Detection of mycobacterial lipoarabinomannan with an antigen-capture ELISA in unprocessed urine of Tanzanian patients with suspected tuberculosis
Detection of mycobacterial lipoarabinomannan with an antigen-capture ELISA in unprocessed urine of Tanzanian patients with suspected tuberculosis
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DOI：
10.1016/j.trstmh.2005.04.014
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发表时间：
2005-12-01
影响因子：
2.2
通讯作者：
Hoelscher, M
中科院分区：
文献类型：
--
作者：
Boehme, C;Molokova, E;Hoelscher, M
基于检测未处理尿液中的分枝杆菌脂阿拉伯甘露聚糖 (LAM) 的直接抗原捕获 ELISA 在临床实践中的有效性进行了评估。在坦桑尼亚，通过标准结核病检测和新的 LAM-ELISA 对 231 名疑似肺结核 (TB) 患者和 103 名健康志愿者进行了筛查。在 132 例确诊为肺分枝杆菌病（痰培养阳性）的患者中，106 例 LAM-ELISA 呈阳性（敏感性 80.3%）。相比之下，抗酸杆菌（AFB）痰镜检查的敏感性为62.1%（132例确诊病例中的82例）。在 231 名患者中，17 名培养和 AFB 均为阴性，但具有典型的肺分枝杆菌影像学征象。感染并且对抗生素治疗没有反应。在这 17 名患者中，13 名（76.5%）LAM-ELISA 检测结果呈阳性。为了确定检测的特异性，还使用 LAM-ELISA 对 103 名健康志愿者的尿液样本进行了筛查。全部。但其中一种的光密度低于截止值（特异性 99%）。令人感兴趣的是痰中分枝杆菌的微观密度水平与尿液中的 LAM 抗原浓度之间存在显着相关性 (chi(2) = 8.44）。 LAM-ELISA 是一种现场适应性工具，可以提高结核病高发国家的筛查标准。 (c) 2005 年皇家热带医学和卫生学会。由爱思唯尔有限公司出版
A direct antigen-capture ELISA based on the detection of mycobacterial lipoarabinomannan (LAM) in unprocessed urine was evaluated for its usefulness in clinical practice. In Tanzania, 231 patients with suspected pulmonary tuberculosis (TB) and 103 healthy volunteers were screened with standard TB tests and with the new LAM-ELISA. Of 132 patients with confirmed pulmonary mycobacterial disease (positive sputum culture), 106 were positive using the LAM-ELISA (sensitivity 80.3%). In comparison, the sensitivity of acid-fast bacilli (AFB) sputum microscopy was 62.1% (82 of 132 confirmed cases). Of the 231 patients, 17 were both culture- and AFB-negative, but had typical radiographic signs of pulmonary mycobacterial. infection and did not respond to antibiotic treatment. Of these 17 patients, 13 (76.5%) had positive LAM-ELISA test results. To define the specificity of the assay, urine samples from 103 healthy volunteers were also screened using LAM-ELISA. All. but one had an optical density below the cut-off (specificity 99%). Of interest was a significant correlation between Level of microscopic density of mycobacteria in sputum and LAM antigen concentration in urine (chi(2) = 8.44). The LAM-ELISA is a field-adapted tool that can improve screening standards in countries with a high incidence of TB. (c) 2005 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd.