Use of Peptide-Based Enzyme-Linked Immunosorbent Assay followed by Immunofluorescence Assay To Document Ehrlichia chaffeensis as a Cause of Febrile Illness in Nicaragua.

Chikeka, Ijeuru; Matute, Armando J; Dumler, J Stephen; Woods, Christopher W; Mayorga, Orlando; Reller, Megan E

Chikeka, Ijeuru; Matute, Armando J; Dumler, J Stephen; Woods, Christopher W; Mayorga, Orlando; Reller, Megan E.

Afiliação

Chikeka I; Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Matute AJ; Hospital Escuela Oscar Danilo Rosales Arguello, Universidad Nacional Autonoma de Nicaragua, León, Nicaragua.
Dumler JS; Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA john.dumler@usuhs.edu mreller1@jhmi.edu.
Woods CW; Hubert-Yeargan Center for Global Health, Duke University School of Medicine, Durham, North Carolina, USA.
Mayorga O; Division of Infectious Diseases and International Health, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
Reller ME; Hospital Escuela Oscar Danilo Rosales Arguello, Universidad Nacional Autonoma de Nicaragua, León, Nicaragua.

J Clin Microbiol ; 54(6): 1581-1585, 2016 06.

Article em En | MEDLINE | ID: mdl-27053675

RESUMO

Ehrlichia chaffeensis, the etiologic agent of human monocytic ehrlichiosis (HME), has been extensively studied as a cause of acute febrile illness and an emerging tick-borne zoonosis in the United States. Limited data suggest its presence in other regions, including Central and South America but not Nicaragua to date. Diagnosis of E. chaffeensis infection by indirect immunofluorescence assay (IFA) is the reference standard due to its presumed high sensitivity and specificity, but IFA is impractical, variably reproducible, and cumbersome for large epidemiologic studies and for clinical diagnosis in resource-poor regions. We evaluated a high-throughput, objective peptide-based enzyme-linked immunosorbent assay (ELISA) for use alone or in combination with IFA. We found that it performed best as a screening test (sensitivity, 100%; specificity, 84%) to reduce the proportion of serum samples that were required by the more cumbersome and subjective IFA testing to <20%. Using a two-step diagnostic approach (IFA is performed if the ELISA is positive), we identified E. chaffeensis or a serologically and antigenically similar organism as a heretofore unrecognized cause of acute febrile illness in humans in Nicaragua and demonstrated the utility of the peptide ELISA as a screening tool for large-scale clinical studies.

Assuntos

Anticorpos Antibacterianos/sangue; Ehrlichia chaffeensis/imunologia; Ehrlichiose/diagnóstico; Ensaio de Imunoadsorção Enzimática/métodos; Técnica Indireta de Fluorescência para Anticorpo/métodos; Doenças Transmitidas por Carrapatos/diagnóstico; Adolescente; Adulto; Idoso; Idoso de 80 Anos ou mais; Criança; Pré-Escolar; Estudos de Coortes; Feminino; Humanos; Lactente; Masculino; Pessoa de Meia-Idade; Nicarágua; Sensibilidade e Especificidade; Adulto Jovem

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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ensaio de Imunoadsorção Enzimática / Ehrlichiose / Doenças Transmitidas por Carrapatos / Ehrlichia chaffeensis / Técnica Indireta de Fluorescência para Anticorpo / Anticorpos Antibacterianos Tipo de estudo: Diagnostic_studies / Etiology_studies / Evaluation_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Aged80 / Child / Child, preschool / Female / Humans / Infant / Male País/Região como assunto: America central / Nicaragua Idioma: En Revista: J Clin Microbiol Ano de publicação: 2016 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos

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