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Chapter 11.7 : Serodiagnosis of Rickettsial Infections

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Abstract:

Rickettsial diseases in humans result from infection with bacteria of the families and . The family includes the genera and , both of which infect endothelial cells and thereby cause vasculitis. spp. share lipopolysaccharides and outer membrane protein B (OmpB); however, spotted fever group (SFG) rickettsiae also possess outer membrane protein A (OmpA), whereas typhus group (TG) rickettsiae do not. Since serologic cross-reactivity between groups is common but antibody titers are generally higher within the specific group, distinction between SFG and TG rickettsiae requires paired testing and is not always possible. The family includes , which infects monocytes and mononuclear phagocytes, and (formerly , , and the HGA agent) and , which infect granulocytes. Serologic cross-reactions occur often (3 to 30%) with and , as they do with , and differentiation requires comparison of specific antibody titers.

Citation: Garcia L. 2010. Serodiagnosis of Rickettsial Infections, p 183-193. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch11.7
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References

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1. Clements, M. L.,, J. S. Dumler,, P. Fiset,, C. L. Wisseman, Jr.,, M. J. Snyder,, and M. M. Levine. 1983. Serodiagnosis of Rocky Mountain spotted fever: comparison of IgM and IgG enzyme-linked immunosorbent assays and indirect fluorescent antibody test. J. Infect. Dis. 148:876880.
2. Jang, W. J.,, M. S. Huh,, K. H. Park,, M. S. Choi,, and I. S. Kim. 2003. Evaluation of an immunoglobulin M capture enzyme-linked immunosorbent assay for diagnosis of Orientia tsutsugamushi infection. Clin. Diagn. Lab. Immunol. 10:394398.
3. Keysary, A.,, and C. Strenger. 1997. Use of enzyme-linked immunosorbent assay techniques with cross-reacting human sera in diagnosis of murine typhus and spotted fever. J. Clin. Microbiol. 35:10341035.
4. Land, M. V.,, W. M. Ching,, G. A. Dasch,, Z. Zhang,, D. J. Kelly,, S. R. Graves,, and P. L. Devine. 2000. Evaluation of a commercially available recombinant-protein enzyme-linked immunosorbent assay for detection of antibodies produced in scrub typhus rickettsial infections. J. Clin. Microbiol. 38:27012705.
5. Newhouse, V. F.,, C. C. Shepard,, M. D. Redus,, T. Tzianabos,, and J. E. McDade. 1979. A comparison of the complement fixation, indirect fluorescent antibody, and microagglutination tests for the serological diagnosis of rickettsial diseases. Am. J. Trop. Med. Hyg. 28:387395.

Tables

Generic image for table
Table 11.7.2-1

Manufacturers of rickettsial and l serodiagnostic kits and reagents

Check with each manufacturer regarding regional availability.

Focus Diagnostics, 10703 Progress Way, Cypress, CA 90630-4717. Telephone: (714) 220-1900, (800) 445-0185. Fax: (714) 220-1683. URL: www.focusdx.com/focus/0-home/index.asp.

PanBio, Limited—Australia, 116 Lutwyche Rd., Windsor, Brisbane 4030, Queensland, Australia. Telephone: 61 (0) 7 3363 7100. Fax: 61 (0) 7 3363 7199. E-mail: PanBio@PanBio.com. URL: http://www.panbio.com.

SciMedx Corporation, 100 Ford Rd., Suite 100-08, Denville, NJ 07834. Telephone: (800) 221-5598 or (international) 1-973-625-8822. Fax: 1-973-625- 8796. E-mail: info@scimedx.com. URL: http://www.scimedx.com/products/ifa_infectious.htm.

Citation: Garcia L. 2010. Serodiagnosis of Rickettsial Infections, p 183-193. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch11.7
Generic image for table
Table 11.7.2-2

Sensitivity and specificity of serologic tests for confirmation of RMSF, murine typhus, HME, and HGA

Citation: Garcia L. 2010. Serodiagnosis of Rickettsial Infections, p 183-193. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch11.7
Generic image for table
Table 11.7.2-3

Selected conditions that may lead to false-positive serologic tests for rickettsial diseases

ANA, antinuclear antibody.

ANCA, antineutrophil cytoplasmic antibody.

Citation: Garcia L. 2010. Serodiagnosis of Rickettsial Infections, p 183-193. In Clinical Microbiology Procedures Handbook, 3rd Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817435.ch11.7

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