Rapid diagnosis of scrub typhus in rural Thailand using polymerase chain reaction
Rapid diagnosis of scrub typhus in rural Thailand using polymerase chain reaction
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DOI：
10.4269/ajtmh.2006.75.1099
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发表时间：
2006-12-01
影响因子：
3.3
通讯作者：
Peacock, Sharon J.
中科院分区：
文献类型：
--
作者：
Sonthayanon, Piengchan;Chierakul, Wirongrong;Peacock, Sharon J.
本研究的目的是评价聚合酶链式反应(PCR)扩增恙虫病16S rRNA基因在泰国农村地区诊断森林斑疹伤寒中的应用。泰国东北部乌东他尼的一项关于急性发热性疾病的前瞻性研究，根据配对血清的免疫荧光抗体检测(IFA)，确定183名患者患有丛林斑疹伤寒。另有366名发烧患者与一系列其他诊断同时入院，作为阴性对照。与间接免疫荧光法相比，16S rRNA聚合酶链式反应的诊断敏感性为44.8%，特异性为99.7%。聚合酶链式反应阳性与症状持续时间和焦痂的存在有关(P<；0.001，两个病例)。用该方法扩增56-kd基因片段，其敏感性为29.0%，特异性为99.2%。在这种流行环境下，聚合酶链式反应对快速诊断斑疹伤寒有很高的特异性，但敏感性较低。
The aim of this study was to evaluate the use of polymerase chain reaction (PCR) amplification of the O. tsutsugamushi 16S rRNA gene for the diagnosis of scrub typhus in rural Thailand. A prospective study of acute febrile illness in Udon Thani, northeast Thailand, identified 183 patients as having scrub typhus on the basis of immunofluorescent antibody testing (IFA) of paired sera. A further 366 febrile patients admitted concurrently with a range of other diagnoses acted as negative controls. Diagnostic sensitivity and specificity of 16S rRNA PCR was 44.8% and 99.7%, respectively, compared with IFA. PCR positivity was related to duration of symptoms and presence of eschar (P < 0.001, both cases). PCR using primers to amplify a fragment of the 56-kd gene had a sensitivity and specificity of 29.0% and 99.2%, respectively. PCR has a high specificity but low sensitivity for the rapid diagnosis of scrub typhus in this endemic setting.