Diagnostic value of serological tests against Pseudomonas aeruginosa in a large cystic fibrosis population

Tramper-Stranders, G. A.; Van Der Ent, C. K.; Slieker, M. G.; Terheggen-Lagro, S. W. J.; Van Berkhout, F. Teding; Kimpen, J. L. L.; Wolfs, T. F. W.
August 2006
Thorax;Aug2006, Vol. 61 Issue 8, p689
Academic Journal
Background: Serological methods to monitor Pseudomonas aeruginosa colonisation in patients with cystic fibrosis (CF) ore advocated but the diagnostic value of a commercially available P aeruginosa antibody test to detect early and chronic P aeruginosa colonisation in a non-research setting has not been assessed. Methods: Colonisation with P aeruginosa was estimated by regular culture of sputum or oropharyngeal swabs during three consecutive years in 220 patients with CF aged 0-65 years. Commercially available ELISA tests with three P aeruginosa antigens (elastase, exotoxin A, alkaline protease) were performed at the end of the study period. In a subgroup of 57 patients (aged 4-14 years) serological tests were performed annually. Results: Using culture as the reference standard, the EUSA tests using the advised cut off values had a sensitivity of 79% and a specificity of 89% for chronic colonisation. Receiver-operator characteristic curves were created to optimise cut off values. Applying these new cut off values resulted in o sensitivity of 96% and a specificity of 79%. All three individual serological tests discriminated well between the absence and presence of chronic P aeruginosa colonisation. The sensitivity of the individual antibody test was 87% far elastase, 79% far exotoxin A, and 76% far alkaline protease. First colonisation was preceded by positive 5 serological results in only five of 13 patients (38%). Conclusion: In patients with CF, serological tests using specific antigens are sensitive far diagnosing chronic P aeruginosa colonisation. However, the failure of serological tests to detect early colonisation in young patients emphasises the need far continued reliance on cultures.


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