دورية أكاديمية
Microbiological challenges in the diagnosis of chronic Q fever.
| العنوان: | Microbiological challenges in the diagnosis of chronic Q fever. |
|---|---|
| المؤلفون: | Kampschreur LM; Division of Medicine, Dept. of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht, the Netherlands. l.m.kampschreur@umcutrecht.nl, Oosterheert JJ, Koop AM, Wegdam-Blans MC, Delsing CE, Bleeker-Rovers CP, De Jager-Leclercq MG, Groot CA, Sprong T, Nabuurs-Franssen MH, Renders NH, van Kasteren ME, Soethoudt Y, Blank SN, Pronk MJ, Groenwold RH, Hoepelman AI, Wever PC |
| المصدر: | Clinical and vaccine immunology : CVI [Clin Vaccine Immunol] 2012 May; Vol. 19 (5), pp. 787-90. Date of Electronic Publication: 2012 Mar 21. |
| نوع المنشور: | Evaluation Study; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Society for Microbiology Country of Publication: United States NLM ID: 101252125 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1556-679X (Electronic) Linking ISSN: 1556679X NLM ISO Abbreviation: Clin Vaccine Immunol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Washington, D.C. : American Society for Microbiology, [2006]- |
| مواضيع طبية MeSH: | Antibodies, Bacterial/*blood , Clinical Laboratory Techniques/*methods , Coxiella burnetii/*immunology , Q Fever/*diagnosis, Adult ; Aged ; Aged, 80 and over ; Coxiella burnetii/genetics ; Coxiella burnetii/isolation & purification ; DNA, Bacterial/blood ; Female ; Humans ; Immunoglobulin G/blood ; Male ; Middle Aged ; Polymerase Chain Reaction ; Predictive Value of Tests ; Sensitivity and Specificity |
| مستخلص: | Diagnosis of chronic Q fever is difficult. PCR and culture lack sensitivity; hence, diagnosis relies mainly on serologic tests using an immunofluorescence assay (IFA). Optimal phase I IgG cutoff titers are debated but are estimated to be between 1:800 and 1:1,600. In patients with proven, probable, or possible chronic Q fever, we studied phase I IgG antibody titers at the time of positive blood PCR, at diagnosis, and at peak levels during chronic Q fever. We evaluated 200 patients, of whom 93 (46.5%) had proven, 51 (25.5%) had probable, and 56 (28.0%) had possible chronic Q fever. Sixty-five percent of proven cases had positive Coxiella burnetii PCR results for blood, which was associated with high phase I IgG. Median phase I IgG titers at diagnosis and peak titers in patients with proven chronic Q fever were significantly higher than those for patients with probable and possible chronic Q fever. The positive predictive values for proven chronic Q fever, compared to possible chronic Q fever, at titers 1:1,024, 1:2,048, 1:4,096, and ≥1:8,192 were 62.2%, 66.7%, 76.5%, and ≥86.2%, respectively. However, sensitivity dropped to <60% when cutoff titers of ≥1:8,192 were used. Although our study demonstrated a strong association between high phase I IgG titers and proven chronic Q fever, increasing the current diagnostic phase I IgG cutoff to >1:1,024 is not recommended due to increased false-negative findings (sensitivity < 60%) and the high morbidity and mortality of untreated chronic Q fever. Our study emphasizes that serologic results are not diagnostic on their own but should always be interpreted in combination with clinical parameters. |
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| المشرفين على المادة: | 0 (Antibodies, Bacterial) 0 (DNA, Bacterial) 0 (Immunoglobulin G) |
| تواريخ الأحداث: | Date Created: 20120324 Date Completed: 20120815 Latest Revision: 20211021 |
| رمز التحديث: | 20240829 |
| مُعرف محوري في PubMed: | PMC3346333 |
| DOI: | 10.1128/CVI.05724-11 |
| PMID: | 22441385 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1556-679X |
|---|---|
| DOI: | 10.1128/CVI.05724-11 |