Improvement of the Diagnostic Sensitivity of Scrub Typhus Using a Mixture of Recombinant Antigens Derived from Orientia tsutsugamushi Serotypes.
10.3346/jkms.2013.28.5.672
- Author:
Young Jin KIM
1
;
Seon Ju YEO
;
Sang Jin PARK
;
Ye Ju WOO
;
Min Woo KIM
;
Seung Han KIM
;
In Ae CHANG
;
Sung Ho JEON
;
Byung Jae PARK
;
Gi Jun SONG
;
Myoung Gu LEE
;
Ik Sang KIM
;
Yoon Won KIM
Author Information
1. Immunemed, Chuncheon, Korea. ywkim@hallym.ac.kr
- Publication Type:Original Article ; Comparative Study ; Research Support, Non-U.S. Gov't
- Keywords:
Scrub Typhus;
Orientia tsutsugamushi;
Recombinant Antigen;
IFA;
ELISA;
RDT
- MeSH:
Antibodies, Bacterial/blood/chemistry/immunology;
Antigens, Bacterial/diagnostic use/genetics/metabolism;
Enzyme-Linked Immunosorbent Assay;
Fluorescent Antibody Technique, Indirect;
Gold/chemistry;
Humans;
Immunoassay;
Immunoglobulin G/blood;
Immunoglobulin M/blood;
Orientia tsutsugamushi/immunology/*metabolism;
Recombinant Proteins/biosynthesis/diagnostic use/genetics;
Scrub Typhus/*diagnosis;
Sensitivity and Specificity;
Serotyping
- From:Journal of Korean Medical Science
2013;28(5):672-679
- CountryRepublic of Korea
- Language:English
-
Abstract:
Diagnosis of scrub typhus is difficult because its symptoms are very similar to other acute febrile illnesses, such as leptospirosis, murine typhus, and other viral hemorrhagic fevers. To differentiate scrub typhus from other acute febrile diseases, a rapid and reliable serological diagnosis is important. We have developed a chimeric recombinant antigen cr56 and two other recombinant antigens, r21 and kr56, from various serotypes of Orientia tsutsugamushi. They were tested for the detection of antibodies against O. tsutsugamushi in the patient's serum samples using enzyme-linked immunosorbent assay (ELISA) and dot-blot analyses. As of conventional immunofluorescence assay (IFA), when the mixture of these three recombinant antigens was used, both sensitivity and specificity of the recombinant antigens were increased up to 98% in IgM and IgG at ELISA and dot blotting. Additionally, both sensitivity and specificity by detection of IgM and IgG antibodies at rapid diagnostic test (RDT), using the mixture of three antigens and gold conjugated antibodies, were 99%. Our results suggest the use of mixture of these recombinant antigen proteins in ELISA or RDT is suitable as a diagnostic test for scrub typhus.
