Volume 90, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Reliable laboratory testing is of great importance to detect infection. We evaluated the sensitivity and specificity of the enzyme-linked immunosorbent assay (ELISA) using recombinant protein Pap31 (rPap31) for the detection of antibodies against as compared with immunofluorescent assay (IFA). Of the 302 sera collected between 1997 and 2000 among an at-risk Peruvian population, 103 and 34 samples tested positive for IFA-immunoglobulin G (IgG) and IFA-IgM, respectively. By using Youden's index, the cutoff values of ELISA-IgG at 0.915 gave a sensitivity of 84.5% and specificity of 94%. The cutoff values of ELISA-IgM at 0.634 gave a sensitivity of 88.2% and specificity of 85.1%. Using latent class analysis, estimates of sensitivity and specificity of almost all the assays were slightly higher than those of a conventional method of calculation. The test is proved beneficial for discriminating between infected and non-infected individuals with the advantage of low-cost and high-throughput capability.


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  1. Maguina C, Gotuzzo E, , 2000. Bartonellosis. New and old. Infect Dis Clin North Am 14: 122 vii.[Crossref]
  2. Lydy SL, Eremeeva ME, Asnis D, Paddock CD, Nicholson WL, Silverman DJ, Dasch GA, , 2008. Isolation and characterization of Bartonella bacilliformis from an expatriate Ecuadorian. J Clin Microbiol 46: 627637.[Crossref]
  3. Huarcaya E, Maguina C, Torres R, Rupay J, Fuentes L, , 2004. Bartonelosis (Carrion's Disease) in the pediatric population of Peru: an overview and update. Braz J Infect Dis 8: 331339.[Crossref]
  4. Kosek M, Lavarello R, Gilman RH, Delgado J, Maguina C, Verastegui M, Lescano AG, Mallqui V, Kosek JC, Recavarren S, Cabrera L, , 2000. Natural history of infection with Bartonella bacilliformis in a nonendemic population. J Infect Dis 182: 865872.[Crossref]
  5. Gray GC, Johnson AA, Thornton SA, Smith WA, Knobloch J, Kelley PW, Obregon Escudero L, Arones Huayda M, Wignall FS, , 1990. An epidemic of Oroya fever in the Peruvian Andes. Am J Trop Med Hyg 42: 215221.
  6. Maguina C, Garcia PJ, Gotuzzo E, Cordero L, Spach DH, , 2001. Bartonellosis (Carrion's disease) in the modern era. Clin Infect Dis 33: 772779.[Crossref]
  7. Birtles RJ, Fry NK, Ventosilla P, Caceres AG, Sanchez E, Vizcarra H, Raoult D, , 2002. Identification of Bartonella bacilliformis genotypes and their relevance to epidemiological investigations of human bartonellosis. J Clin Microbiol 40: 36063612.[Crossref]
  8. Chamberlin J, Laughlin LW, Romero S, Solorzano N, Gordon S, Andre RG, Pachas P, Friedman H, Ponce C, Watts D, , 2002. Epidemiology of endemic Bartonella bacilliformis: a prospective cohort study in a Peruvian mountain valley community. J Infect Dis 186: 983990.[Crossref]
  9. Ellis BA, Rotz LD, Leake JA, Samalvides F, Bernable J, Ventura G, Padilla C, Villaseca P, Beati L, Regnery R, Childs JE, Olson JG, Carrillo CP, , 1999. An outbreak of acute bartonellosis (Oroya fever) in the Urubamba region of Peru, 1998. Am J Trop Med Hyg 61: 344349.
  10. Sanchez Clemente N, Ugarte-Gil CA, Solorzano N, Maguina C, Pachas P, Blazes D, Bailey R, Mabey D, Moore D, , 2012. Bartonella bacilliformis: a systematic review of the literature to guide the research agenda for elimination. PLoS Negl Trop Dis 6: e1819.[Crossref]
  11. Knobloch J, Solano L, Alvarez O, Delgado E, , 1985. Antibodies to Bartonella bacilliformis as determined by fluorescence antibody test, indirect hemagglutination and ELISA. Trop Med Parasitol 36: 183185.
