Salmonella Typhi 감염증의 진단을 위한 신속 면역크로마토그래피법의 평가
Evaluation of a Rapid Immunochromatographic Assay Kit forthe Diagnosis of Salmonella Typhi Infection
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배경: Salmonella Typhi 감염증의 진단을 위해 Widal test가 많이 사용되고 있는데, 이 검사는 우리나라에서 양성 예측도가 낮은 편이며 지역과 장티푸스의 빈도가 다르면 민감도와 특이도가 다르다. 저자들은 Salmonella Typhi 감염증의 신속 진단 검사법 immunochromatographic assay (ICA) 키트를 평가하였다. 방법: 환자군으로 혈액배양 검사에 Salmonella Typhi가 분리된 환자 25명의 혈청을 사용하였고, 대조군으로 다른 Salmonella 균이 분리된 환자 21명, Salmonella가 아닌 다른 세균이 분리된 환자 56명, 건강인 57명의 혈청을 사용하여 총 159명을 대상으로 하였다. 각 검체는 SD Salmonella Typhi IgG/IgM 키트로 ICA 검사를 시행하였다. 결과: Salmonella Typhi 감염증 진단을 위한 ICA의 민감도는 100%를 보였고, 비장티푸스성 살모넬라증, Salmonella가 아닌 다른 균혈증, 건강인에서 각각 61.9%, 82.1%, 91.2%의 특이도를 보였다. Widal 검사와 비교하여 민감도는 우수하였으나 특이도는 낮았다. 결론: SD Salmonella Typhi IgG/IgM 키트는 Salmonella Typhi 감염증의 진단에 우수한 민감도를 보이며 사용하기에 간편하여, 장티푸스의 신속한 선별 검사용으로 사용하기에 적합한 것으로 생각한다.
Abstract
Background: Widal test, whose sensitivity and specificity are variable from region to region depending on the incidence of typhoid fever, is still in use and shows a relatively low positive predictive value in Korea. We evaluated a rapid immunochromatographic assay (ICA) kit for the rapid diagnosis of Salmonella Typhi infection. Methods: Twenty five patients with Salmonella Typhi bacteremia were selected for the patient group. For the control group, 21 nontyphoidal salmonellosis patients, 56 non-Salmonella bacteremia patients, and 57 healthy individuals were selected for evaluating the specificity of ICA test. Each serum specimen was tested with the SD Salmonella Typhi IgG/IgM kits (Standard Diagnostics, Inc., Yongin, Korea). Results: The ICA showed a sensitivity of 100% in Salmonella Typhi patients, and specificities of 61.9%, 82.1% and 91.2% in nontyphoidal salmonellosis patients, non-Salmonella bacteremia patients, and healthy individuals, respectively. The ICA test showed a high sensitivity but a low specificity when compared with the Widal test. Conclusion: The ICA test by SD Salmonella Typhi IgG/IgM kit is highly sensitive, but its specificity is relatively low. The ICA test is simple, objective, and suitable for screening typhoid fever.
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