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首页> 外文期刊>Journal of Clinical Microbiology >High Coxiella burnetii DNA Load in Serum during Acute Q Fever Is Associated with Progression to a Serologic Profile Indicative of Chronic Q Fever
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High Coxiella burnetii DNA Load in Serum during Acute Q Fever Is Associated with Progression to a Serologic Profile Indicative of Chronic Q Fever

机译：急性Q发热期间血清中Coxiella Burnetii DNA的高负荷与进展为慢性Q发热的血清学指标相关

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PCR is very effective in diagnosing acute Q fever in the early stages of infection, when bacterial DNA is present in the bloodstream but antibodies have not yet developed. The objective of this study was to further analyze the diagnostic value of semiquantitative real-time PCR (qPCR) in diagnosing acute Q fever in an outbreak situation. At the Jeroen Bosch Hospital, in 2009, qPCR testing for Coxiella burnetii DNA was performed for 2,715 patients suspected of having acute Q fever (positive, n = 385; negative, n = 2,330). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the qPCR assay were calculated for patients with negative qPCR results with a follow-up sample obtained within 14 days (n = 305) and qPCR-positive patients with at least one follow-up sample (n = 369). The correctness of the qPCR result was based on immunofluorescence assay results for samples submitted for qPCR and follow-up testing. The sensitivity of the Q fever qPCR assay was 92.2%, specificity 98.9%, PPV 99.2%, and NPV 89.8%. Patients who later developed serologic profiles indicative of chronic Q fever infection had significantly higher C. burnetii DNA loads during the acute phase than did patients who did not (P < 0.001). qPCR testing is a valuable tool for the diagnosis of acute Q fever and should be used in outbreak situations when the onset of symptoms is <15 days earlier. Special attention is needed in the follow-up monitoring of patients with high C. burnetii DNA loads during the acute phase, as this might be an indicator for the development of a serologic profile indicative of chronic infection.
机译：当细菌DNA存在于血液中但尚未形成抗体时，PCR在感染的早期阶段对诊断急性Q发热非常有效。这项研究的目的是进一步分析半定量实时PCR（qPCR）在暴发情况下诊断急性Q发热的诊断价值。在Jeroen Bosch医院，2009年，对2,715名怀疑患有急性Q发热（阳性， n = 385;阴性， n ）的患者，进行了伯氏柯氏杆菌DNA的qPCR测试。 = 2,330）。对qPCR结果阴性的患者计算qPCR测定的敏感性，特异性，阳性预测值（PPV）和阴性预测值（NPV），并在14天内获得随访样本（ n = 305）和qPCR阳性患者，且至少有一个随访样本（ n = 369）。 qPCR结果的正确性基于提交给qPCR和后续测试的样品的免疫荧光分析结果。 Q发热qPCR测定的灵敏度为92.2％，特异性98.9％，PPV 99.2％和NPV 89.8％。后来表现出指示慢性Q热感染的血清学特征的患者在急性期的伯氏梭状芽胞杆菌DNA负载明显高于未感染的患者（ P <0.001）。 qPCR测试是诊断急性Q发热的有价值的工具，应在症状发作少于15天之前用于爆发情况。在急性期对高负荷的伯氏梭菌DNA负荷的患者进行随访监测时，需要特别注意，因为这可能是指示慢性感染的血清学特征发展的指标。

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