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The temporal dynamics of humoral immunity to Rickettsia typhi infection in murine typhus patients.


ABSTRACT: OBJECTIVES:This study examined individuals with Rickettsia typhi infection in the Lao People's Democratic Republic (Lao PDR) to (a) investigate humoral immune dynamics; (b) determine the differences in reference diagnostic results and recommend appropriate cut-offs; (c) determine differences in immune response after different antibiotic treatments; and (d) determine appropriate diagnostic cut-off parameters for indirect immunofluorescence assay (IFA). METHODS:Sequential serum samples from 90 non-pregnant, adults were collected at seven time-points (days 0, 7, 14, 28, 90, 180 and 365) as part of a clinical antibiotic treatment trial. Samples were tested using IFA to determine IgM and IgG antibody reciprocal end-point titres against R. typhi and PCR. RESULTS:For all 90 individuals, reciprocal R. typhi IgM and IgG antibody titres ranged from <400 to ?3200. The median half-life of R. typhi IgM was 126 days (interquartile range 36-204 days) and IgG was 177 days (interquartile range 134-355 days). Overall median patient titres for R. typhi IgM and IgG were significantly different (p < 0.0001) and at each temporal sample collection point (range p < 0.0001 to p 0.0411). Using Bayesian latent class model analysis, the optimal diagnostic cut-off reciprocal IFA titer on patient admission for IgM was 800 (78.6%, 95% CI 71.6%-85.2% sensitivity; 89.9%, 95% CI 62.5%-100% specificity), and for IFA IgG 1600 (77.3%; 95% CI 68.2%-87.6% sensitivity; 99%, 95% CI 95%-100% specificity). CONCLUSIONS:This study suggests suitable diagnostic cut-offs for local diagnostic laboratories and other endemic settings and highlights antibody persistence following acute infection. Further studies are required to validate and define cut-offs in other geographically diverse locations.

SUBMITTER: Phakhounthong K 

PROVIDER: S-EPMC7284305 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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The temporal dynamics of humoral immunity to Rickettsia typhi infection in murine typhus patients.

Phakhounthong K K   Mukaka M M   Dittrich S S   Tanganuchitcharnchai A A   Day N P J NPJ   White L J LJ   Newton P N PN   Blacksell S D SD  

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases 20191031 6


<h4>Objectives</h4>This study examined individuals with Rickettsia typhi infection in the Lao People's Democratic Republic (Lao PDR) to (a) investigate humoral immune dynamics; (b) determine the differences in reference diagnostic results and recommend appropriate cut-offs; (c) determine differences in immune response after different antibiotic treatments; and (d) determine appropriate diagnostic cut-off parameters for indirect immunofluorescence assay (IFA).<h4>Methods</h4>Sequential serum samp  ...[more]

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