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首页> 外文期刊>Journal of Clinical Microbiology >Serology of Typhoid Fever in an Area of Endemicity and Its Relevance to Diagnosis
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Serology of Typhoid Fever in an Area of Endemicity and Its Relevance to Diagnosis

机译：地方性地区伤寒的血清学检测及其与诊断的关系

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Currently, the laboratory diagnosis of typhoid fever is dependent upon either the isolation of Salmonella enterica subsp.enterica serotype Typhi from a clinical sample or the detection of raised titers of agglutinating serum antibodies against the lipopolysaccharide (LPS) (O) or flagellum (H) antigens of serotype Typhi (the Widal test). In this study, the serum antibody responses to the LPS and flagellum antigens of serotype Typhi were investigated with individuals from a region of Vietnam in which typhoid is endemic, and their usefulness for the diagnosis of typhoid fever was evaluated. The antibody responses to both antigens were highly variable among individuals infected with serotype Typhi, and elevated antibody titers were also detected in a high proportion of serum samples from healthy subjects from the community. In-house enzyme-linked immunosorbent assays (ELISAs) for the detection of specific classes of anti-LPS and antiflagellum antibodies were compared with other serologically based tests for the diagnosis of typhoid fever (Widal TO and TH, anti-serotype Typhi immunoglobulin M [IgM] dipstick, and IDeaL TUBEX). At a specificity of ≥0.93, the sensitivities of the different tests were 0.75, 0.55, and 0.52 for the anti-LPS IgM, IgG, and IgA ELISAs, respectively; 0.28 for the antiflagellum IgG ELISA; 0.47 and 0.32 for the Widal TO and TH tests, respectively; and 0.77 for the anti-serotype Typhi IgM dipstick assay. The specificity of the IDeaL TUBEX was below 0.90 (sensitivity, 0.87; specificity, 0.76). The serological assays based on the detection of IgM antibodies against either serotype Typhi LPS (ELISA) or whole bacteria (dipstick) had a significantly higher sensitivity than the Widal TO test when used with a single acute-phase serum sample (P ≤ 0.007). These tests could be of use for the diagnosis of typhoid fever in patients who have clinical typhoid fever but are culture negative or in regions where bacterial culturing facilities are not available.
机译：目前，伤寒的实验室诊断取决于从临床样本中分离出肠炎沙门氏菌亚种肠型血清型Typhi或检测到凝集的血清抗体滴度升高抵抗血清型Typhi的脂多糖（LPS）（O）或鞭毛（H）抗原（维达尔试验）。在这项研究中，对来自伤寒地方病的越南地区的个体调查了血清型伤寒血清对LPS和鞭毛抗原的抗体反应，并评估了其在伤寒诊断中的有用性。在感染血清型鼠伤寒的个体中，对两种抗原的抗体反应高度可变，并且在社区中健康受试者的高比例血清样品中也检测到抗体滴度升高。将用于检测特定类别的抗LPS和抗鞭毛抗体的内部酶联免疫吸附测定（ELISA）与其他基于血清学的伤寒诊断方法进行了比较（Widal TO和TH，抗血清型Typhi免疫球蛋白M [ IgM]量油尺和IDeaL TUBEX）。在特异性≥≥0.93的情况下，不同测试对于抗LPS IgM，IgG和IgA ELISA的敏感性分别为0.75、0.55和0.52;抗鞭毛IgG ELISA为0.28; Widal TO和TH测试分别为0.47和0.32;抗血清型Typhi IgM试纸检测法为0.77。 IDeaL TUBEX的特异性低于0.90（敏感性0.87;特异性0.76）。当与单一急性期血清样品一起使用时，基于针对血清型伤寒LPS（ELISA）或全细菌（试纸）的IgM抗体检测的血清学检测方法的灵敏度明显高于Widal TO检测（ P < / em>≤0.007）。这些测试可用于诊断患有临床伤寒但培养阴性的患者或没有细菌培养设施的地区的伤寒。

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