Korean Journal of Microbiology (미생물학회지)

The Microbiological Society of Korea (한국미생물학회)
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Evaluation of Vi-Passive Hemagglutination, SD$^{(R)}$ Kit, and Widal Test for Serological Diagnosis of Typhoid Fever

장티푸스의 혈청학적 진단을 위한 Vi-수동혈구응집법, SD$^{(R)}$ Kit 및 Widal 시험에 대한 효용성 평가

  • Kim, Sung-Hun (Division of Enteric Bacterial Infections, Center for Infectious Disease, National Institute of Health) ;
  • Kim, Shuk-Ho (Department of Microbiology, School of Medicine, Kyungpook National University) ;
  • Lee, Deog-Yong (Division of Enteric Bacterial Infections, Center for Infectious Disease, National Institute of Health) ;
  • Lee, Esther (Division of Enteric Bacterial Infections, Center for Infectious Disease, National Institute of Health) ;
  • Park, Mi-Sun (Division of Enteric Bacterial Infections, Center for Infectious Disease, National Institute of Health) ;
  • Lee, Bok-Kwon (Division of Enteric Bacterial Infections, Center for Infectious Disease, National Institute of Health)
  • 김성훈 (국립보건연구원 장내세균과) ;
  • 김석호 (경북대학교 의과대학 미생물학교실) ;
  • 이덕용 (국립보건연구원 장내세균과) ;
  • 이에스더 (국립보건연구원 장내세균과) ;
  • 박미선 (국립보건연구원 장내세균과) ;
  • 이복권 (국립보건연구원 장내세균과)
  • Received : 2010.02.11
  • Accepted : 2010.03.23
  • Published : 2010.06.30
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Abstract

In this study, we evaluated Vi-passive hemagglutination (Vi-PHA), SD Salmonella Typhi IgG/IgM ($SD^{(R)}$ kit) and Widal test for the rapid laboratory diagnosis of typhoid fever patients. A total of 36 serum samples from febrile patients in Korea from 2005 to 2006 were used. Among 36 patients, 27 were fever patients without typhoid, 9 were typhoid fever. Vi-PHA showed 8 positive results out of 9 typhoid fever patients (sensitivity 88.9%) and 1 positive and 26 negative results out of 27 febrile patients without typhoid (specificity 96.3%). The sensitivity and the specificity of $SD^{(R)}$ kit were 100% and 92.6%, respectively. However, the sensitivity and the specificity of Widal O & H tests were 88.9%, 100%, and 77.8%, 70.4%, respectively. Consequently, Widal H and $SD^{(R)}$ kit showed higher sensitivity and Vi-PHA showed higher specificity. To efficient diagnosis, Vi-PHA may be sufficient diagnosis method in acute cases and $SD^{(R)}$ kit and Widal test may be sufficient in sporadic area and high risk group.

본 연구는 장티푸스 환자에 대한 혈청학적 시험법인 Vi-PHA, $SD^{(R)}$ kit, Widal 시험(O & H)에 대하여 평가를 위해 수행하였다. 2005년부터 2006년까지 수집된 36건의 혈청검체를 대상으로 하였으며, 9건은 배양검사를 통하여 장티푸스균이 검출된 확진환자의(Typhoid fever) 검체이며, 27건은 비장티푸스성 열성환자의(Non-typhoid fever) 검체이다. 시험결과 Vi-PHA는 환자 혈청 9건 중 양성 8건으로 민감도 88.9% (P<0.001; Fisher's exact test), 비장티푸스성 열성환자 27건 중 1건이 양성을 보여 특이도 96.3%로 나타났다. $SD^{(R)}$ kit는 민감도 100% (P<0.001), 특이도 92.6%로 나타났다. Widal (O & H) 시험의 민감도는 각각 88.9% (P=0.001), 100% (P<0.001), 특이도는 77.8%, 70.4%로 나타났다. 민감도는 $SD^{(R)}$ kit와 Widal H 검사법이 가장 높은 것으로 확인되었으며, 특이도는 Vi-PHA가 가장 높게 나타났다. 장티푸스의 효과적인 혈청학적 진단을 위하여 급성 또는 유행지역에서는 특이도가 높은 Vi-PHA로 검사를 수행하고, 장티푸스 비 유행지역과 고위험군에 대하여는 민감도가 높은 Widal H와 $SD^{(R)}$ kit를 적용하는 것이 진단의 유의수준을 높일 수 있을 것으로 판단된다.

Keywords

References

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