背景:网虫线虫病是由被忽视的线虫引起的,表现为慢性肠道感染,有潜在的严重表现。这种疾病在非流行国家是一个新出现的问题,影响旅行者和移民。缺乏标准化和缺乏黄金标准,阻碍了对圆线虫病的诊断。由于检测粪便样本中活动幼虫的直接方法尚不广泛,已经开发了其他技术,如血清学。
方法:我们评估了三种商业ELISA试剂盒(DRGInstruments,IVD研究,和BordierAffinityProducts),以利用显微镜证实的圆线虫病(n=50)和其他输入性蠕虫感染(n=159)以及健康对照(n=50)的旅行者的血清样本来检测抗骨圆线虫的IgG抗体。
结果:DRG,IVD,Bordier检测显示灵敏度为58.0%,64.0%,和56.0%,分别。特异性值为96.0%,96.0%,健康对照组为92.0%,和67.3%,62.9%,其他蠕虫感染病例占76.7%,分别。在与其他线虫的病例中主要观察到交叉反应(37.5%,42.5%,和20.0%,分别),而且在吸虫中(33.3%,38.1%,和19.0%,分别)和在c虫感染中(25.0%,30.0%,32.5%,分别)。
结论:该研究表明,在返回的旅行者中检测或排除线圆线虫病的血清学检测的诊断局限性,经常出现近期或急性感染的人。
BACKGROUND: Strongyloidiasis is caused by a neglected nematode, manifesting as chronic intestinal infection with potentially severe manifestations. The disease is an emerging problem in non-endemic countries affecting travelers and migrants. Diagnosis of
strongyloidiasis is hampered by the lack of standardization and absence of a gold standard. Since adequate direct methods to detect the motile larvae in stool samples are not widely available, other techniques such as serology have been developed.
METHODS: We evaluated three commercial ELISA kits (DRG Instruments, IVD Research, and Bordier Affinity Products) to detect IgG antibodies against Strongyloides stercoralis assays utilizing serum samples from travelers with microscopically confirmed
strongyloidiasis (n = 50) and other imported helminthic infections (n = 159) as well as healthy controls (n = 50).
RESULTS: The DRG, IVD, and Bordier assays showed sensitivities of 58.0%, 64.0%, and 56.0%, respectively. Specificity values were 96.0%, 96.0%, and 92.0% in healthy controls, and 67.3%, 62.9%, and 76.7% in cases with other helminth infections, respectively. Cross-reactions were mostly observed in cases with other nematodes (37.5%, 42.5%, and 20.0%, respectively), but also in trematode (33.3%, 38.1%, and 19.0%, respectively) and in cestode infections (25.0%, 30.0%, and 32.5%, respectively).
CONCLUSIONS: The study demonstrates the diagnostic limitations of serological assays to detect or exclude cases of
strongyloidiasis in returning travelers, who frequently present with recent or acute infections.