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首页> 美国卫生研究院文献>Journal of Clinical Microbiology >Sensitivities and Specificities of Premier E. coli O157 and Premier EHEC Enzyme Immunoassays for Diagnosis of Infection with Verotoxin (Shiga-Like Toxin)-Producing Escherichia coli
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Sensitivities and Specificities of Premier E. coli O157 and Premier EHEC Enzyme Immunoassays for Diagnosis of Infection with Verotoxin (Shiga-Like Toxin)-Producing Escherichia coli

机译：特异大肠杆菌O157和特异EHEC酶免疫法对产Verotoxin（志贺样毒素）大肠杆菌感染的诊断的敏感性和特异性

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This study describes the performance of two rapid enzyme immunoassays, Premier E. coli O157 and Premier EHEC (Meridian Diagnostics Inc., Cincinnati, Ohio) for the detection in stools of Escherichia coli O157 and verotoxins (Shiga-like toxins), respectively. Both tests were performed on stools from 876 children presenting to eight emergency departments with diarrhea. Standard culture, including E. coli O157:H7 isolation, was performed, and paired sera were taken for anti-O157-lipopolysaccharide antibody determination. Stools from patients enrolled in the study, and those yielding discordant results, were sent to a reference laboratory for repeat testing and further investigation, including cytotoxicity and non-O157 verotoxin-producing E. coli culture. Results were classified as field results (obtained in the eight site laboratories) and resolved results (obtained after repeat testing in the central laboratory). The “gold standard” for sensitivity of both tests and for specificity of Premier E. coli O157 was isolation of E. coli O157:H7 or a fourfold anti-O157 antibody rise. Specimens positive by the Premier EHEC test and negative for E. coli O157 culture were examined for non-O157 verotoxin-producing E. coli. The field sensitivity of Premier E. coli O157 was 86%, that of Premier EHEC was 89%, and the specificity of Premier E. coli O157 was 98%. Ten of 13 discordant Premier E. coli O157 results were reassigned as true results after repeat testing. Ten non-O157 verotoxin-producing E. coli isolates were recovered from Premier EHEC-positive, E. coli O157 culture-negative stools. Only one specimen gave an unequivocally false-positive Premier EHEC result. Both tests are highly sensitive and are specific if correctly performed. The Premier EHEC test will be particularly valuable as a practical routine test for the detection of non-O157 verotoxin-producing E. coli.
机译：这项研究描述了两种快速酶免疫测定法，分别是Premier O. coli O157和Premier EHEC（Meridian Diagnostics Inc.，俄亥俄州辛辛那提，俄亥俄州）的检测粪便中大肠杆菌O157和Verotoxins毒素（志贺样毒素）的性能。两项测试都是在876名儿童的粪便上进行的，这些儿童出现在八个急诊科的腹泻中。进行包括大肠杆菌O157：H7分离在内的标准培养，并获取配对血清用于抗O157-脂多糖抗体测定。来自研究的患者的粪便和那些产生不一致结果的粪便被送到参考实验室进行重复测试和进一步研究，包括细胞毒性和非O157产生Verotoxin的大肠杆菌培养物。结果分为现场结果（在八个站点实验室中获得）和分辨的结果（在中央实验室中重复测试后获得）。两项测试的敏感性和Premier E. coli O157的特异性的“金标准”是大肠杆菌O157：H7的分离或四倍抗O157抗体的升高。通过Premier EHEC测试呈阳性的样本和大肠杆菌O157培养阴性的样本被检查是否产生非O157毒素的大肠杆菌。 Premier E. coli O157的田间敏感性为86％，Premier EHEC的田间敏感性为89％，Premier E. coli O157的特异性为98％。在重复测试后，将13个不一致的Premier E. coli O157结果中的10个重新分配为真实结果。从Premier EHEC阳性，大肠杆菌O157培养阴性的粪便中回收了十种不产生Vero毒素的大肠杆菌分离物。只有一个标本明确给出了假阳性的Premier EHEC结果。两种测试都是高度敏感的，如果正确执行，它们是特定的。 Premier EHEC测试作为一种实用的常规测试，对于检测不产生O157毒素的大肠杆菌特别有价值。

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