Usefulness of nested PCR for the diagnosis of scrub typhus in clinical practice: A prospective study.
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.
Kim
Dong-Min
DM
Division of Infectious Diseases, Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Korea. drongkim@chosun.ac.kr
Yun
Na Ra
NR
Yang
Tae Young
TY
Lee
Ji Hyun
JH
Yang
Jong Tae
JT
Shim
Soo-Kyoung
SK
Choi
Eun-Na
EN
Park
Mi-Yeoun
MY
Lee
Seung-Hyun
SH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001483:Base Sequence; D017931:DNA Primers; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods*; D011446:Prospective Studies; D012612:Scrub Typhus / Q000175:diagnosis*
D017931:DNA Primers