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ORIGINAL ARTICLE
Year : 2017  |  Volume : 146  |  Issue : 3  |  Page : 386-391

Unreliability of three commercial Coxiella burnetii phase II IgM ELISA kits for the seroscreening of acute Q fever in human cases


1 Department of Microbiology, Mahatma Gandhi Medical College & Research Institute, Puducherry, India
2 Department of General Medicine, Indira Gandhi Government General Hospital & Post Graduate Institute, Puducherry, India
3 Department of Paediatrics, Mahatma Gandhi Medical College & Research Institute, Puducherry, India
4 Department of Microbiology, Indira Gandhi Government General Hospital & Post Graduate Institute, Puducherry, India

Correspondence Address:
Dr Selvaraj Stephen
Department of Microbiology, Mahatma Gandhi Medical College & Research Institute, Pondy-Cuddalore Main Road, Pillaiyarkuppam, Puducherry 607 402
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_1815_15

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Background & objectives: Seroprevalence of Q fever (QF) caused by Coxiella burnetii has been reported from different parts of India. Usually serological/molecular tests are employed for detection of infection. The present study was undertaken to verify the validity of three different QF phase II IgM ELISA kits for acute QF diagnosis by comparing with the gold standard indirect fluorescent antibody assay (IFA). Methods: Fifty eight serum samples collected from 42 patients (26 patients provided acute sample only and 16 both acute and convalescent samples) which were examined by all three commercial kits, were cross-checked with QF Phase II IgM IFA for confirmation. Results: Eleven patients were positive for C. burnetii antibodies by IFA in acute and/or convalescent serum samples. Taking IFA as a reference, percentages of sensitivity, specificity, positive predictive value and negative predictive value for Virion-Serion/Vircell/NovaTec were 36.36, 61.29, 25.00, 73.08; 81.82, 35.48, 31.03, 84.62 and 100, 25.81, 32.35, 100 per cent, respectively. Interpretation & conclusions: The three different ELISA kits exhibited poor agreement amongst them and unacceptable level of false positivity. IFA remains to be the only option for diagnosing acute QF. Discrepancy between the clinical findings and IFA/ELISA results needs confirmation by C. burnetii DNA detection in real-time polymerase chain reaction.


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