Serodiagnosis of Mycobacterium abscessus complex infection in cystic fibrosis.
Early signs of pulmonary disease with Mycobacterium abscessus complex (MABSC) can be missed in patients with cystic fibrosis (CF). A serological method could help stratify patients according to risk. The objective of this study was to test the diagnostic accuracy of a novel method for investigating IgG activity against MABSC.A prospective study of all patients attending the Copenhagen CF Centre was conducted by culturing for MABSC during a 22-month period and then screening patients with an anti-MABSC IgG ELISA. Culture-positive patients had stored serum examined for antibody kinetics before and after culture conversion.307 patients had 3480 respiratory samples cultured and were then tested with the anti-MABSC IgG ELISA. Patients with MABSC pulmonary disease had median anti-MABSC IgG levels six-fold higher than patients with no history of infection (434 versus 64 ELISA units; p<0.001). The test sensitivity was 95% (95% CI 74-99%) and the specificity was 73% (95% CI 67-78%). A diagnostic algorithm was constructed to stratify patients according to risk.The test accurately identified patients with pulmonary disease caused by MABSC and was suited to be used as a complement to mycobacterial culture.
Copenhagen Cystic Fibrosis Centre, Dept of Infectious Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark tavs.qvist@gmail.com.
Tavs
T
Qvist
Copenhagen Cystic Fibrosis Centre, Dept of Infectious Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Tania
T
Pressler
Dept of Public Health and Policy, University of Liverpool, Liverpool, UK.
David
D
Taylor-Robinson
Copenhagen Cystic Fibrosis Centre, Dept of Infectious Diseases, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Terese L
TL
Katzenstein
Dept of Clinical Microbiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Niels
N
Høiby
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000175:diagnosis / Q000382:microbiology*; D003718:Denmark / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000453:epidemiology*; D020380:Needs Assessment; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification*; D011237:Predictive Value of Tests; D015995:Prevalence; D018570:Risk Assessment; D012698:Serologic Tests / Q000379:methods*; D012720:Severity of Illness Index; D055815:Young Adult