水平。所有入组研究的患者在疾病急性期采集两次血液样本，在恢复期采集一次，然后从首次住院到研究期结束每年采集一次。638名患者因急性发热性疾病入院，其中321人被诊断为钩端螺旋体病。严重的钩端螺旋体病患者通常保持血清阳性，IgM，IgG和凝集抗体检测数年后感染。很大一部分病例具有通过显微镜凝集试验可检测到的高滴度凝集抗体（大于或等于800）。针对不同血清群的凝集抗体持续存在的幅度和持续时间有显着差异。超过20%的有秋季血清群感染证据的病例在急性疾病后4年仍保持滴度> 800。在一个病例中，在感染后11年检测到滴度为800。凝集抗体滴度的持续存在可能会给血清学结果的解释带来问题，并且无法根据特定滴度估计感染时间。这项研究表明，在血清阳性率高的流行地区，使用单一的升高滴度是不可靠的，以确定当前的感染。
The persistence of anti-leptospiral IgM and IgG antibodies and agglutinating antibodies was studied in serologically confirmed cases of severe leptospirosis during the acute illness and over periods of several years after recovery. The antibody response in non-leptospirosis patients presenting to hospital with similar symptoms over the same period of time was used to estimate the background antibody level to leptospirosis in the community. All patients enrolled in the study had blood samples collected twice in the acute stage of illness, once during convalescence and then annually from the time of initial hospitalisation until the end of the study period. Six hundred and thirty-eight patients presented to hospital with acute febrile illness, of whom 321 were diagnosed with leptospirosis. Patients who had severe leptospirosis commonly remained seropositive, with IgM, IgG and agglutinating antibodies detectable for several years after infection. A significant proportion of cases had high titres of agglutinating antibody detectable by the microscopic agglutination test (greater than or equal to 800). There were marked differences in the magnitude and duration of persistence of agglutinating antibodies directed against different serogroups. More than 20% of cases with evidence of infection with serogroup Autumnalis retained titres of > 800, 4 years after the acute illness. In one case a titre of 800 was detected 11 years after infection. Persistence of agglutinating antibody titres can create problems in interpretation of serological results and make it impossible to estimate the time of infection, given a specific titre. This study demonstrates that in endemic areas where seroprevalence is high, use of a single elevated titre is not reliable to define a current infection.