Advanced

Diagnostic significance of measurements of specific IgG antibodies to Pseudomonas aeruginosa by three different serological methods

Pressler, Tacjana; Karpati, Ferenc; Granstrom, Marta; Knudsen, Per Kristian; Lindblad, Anders; Hjelte, Lena; Olesen, Hanne V.; Meyer, Peter LU and Hoiby, Niels (2009) In Journal of Cystic Fibrosis 8(1). p.37-42
Abstract
The aim of the study was to evaluate three serological methods for their ability to identify CF patients in different infection status especially those at risk of developing chronic Pseudomonas aeruginosa (Pa) infection. Methods: Two ELISA methods: exotoxin A (ExoA) and CF-IgG-ELISA (CF-IgG) and Crossed Immunoelectrophoresis (CIE) were used for measurement of Pa-antibodies in sera from 791 Scandinavian CF patients. Results: 381 patients were cultured negative for Pa in the year before study start, 129 patients were intermittently colonized and 281 patients were chronically infected. The sensitivity of the investigated assays was 96%, 93% and 97%, specificity 89%, 89% and 83% for CIE, ExoA and CF-IgG respectively. The negative predictive... (More)
The aim of the study was to evaluate three serological methods for their ability to identify CF patients in different infection status especially those at risk of developing chronic Pseudomonas aeruginosa (Pa) infection. Methods: Two ELISA methods: exotoxin A (ExoA) and CF-IgG-ELISA (CF-IgG) and Crossed Immunoelectrophoresis (CIE) were used for measurement of Pa-antibodies in sera from 791 Scandinavian CF patients. Results: 381 patients were cultured negative for Pa in the year before study start, 129 patients were intermittently colonized and 281 patients were chronically infected. The sensitivity of the investigated assays was 96%, 93% and 97%, specificity 89%, 89% and 83% for CIE, ExoA and CF-IgG respectively. The negative predictive value was for CIE 97%, for ExoA 95% and for CF-IgG 98% and positive predictive values 87%, 86% and 80%. Out of the 381 patients cultured negative for Pa, 11 changed status to chronically infected. Twenty-four out of the 129 patients intermittently colonized became chronically infected. The antibody levels in this latter group of patients were significantly higher already at the study start and increased significantly during the study period (p < 0.05). Elevated levels of specific anti-Pseudomonal antibodies showed to be the risk factor for developing chronic P. aeruginosa infection (OR 4.9 and OR 2.7, p < 0.05 for CF-IgG and ExoA). Conclusion: All three serological assays were equally informative. The very high sensitivity of the assays made it possible to characterize patients with different infection status. Elevated levels of specific anti-Pseudomonas antibodies showed to be the risk factor for developing chronic Pa infection. Due to the specificity of the tests, antibiotic treatment based on serology might be considered in selected cases. There is a window of opportunity for suppression and eradication of initial P aeruginosa infection making measurement of specific anti-Pseudomonas antibodies helpful. (c) 2008 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cystic fibrosis, Anti-Pseudomonas antibodies, Chronic infection, Serological assays
in
Journal of Cystic Fibrosis
volume
8
issue
1
pages
37 - 42
publisher
Elsevier
external identifiers
  • wos:000262553800007
  • scopus:57649159191
ISSN
1873-5010
DOI
10.1016/j.jcf.2008.08.002
language
English
LU publication?
yes
id
e5b594fc-af84-4b04-b19d-f8671e89ede1 (old id 1312571)
date added to LUP
2009-03-18 08:56:43
date last changed
2017-10-29 03:38:37
@article{e5b594fc-af84-4b04-b19d-f8671e89ede1,
  abstract     = {The aim of the study was to evaluate three serological methods for their ability to identify CF patients in different infection status especially those at risk of developing chronic Pseudomonas aeruginosa (Pa) infection. Methods: Two ELISA methods: exotoxin A (ExoA) and CF-IgG-ELISA (CF-IgG) and Crossed Immunoelectrophoresis (CIE) were used for measurement of Pa-antibodies in sera from 791 Scandinavian CF patients. Results: 381 patients were cultured negative for Pa in the year before study start, 129 patients were intermittently colonized and 281 patients were chronically infected. The sensitivity of the investigated assays was 96%, 93% and 97%, specificity 89%, 89% and 83% for CIE, ExoA and CF-IgG respectively. The negative predictive value was for CIE 97%, for ExoA 95% and for CF-IgG 98% and positive predictive values 87%, 86% and 80%. Out of the 381 patients cultured negative for Pa, 11 changed status to chronically infected. Twenty-four out of the 129 patients intermittently colonized became chronically infected. The antibody levels in this latter group of patients were significantly higher already at the study start and increased significantly during the study period (p &lt; 0.05). Elevated levels of specific anti-Pseudomonal antibodies showed to be the risk factor for developing chronic P. aeruginosa infection (OR 4.9 and OR 2.7, p &lt; 0.05 for CF-IgG and ExoA). Conclusion: All three serological assays were equally informative. The very high sensitivity of the assays made it possible to characterize patients with different infection status. Elevated levels of specific anti-Pseudomonas antibodies showed to be the risk factor for developing chronic Pa infection. Due to the specificity of the tests, antibiotic treatment based on serology might be considered in selected cases. There is a window of opportunity for suppression and eradication of initial P aeruginosa infection making measurement of specific anti-Pseudomonas antibodies helpful. (c) 2008 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.},
  author       = {Pressler, Tacjana and Karpati, Ferenc and Granstrom, Marta and Knudsen, Per Kristian and Lindblad, Anders and Hjelte, Lena and Olesen, Hanne V. and Meyer, Peter and Hoiby, Niels},
  issn         = {1873-5010},
  keyword      = {Cystic fibrosis,Anti-Pseudomonas antibodies,Chronic infection,Serological assays},
  language     = {eng},
  number       = {1},
  pages        = {37--42},
  publisher    = {Elsevier},
  series       = {Journal of Cystic Fibrosis},
  title        = {Diagnostic significance of measurements of specific IgG antibodies to Pseudomonas aeruginosa by three different serological methods},
  url          = {http://dx.doi.org/10.1016/j.jcf.2008.08.002},
  volume       = {8},
  year         = {2009},
}