Test inaccuracies in Bb infection
By Linda on Mar 2, 2011 in Infections | comments(0)
Excerpt:
We investigated the influence of assay choice on the results in a two-tier
testing algorithm for the detection of anti-Borrelia antibodies.Eighty-nine serum samples from clinically well-defined patients were tested
in eight different enzyme-linked immunosorbent assay (ELISA) systems based
on whole-cell antigens, whole-cell antigens supplemented with VlsE and
assays using exclusively recombinant proteins.A subset of samples was tested in five immunoblots: one whole-cell blot, one
whole-cell blot supplemented with VlsE and three recombinant blots.The number of IgM- and/or IgG-positive ELISA results in the group of
patients suspected of Borrelia infection ranged from 34 to 59%.The percentage of positives in cross-reactivity controls ranged from 0 to
38%.Comparison of immunoblots yielded large differences in inter-test agreement
and showed, at best, a moderate agreement between tests.***Remarkably, some immunoblots gave positive results in samples that had
been tested negative by all eight ELISAs.***The percentage of positive blots following a positive ELISA result depended
heavily on the choice of ELISA-immunoblot combination.We conclude that the assays used to detect anti-Borrelia antibodies have
widely divergent sensitivity and specificity.The choice of ELISA-immunoblot combination severely influences the number of
positive results, making the exchange of test results between laboratories
with different methodologies hazardous.
