Evaluation of a commercial enzyme-linked immunosorbent assay for detection of immunoglobulin M antibody in diagnosis of human leptospiral infection

被引:87
作者
Winslow, WE
Merry, DJ
Pirc, ML
Devine, PL
机构
[1] UNIV QUEENSLAND,ROYAL BRISBANE HOSP,HERSTON,QLD 4029,AUSTRALIA
[2] INST MED & VET SCI,DIV CLIN MICROBIOL,ADELAIDE,SA 5000,AUSTRALIA
关键词
D O I
10.1128/JCM.35.8.1938-1942.1997
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
The PanBio Leptospira immunoglobulin M (IgM) enzyme-linked immunosorbent ass;lv (ELISA) is a commercially available screening test for the diagnosis of acute leptospiral infection, The ability of the test to diagnose early; or recent Leptospira interrogans infection was assessed by testing sera with known microagglutination test (MAT) titers to serovars pomona, hardjo, copenhageni, and australis, The IgM ELISA detected all 41 cases of early or recent leptospiral infection (sensitivity, 100%), with a positive ELISA result seen in many cases before MAT antibody titers reached 1:50. Thirty-eight oi 41 patients showed seroconversion (fourfold or greater increase in titer by MAT, 2 of 41 patients had a single sample with elevated titer, and 1 patient from whom leptospires were isolated from a blood sample failed to show MAT titers, despite a seroconversion (negative to positive result) in the ELISA, Follow-up sera obtained from 8 of 12 patients (67%) for 3 to 45 months after the acute stage of illness showed persisting IgM antibody, However, the range of levels detected in these samples (maximum ELISA ratio, 2.0) was lower than the! range seen when infection mas recent, Reactivity in the IgM ELISA was observed for only 1 of 59 serum samples from asymptomatic donors (specificity, 98%) and 16 of 233 serum samples from patients with Ross River virus, brucella, Epstein-Barr virus, cytomegalovirus, mycoplasma, Q-fever, toxoplasma, hepatitis A virus, Treponema pallidum, or Borrelia burgdorferi infection (specificity, 93%), with the majority of these patients showing lower levels of IgM in comparison to those in patients with leptospiral infection. We conclude that this ELISA is sufficiently sensitive for use as an initial screen for leptospiral infections, with subsequent confirmation of positive test results by MAT.
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页码:1938 / 1942
页数:5
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