最新的快速床邊鼠疫檢驗法


  Jan. 16, 2003 - 今年1月18日出刊的「刺烙針」雜誌報導指出,研究人員發展出一套可在床邊進行的快速疫情測驗方法,它可應用於疫情流行的國家,同時也促進我們對生物恐怖主義的攻擊做好反擊的準備。
  
  Pasteur 研究院暨馬達加斯加衛生部Suzanne Chanteau博士說,有了這項測驗方法,即使在偏遠且人跡罕至之地的衛生工作者,也能以快速又省錢的方式來診斷出腺鼠疫與肺鼠疫。經由快速預防檢查,能降低民眾的患病率,快又有效的治療則降低民眾的致死率,再藉由合理使用昂貴殺蟲劑來降低跳蚤對殺蟲劑的抗藥性。
  
  這種診斷試驗約需15分鐘的時間,它利用單株抗體來對抗鼠疫桿菌的F1抗原,當濃度約在0.5 ng/mL時可偵測到F1抗原,這種診斷試驗方法能偵測到比微生物檢驗法還多41.66%以上的感染現象,也能偵測到比免疫學偵測法(ELISA)多31%以上的感染;它的敏感度與專一性都是100%,陽性預測值(positive predictive value)約為90.6%,陰性預測值(negative predictive value)約為86.7%。
  
  在隨後的評論中,疾病預防與控制中心的David Dennis與May Chu對這項研究的廣泛評估表示讚揚,尤其馬達加斯加本身即是鼠疫流行的地區。
  
  預料在不久的將來,全世界各地的疫區都能很快取得這種診斷試驗方法來確認疫情;此外,大家也期待能藉由這種診斷試驗方法及時發現生物恐怖主義的進行並加以反擊。

New Rapid Bedside Test for Pla

By Laurie Barclay, MD
Medscape Medical News

Jan. 16, 2003 — Investigators have developed a rapid bedside test for plague, according to a report in the Jan. 18 issue of The Lancet. The commentator suggests that in addition to being useful in endemic countries, this test will also enhance our preparedness for bioterrorism.

"With this test, the rapid and cost-effective diagnosis of bubonic and pneumonic plague could easily be achieved by health workers in remote sites," lead author Suzanne Chanteau, PhD, from the Pasteur Institute and the Ministry of Health in Madagascar, says in a news release. "Use of the test could help to reduce mortality (through rapid and efficient treatment of patients), morbidity (by rapid implementation of preventive measures), and insecticide resistance of fleas (through rational use of expensive insecticides)."

This diagnostic test, which takes up to 15 minutes, uses monoclonal antibodies to the F1 antigen of Yersinia pestis. While detecting F1 antigen at concentrations as low as 0.5 ng/mL, this test also detected 41.66% more infections than did bacteriological methods and 31% more infections than did ELISA. Sensitivity and specificity were both 100%, positive predictive value was 90.6%, and negative predictive value was 86.7%.

In an accompanying commentary, David Dennis and May Chu from the Centers for Disease Control and Prevention in Atlanta, Georgia, praise this study for its comprehensive evaluation in health centers in Madagascar where plague is endemic.

"It is anticipated that it will soon be available in plague-endemic areas worldwide, providing opportunities for validations under various conditions," they write. "In addition, the test...is expected to fill an important need in bioterrorism preparedness and response."

Lancet. 2003;361:191-192, 211-216

Reviewed by Gary D. Vogin, MD

    



回上一頁




回上一頁