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首页> 外文期刊>Clinical and diagnostic laboratory immunology >Field evaluation of an immunoglobulin G anti-F1 enzyme-linked immunosorbent assay for serodiagnosis of human plague in Madagascar.
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Field evaluation of an immunoglobulin G anti-F1 enzyme-linked immunosorbent assay for serodiagnosis of human plague in Madagascar.

机译：在马达加斯加对人鼠疫进行血清诊断的免疫球蛋白G抗F1酶联免疫吸附试验的现场评估。

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Bacteriological isolation of Yersinia pestis is the reference test for confirming plague infection, but recovery of the pathogen from human samples is usually very poor. When the etiology of the disease cannot be bacteriologically confirmed, it may be useful to possess alternative tests such as detection of specific circulating antibodies to help guide the diagnosis. In the present study, the immunoglobulin G (IgG) anti-F1 enzyme-linked immunosorbent assay (ELISA) has been applied to various human sera to evaluate its large-scale applicability in the high-endemicity plague foci of Madagascar. The sensitivity of the test was found to be 91.4%, and its specificity was 98.5%. The positive and negative predictive values were 96 and 96.6%, respectively. Seroconversion was observed on day 7 after onset of the disease. Patients with a positive ELISA result could be separated into high (82%) and low (18%) IgG anti-F1 responders. Cross-reactions with eight other infectious diseases prevalent in Madagascar were scarce and were found in 1 of 27 Mycobacterium tuberculosis-, 3 of 34 Schistosoma haematobium-, and 1 of 41 Salmonella-infected patients. Finally, the efficiency of the IgG anti-F1 ELISA was evaluated during the Mahajanga, Madagascar, plague outbreak of 1995. When the number of ELISA-positive patients was added to the number of bacteriologically confirmed and probable cases, the number of positive patients was increased by 35%. In conclusion, although it does not replace bacteriology, IgG anti-F1 ELISA is a useful and powerful tool for retrospective diagnosis and epidemiological surveillance of plague outbreaks.
机译：鼠疫耶尔森氏菌的细菌学分离是确认鼠疫感染的参考测试，但从人类样品中回收病原体通常非常困难。当无法通过细菌学确认疾病的病因时，拥有其他检测方法（例如检测特定的循环抗体）可能有助于指导诊断。在本研究中，免疫球蛋白G（IgG）抗F1酶联免疫吸附测定（ELISA）已应用于各种人类血清，以评估其在马达加斯加的高流行鼠疫病灶中的大规模适用性。发现该测试的灵敏度为91.4％，并且其特异性为98.5％。阳性和阴性预测值分别为96和96.6％。在疾病发作后第7天观察到血清转化。 ELISA结果呈阳性的患者可分为高（82％）和低（18％）IgG抗F1应答者。与马达加斯加流行的其他八种传染病的交叉反应稀少，发现于27例结核分枝杆菌中的1例，34例血吸虫血吸虫中的3例和41例沙门氏菌感染的患者中。最后，在1995年马达加斯加马哈詹加（Mahajanga），马达加斯加（Madagascar）鼠疫暴发期间评估了IgG抗F1 ELISA的效率。当将ELISA阳性患者的数量加上细菌学确诊和可能的病例数量时，阳性患者的数量为增加了35％。总而言之，尽管IgG抗F1 ELISA不能代替细菌学，但它是鼠疫暴发的回顾性诊断和流行病学监测的有用而强大的工具。

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