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Early diagnosis of scrub typhus with a rapid flow assay using recombinant major outer membrane protein antigen (r56) of Orientia tsutsugamushi.
Clin Diagn Lab Immunol. 2001 Mar; 8(2):409-14.CD

Abstract

The variable 56-kDa major outer membrane protein of Orientia tsutsugamushi is the immunodominant antigen in human scrub typhus infections. We developed a rapid immunochromatographic flow assay (RFA) for the detection of immunoglobulin M (IgM) and IgG antibodies to O. tsutsugamushi. The RFA employs a truncated recombinant 56-kDa protein from the Karp strain as the antigen. The performance of the RFA was evaluated with a panel of 321 sera (serial bleedings of 85 individuals suspected of scrub typhus) which were collected in the Pescadore Islands, Taiwan, from 1976 to 1977. Among these 85 individuals, IgM tests were negative for 7 cases by both RFA and indirect fluorescence assay (IFA) using Karp whole-cell antigen. In 29 cases specific responses were detected by the RFA earlier than by IFA, 44 cases had the same detection time, and 5 cases were detected earlier by IFA than by RFA. For IgG responses, 4 individuals were negative with both methods, 37 cases exhibited earlier detection by RFA than IFA, 42 cases were detected at the same time, and 2 cases were detected earlier by IFA than by RFA. The sensitivities of RFA detection of antibody in sera from confirmed cases were 74 and 86% for IgM and IgG, respectively. When IgM and IgG results were combined, the sensitivity was 89%. A panel of 78 individual sera collected from patients with no evidence of scrub typhus was used to evaluate the specificity of the RFA. The specificities of the RFA were 99% for IgM and 97% for IgG. The sensitivities of IFA were 53 and 73% for IgM and IgG, respectively, and were 78% when the results of IgM and IgG were combined. The RFA test was significantly better than the IFA test for the early detection of antibody to scrub typhus in primary infections, while both tests were equally sensitive with reinfected individuals.

Authors+Show Affiliations

Viral and Ricksettial Diseases Department, Infectious Diseases Directorate, Code 41, Naval Medical Research Center, Bethesda, Maryland, USA. Chingw@nmrc.navy.milNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

11238230

Citation

Ching, W M., et al. "Early Diagnosis of Scrub Typhus With a Rapid Flow Assay Using Recombinant Major Outer Membrane Protein Antigen (r56) of Orientia Tsutsugamushi." Clinical and Diagnostic Laboratory Immunology, vol. 8, no. 2, 2001, pp. 409-14.
Ching WM, Rowland D, Zhang Z, et al. Early diagnosis of scrub typhus with a rapid flow assay using recombinant major outer membrane protein antigen (r56) of Orientia tsutsugamushi. Clin Diagn Lab Immunol. 2001;8(2):409-14.
Ching, W. M., Rowland, D., Zhang, Z., Bourgeois, A. L., Kelly, D., Dasch, G. A., & Devine, P. L. (2001). Early diagnosis of scrub typhus with a rapid flow assay using recombinant major outer membrane protein antigen (r56) of Orientia tsutsugamushi. Clinical and Diagnostic Laboratory Immunology, 8(2), 409-14.
Ching WM, et al. Early Diagnosis of Scrub Typhus With a Rapid Flow Assay Using Recombinant Major Outer Membrane Protein Antigen (r56) of Orientia Tsutsugamushi. Clin Diagn Lab Immunol. 2001;8(2):409-14. PubMed PMID: 11238230.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early diagnosis of scrub typhus with a rapid flow assay using recombinant major outer membrane protein antigen (r56) of Orientia tsutsugamushi. AU - Ching,W M, AU - Rowland,D, AU - Zhang,Z, AU - Bourgeois,A L, AU - Kelly,D, AU - Dasch,G A, AU - Devine,P L, PY - 2001/3/10/pubmed PY - 2001/6/19/medline PY - 2001/3/10/entrez SP - 409 EP - 14 JF - Clinical and diagnostic laboratory immunology JO - Clin Diagn Lab Immunol VL - 8 IS - 2 N2 - The variable 56-kDa major outer membrane protein of Orientia tsutsugamushi is the immunodominant antigen in human scrub typhus infections. We developed a rapid immunochromatographic flow assay (RFA) for the detection of immunoglobulin M (IgM) and IgG antibodies to O. tsutsugamushi. The RFA employs a truncated recombinant 56-kDa protein from the Karp strain as the antigen. The performance of the RFA was evaluated with a panel of 321 sera (serial bleedings of 85 individuals suspected of scrub typhus) which were collected in the Pescadore Islands, Taiwan, from 1976 to 1977. Among these 85 individuals, IgM tests were negative for 7 cases by both RFA and indirect fluorescence assay (IFA) using Karp whole-cell antigen. In 29 cases specific responses were detected by the RFA earlier than by IFA, 44 cases had the same detection time, and 5 cases were detected earlier by IFA than by RFA. For IgG responses, 4 individuals were negative with both methods, 37 cases exhibited earlier detection by RFA than IFA, 42 cases were detected at the same time, and 2 cases were detected earlier by IFA than by RFA. The sensitivities of RFA detection of antibody in sera from confirmed cases were 74 and 86% for IgM and IgG, respectively. When IgM and IgG results were combined, the sensitivity was 89%. A panel of 78 individual sera collected from patients with no evidence of scrub typhus was used to evaluate the specificity of the RFA. The specificities of the RFA were 99% for IgM and 97% for IgG. The sensitivities of IFA were 53 and 73% for IgM and IgG, respectively, and were 78% when the results of IgM and IgG were combined. The RFA test was significantly better than the IFA test for the early detection of antibody to scrub typhus in primary infections, while both tests were equally sensitive with reinfected individuals. SN - 1071-412X UR - https://www.unboundmedicine.com/medline/citation/11238230/Early_diagnosis_of_scrub_typhus_with_a_rapid_flow_assay_using_recombinant_major_outer_membrane_protein_antigen__r56__of_Orientia_tsutsugamushi_ DB - PRIME DP - Unbound Medicine ER -