쯔쯔가무시병의 진단에 사용되는 피동혈구응집법과 간접면역형광법의 비교 연구 = Comparison of Passive Hemagglutination and Indirect Immunofluorescence Assay for the Diagnosis of Scrub typhus

다국어 초록 (Multilingual Abstract)

The gold standard for the serologic detection of scrub typhus is the indirect immunofluorescence assay (IFA), however the passive hemagglutination assay (PHA) is commonly used method in Korea because of its availability, easy handling. We compared the sensitivity of PHA and IFA to compare their effectiveness in diagnosing scrub typhus. Out of 35 patients who were eventually diagnosed of scrub typhus by positive IFA, 19 patients (54%) were also tested positive for PHA during the acute phase (titer=1:80). Whereas 30 patients (85%) were positive in IFA during the acute phase. During the recovery phase 30 (85%) patients were positive in PHA, whereas all patients were found to be positive in IFA. Patients with 4-fold or greater rise of antibody were 12 (34.3%) in PHA, and 19 (54.3%) in IFA. We note that IFA has better sensitivity over PHA in detecting scrub typhus.

참고문헌 (Reference)

1 Kim DM, "Usefulness of nested PCR for the diagnosis of scrub typhus in clinical practice: A prospective study" 75 : 542-545, 2006

2 Thap LC, "Septic shock secondary to scrub typhus: characteristics and complications" 33 : 780-786, 2002

3 Blacksell SD, "Scrub typhus serologic testing with the indirect immunofluorescence method as a diagnostic gold standard: a lack of consensus leads to a lot of confusion" 44 : 391-401, 2007

4 Silpapojakul K, "Scrub and murine typhus in children with obscure fever in the tropics" 10 : 200-203, 1991

5 Kim IS, "Rapid diagnosis of scrub typhus by a passive hemagglutination assay using recombinant 56-kilodalton polypeptides" 31 : 2057-2060, 1993

6 Cracco C, "Multiple organ failure complicating probable scrub typhus" 31 : 191-192, 2000

7 Kim IS, "Molecular Cloning of the Major Immunogen of Orientia tsutsugamushi Thai Strains and Development Passive Hemagglutination Test" 32 : 405-414, 1997

8 Kim BN, "Association between Location of Eschar and Clothing in Scrub Typhus" 38 : 389-393, 2006

9 Robinson DM, "Adaptation of a microimmunofluorescence test to the study of human Rickettsia tsutsugamuskh antibody" 25 : 900-905, 1976

10 Wang CC, "Acute respiratory distress syndrome in scrub typhus" 76 : 1148-1152, 2007

11 Kuroda T, "A case of scrub typhus with disseminated intravascular coagulation, meningitis and pulmonary fibrosis" 80 : 1816-1817, 1991

12 Lee CS, "A case of scrub typhus manifested with acute respiratory distress syndrome" 57 : 216-219, 1999