Eur J Clin Microbiol Infect Dis. 2011 Jan 27; [Epub ahead of print]
Large differences between test strategies for the detection of
anti-Borrelia
antibodies are revealed by comparing eight ELISAs and five immunoblots.
Ang CW, Notermans DW, Hommes M, Simoons-Smit AM, Herremans T.
VUMC, Amsterdam, The Netherlands,w.ang@vumc.nl.
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.
http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=212
71270&retmode=ref&cmd=prlinks
PMID: 21271270 [PubMed - as supplied by publisher]
[Non-text portions of this message have been removed]
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