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      THE PERSISTENCE OF LEPTOSPIRAL AGGLUTININS TITERS IN HUMAN SERA DIAGNOSED BY THE MICROSCOPIC AGGLUTINATION TEST

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          Abstract

          The persistence of agglutinins detected by MAT has created some problems to the interpretation of the results. The aim of this study was to examine the data of serology from 70 patients with serologically confirmed diagnosis of leptospirosis by during 3-13 months after being affected with leptospires in order to elucidate the interpretation of the persistence of agglutinins detected by MAT. Sixty-one patients sera (87.14%) had titers equal or greater than 800. Of these, two individuals maintained titers of 800 thirteen months after the onset. This study showed that only one sample of sera with high titers is not reliable to determine the time at which infection occurred.

          Translated abstract

          Persistência de títulos de aglutininas anti-leptospiras em soros humanos diagnosticados pelo teste de aglutinação microscópica A persistência de aglutininas detectadas por MAT tem criado problemas na interpretação dos resultados. O objetivo deste trabalho foi examinar os resultados da sorologia de 70 pacientes com confirmação sorológica de leptospirose durante 3-13 meses após terem sido infectados para se poder elucidar a interpretação da persistência de aglutininas detectadas por MAT. Sessenta e um soros de pacientes (87,14%) apresentaram títulos iguais, ou maiores, que 800. Destes, 2 indivíduos mantiveram títulos de 800 treze meses após terem sido infectados. Este estudo mostra que apenas uma amostra de soro, mesmo com alto título de aglutininas, não pode ser considerada para determinar a fase da doença.

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          Guidelines for the control of leptospirosis

          S FAINE, S Faine, S. Faine … (1982)
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            Evaluation of a commercial enzyme-linked immunosorbent assay for detection of immunoglobulin M antibody in diagnosis of human leptospiral infection.

            Lauren R. Devine, M L Pirc, D Merry … (1997)
            The PanBio Leptospira immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) is a commercially available screening test for the diagnosis of acute leptospiral infection. The ability of the test to diagnose early or recent Leptospira interrogans infection was assessed by testing sera with known microagglutination test (MAT) titers to serovars pomona, hardjo, copenhageni, and australis. The IgM ELISA detected all 41 cases of early or recent leptospiral infection (sensitivity, 100%), with a positive ELISA result seen in many cases before MAT antibody titers reached 1:50. Thirty-eight of 41 patients showed seroconversion (fourfold or greater increase in titer by MAT, 2 of 41 patients had a single sample with elevated titer, and 1 patient from whom leptospires were isolated from a blood sample failed to show MAT titers, despite a seroconversion (negative to positive result) in the ELISA. Follow-up sera obtained from 8 of 12 patients (67%) for 3 to 48 months after the acute stage of illness showed persisting IgM antibody. However, the range of levels detected in these samples (maximum ELISA ratio, 2.0) was lower than the range seen when infection was recent. Reactivity in the IgM ELISA was observed for only 1 of 59 serum samples from asymptomatic donors (specificity, 98%) and 16 of 233 serum samples from patients with Ross River virus, brucella, Epstein-Barr virus, cytomegalovirus, mycoplasma, Q-fever, toxoplasma, hepatitis A virus, Treponema pallidum, or Borrelia burgdorferi infection (specificity, 93%), with the majority of these patients showing lower levels of IgM in comparison to those in patients with leptospiral infection. We conclude that this ELISA is sufficiently sensitive for use as an initial screen for leptospiral infections, with subsequent confirmation of positive test results by MAT.
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              Behaviour of specific IgM, IgG and IgA class antibodies in human leptospirosis during the acute phase of the disease and during convalescence.

              Miguel L. Batista Jr., Mário Vaz, M. Silva … (1995)
              The behaviour of specific IgM, IgG and IgA class antibodies in human leptospirosis was studied by ELISA. Two groups of patients were followed up, 57 of them in the acute phase and 10 during convalescence, the latter with a mean follow-up of 10.5 months. IgM class antibodies were detected starting on the 2nd day of symptoms and were observed in 100% of patients up to the 5th month, in 66.7% up to the 7th month and in 50% up to the 12th month after the onset of symptoms. IgG class antibodies were first detected on the 7th day of symptoms in 9.1% of patients, with maximum reactivity (87.5%) between the 2nd and 3rd month, and were not detected at all in one patient. IgA class antibodies were detected starting on the 5th day of symptoms in 7.7% of patients, and in all patients on the 15th day, persisting in 100% of cases up to the 9th follow-up month. During the 12th month, they were observed in 83.3% of patients. The results indicate that an anti IgA ELISA could be of great value in seroprevalence studies on human leptospirosis.
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                Author and article information

                Journal
                Journal ID (publisher-id): rimtsp
                Title: Revista do Instituto de Medicina Tropical de São Paulo
                Abbreviated Title: Rev. Inst. Med. trop. S. Paulo
                Publisher: Instituto de Medicina Tropical de São Paulo (São Paulo, SP, Brazil )
                ISSN (Electronic): 1678-9946
                Publication date (Print and electronic): May 1998
                Volume: 40
                Issue: 3
                Pages: 183-184
                Affiliations
                [01] orgnameAdolfo Lutz Institute orgdiv1 Department of Medical Biology
                [02] orgnameUniversity of São Paulo orgdiv1 Biomedical Science Institute, Department of Microbiology
                Article
                Publisher ID: S0036-46651998000300009 Publisher ID: S0036-4665(98)04000309
                DOI: 10.1590/S0036-46651998000300009
                SO-VID: e813d30d-3945-406a-a1ca-c29289375a37
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                Date accepted : 16 June 1998
                Date received : 03 December 1997
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 8, Pages: 2
                Product

                SciELO Brazil

                Categories
                Subject: Serodiagnosis

                Keywords: Leptospirosis,Microscopic Agglutination Test,Leptospiral agglutinins
                Data availability:
                Keywords: Leptospirosis, Microscopic Agglutination Test, Leptospiral agglutinins

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