1921
Volume 75, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

The aims of this study were to determine the diagnostic accuracy and clinical usefulness of using nested polymerase chain reaction (PCR) for the diagnosis of scrub typhus through a prospective comparison of nested PCR and indirect immunofluorescent antibody assay (IFA). We conducted a multi-center prospective study of patients who were suffering with possible scrub typhus infection. Whole blood samples were collected for PCR testing, and sera were obtained for serology evaluation using the indirect IFA and the passive hemagglutination assay (PHA). We prospectively studied 135 patients with possible scrub typhus. One hundred eighteen patients were confirmed as having scrub typhus, 7 patients were undetermined, and 10 patients were confirmed as having other diseases. The results of nested PCR assay showed a sensitivity of 82.2% and a specificity of 100%. Ninety-six of the 118 patients were positive for IgM on their admission day. Of the 22 patients who were negative for IgM antibody at admission, 19 had positive results for nested PCR of the buffy coat. The nested PCR assay of the buffy coat is useful as a rapid and reliable test for confirming the diagnosis of scrub typhus.

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2006-09-01
2017-11-22
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References

  1. Bozeman GW, Elisberg BL, 1963. Serological diagnosis of scrub typhus by indirect immunofluorescent. Proc Soc Exp Biol Med 112 : 568–573.
  2. Murai K, Tachibana N, Okayama A, Shishime E, Tsuda K, Oshikawa T, 1992. Sensitivity of polymerase chain reaction assay for Rickettsia tsutsugamushi in patients’ blood samples. Microbiol Immunol 36 : 1145–1153.
  3. Suto T, 1980. Rapid serologic diagnosis of tsutsugamushi disease employing the immunoperoxidase reaction with cell cultured rickettsia. Clin Virol 8 : 425–429.
  4. Furuya Y, Yoshida Y, Katayama T, Yamamoto S, Kawamura A Jr, 1993. Serotype-specific amplification of Rickettsia tsutsugamushi DNA by nested polymerase chain reaction. J Clin Microbiol 31 : 1637–1640.
  5. Manosroi J, Chutipongvivate S, Auwanit W, Manosroi A, 2003. Early diagnosis of scrub typhus in Thailand from clinical specimens by nested polymerase chain reaction. Southeast Asian J Trop Med Public Health 34 : 831–838.
  6. World Health Organization, 2004. WHO recommended surveillance standards. 2nd ed. Available at http://www.who.int/emc-documents/surveillance/docs/whocdscsrisr992.pdf. Accessed 19 June 2004.
  7. Kwok S, Higuchi R, 1989. Avoiding false positives with PCR. Nature 339 : 237–238.
  8. Robinson DM, Brown G, Gan E, Huxsoll DL, 1976. Adaptation of a microimmunofluorescent test to the study of human Rickettsia tsutsugamushi antibody. Am J Trop Med Hyg 25 : 900–905.
  9. Kim IS, Seong SY, Woo SG, Choi MS, Kang JS, Chang WH, 1993. Rapid diagnosis of scrub typhus by a passive hemagglutination assay using recombinant 56-kilodalton polypeptides. J Clin Microbiol 31 : 2057–2060.
  10. Silpapojakul K, Chupuppakarn S, Yuthasompob S, Varachit B, Chaipak D, Borkerd T, Silpapojakul K, 1991. Scrub and murine typhus in children with obscure fever in the tropics. Pediatr Infect Dis 10 : 200–203.
  11. Eiscenstein BI, 1990. The polymerase chain reaction. A new method of using molecular genetics for medical diagnosis. N Engl J Med 323 : 178–183.
  12. Kelly DJ, Wong PW, Gan E, Lewis GE Jr, 1988. Comparative evalusion of the indirect immunoperoxidase test for the serodiagnosis of rickettsial disease. Am J Trop Med Hyg 38 : 400–406.
  13. Kawamura A Jr, Tanaka H, Tamura A, 1995. Tsutsugamushi Disease. Tokyo: University of Tokyo Press.
  14. Hanson BA, 1983. Effect of immune serum on infectivity of Rickettsia tsutsugamushi. Infect Immun 42 : 341–349.
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  • Received : 26 Jan 2006
  • Accepted : 16 May 2006

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