  12. Chamberlin J, Laughlin L, Gordon S, Romero S, Solorzano N, Regnery RL, , 2000. Serodiagnosis of Bartonella bacilliformis infection by indirect fluorescence antibody assay: test development and application to a population in an area of bartonellosis endemicity. J Clin Microbiol 38: 42694271.
  13. Knobloch J, , 1988. Analysis and preparation of Bartonella bacilliformis antigens. Am J Trop Med Hyg 39: 173178.
  14. La Scola B, Raoult D, , 1996. Serological cross-reactions between Bartonella quintana, Bartonella henselae, and Coxiella burnetii . J Clin Microbiol 34: 22702274.
  15. Taye A, Chen H, Duncan K, Zhang Z, Hendrix L, Gonzalez J, Ching W, , 2005. Production of recombinant protein Pap31 and its application for the diagnosis of Bartonella bacilliformis infection. Ann N Y Acad Sci 1063: 280285.[Crossref]
  16. Dabo SM, Confer AW, Anderson BE, Gupta S, , 2006. Bartonella henselae Pap31, an extracellular matrix adhesin, binds the fibronectin repeat III13 module. Infect Immun 74: 25132521.[Crossref]
  17. Amano Y, Rumbea J, Knobloch J, Olson J, Kron M, , 1997. Bartonellosis in Ecuador: serosurvey and current status of cutaneous verrucous disease. Am J Trop Med Hyg 57: 174179.
  18. Kumar R, Indrayan A, , 2011. Receiver operating characteristic (ROC) curve for medical researchers. Indian Pediatr 48: 277287.[Crossref]
  19. Grimes DA, Schulz KF, , 2005. Refining clinical diagnosis with likelihood ratios. Lancet 365: 15001505.[Crossref]
  20. Linzer D, Lewis J, , 2013. poLCA: Polytomous Variable Latent Class Analysis. R package version 1.4.
  21. Beath K, , 2013. randomLCA: Random effects latent class analysis. R package version 0.8–6.
  22. Sim J, Wright CC, , 2005. The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther 85: 257268.
  23. Knobloch J, Schreiber M, , 1990. Bb65, a major immunoreactive protein of Bartonella bacilliformis . Am J Trop Med Hyg 43: 373379.
  24. Mallqui V, Speelmon EC, Verastegui M, Maguina-Vargas C, Pinell-Salles P, Lavarello R, Delgado J, Kosek M, Romero S, Arana Y, Gilman RH, , 2000. Sonicated diagnostic immunoblot for bartonellosis. Clin Diagn Lab Immunol 7: 15.
  25. Sander A, Berner R, Ruess M, , 2001. Serodiagnosis of cat scratch disease: response to Bartonella henselae in children and a review of diagnostic methods. Eur J Clin Microbiol Infect Dis 20: 392401.[Crossref]
  26. Lencakova D, Fingerle V, Stefancikova A, Schulte-Spechtel U, Petko B, Schreter I, Wilske B, , 2008. Evaluation of recombinant line immunoblot for detection of Lyme disease in Slovakia: comparison with two other immunoassays. Vector Borne Zoonotic Dis 8: 381390.[Crossref]
  27. Reed KD, , 2002. Laboratory testing for Lyme disease: possibilities and practicalities. J Clin Microbiol 40: 319324.[Crossref]
  28. Edkins TJ, Koller-Eichhorn R, Alhadeff JA, Mayer U, Faust H, Del Tito BJ, , 2012. Assessment of potential cross-reactivity of human endogenous matrix metalloproteinases with collagenase Clostridium histolyticum antibodies in human sera obtained from patients with Dupuytren's contracture. Clin Vaccine Immunol 19: 562569.[Crossref]
  29. Anderson B, Lu E, Jones D, Regnery R, , 1995. Characterization of a 17-kilodalton antigen of Bartonella henselae reactive with sera from patients with cat scratch disease. J Clin Microbiol 33: 23582365.

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  • Received : 13 Mar 2013
  • Accepted : 08 Nov 2013

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