BMC Infectious Diseases | |
Reliability of the Siemens Enzygnost and Novagnost Epstein–Barr Virus assays for routine laboratory diagnosis: agreement with clinical diagnosis and comparison with the Merifluor Epstein–Barr Virus immunofluorescence assay | |
Elisabeth Daghofer1  H Roma Levy3  Klaus Udo Nabeck2  Christina Kreuzer1  | |
[1] University of Graz, Institute for Hygiene, Universitätsplatz 4, Graz, 8010, Austria;Siemens Healthcare Diagnostics Products GmbH, Emil-von-Behring-Str. 76, Marburg 35041, Germany;Siemens Healthcare Diagnostics, 5210 Pacific Concourse Drive, Los Angeles, CA, USA | |
关键词: Merifluor; Novagnost; Enzygnost; Microtiter; EIA; Serodiagnosis; EBV; | |
Others : 1147956 DOI : 10.1186/1471-2334-13-260 |
|
received in 2012-08-28, accepted in 2013-04-22, 发布年份 2013 | |
【 摘 要 】
Background
Diagnosis of Epstein–Barr virus (EBV) infection is routinely conducted by clinical laboratories, especially to diagnose infectious mononucleosis. At an estimated general population incidence of 1:200, this represents a potentially significant testing burden. We evaluated the reliability of the Siemens Novagnost® and Enzygnost® EBV microtiter assays measuring VCA IgM and IgG, and EBNA-1 IgG for clinical diagnosis of EBV-related infectious mononucleosis.
Methods
Remnant sera from 537 patients tested for EBV infection were used to compare the Siemens assays to each other and to the Merifluor assay. The Siemens assays are qualitative/semiquantitative, automatable enzyme immunoassays. The Merifluor assays are manual, qualitative indirect immunofluorescent assays. Testing was conducted on the Siemens and Merifluor assays in parallel. All assays were conducted and interpreted according to each manufacturer’s specifications. Agreement of serostatus between each of the three assays was assessed. Discrepant results were resolved using a third method (Mikrogen recomLine).
Results
Final EBV serostatus indicated 2.9% of the population had an acute infection, 89.6% had a past infection, and 7.5% were EBV naive. All three assays demonstrated 100% agreement with acute infection. Agreement with past-infection serostatus was 99.1% for Enzygnost, between 86% and 98.8% for Novagnost, and 98.1% for Merifluor. Seronegative agreement was 100% for Enzygnost, 89.7% for Novagnost, and 92.3% for Merifluor.
Conclusions
The Siemens Enzygnost and Novagnost EBV microtiter assays are suitable for clinical rule-in of acute EBV infection and for identifying EBV-naive individuals. Both assays also adequately identify remote EBV infections. Because these assays can be automated, they can improve speed and efficiency of EBV testing, especially in high-volume laboratories.
【 授权许可】
2013 Kreuzer et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150404070524204.pdf | 212KB | download |
【 参考文献 】
- [1]World Health Organization: Initiative for Vaccine Research (IVR): Viral Cancers; EBV. 2011. http://www.who.int/vaccine_research/diseases/viral_cancers/en/index1.html webcite
- [2]Luzuriaga K, Sullivan JL: Infectious mononucleosis. NEJM 2010, 362(21):1993-2000.
- [3]Ebell MH: Epstein–Barr Virus Infectious Mononucleosis. Am Fam Phys 2004, 70(7):1279-1287.
- [4]Hurt C, Tammaro D: Diagnostic Evaluation of Mononucleosis-Like Illnesses. Am J Med 2007, 120(911):e1-e8.
- [5]Weiss RL (Ed): Infectious Mononucleosis Slide Test In ARUP’s Guide to Clinical Laboratory Testing. 3rd edition. Utah: ARUP Laboratories; 2001:424-425.
- [6]Chernecky CC, Berger BJ (Eds): Monospot Screen (Heterophil Screen)—Blood In Laboratory Tests and Diagnostics Procedures. 5th edition. Missouri: Saunders Elsevier; 2008:789-80.
- [7]Rea TD, Ashley RL, Russo JE, Buchwald DS: A Systematic Study of Epstein–Barr Virus Serologic Assays Following Acute Infection. Am J Clin Pathol 2002, 117:156-161.
- [8]Tselis A, Merline JR, Storch GA: Epstein–Barr Virus Disease—Serologic and Virologic Diagnosis. In Epstein–Barr Virus. Edited by Tselis A, Jenson HB. New York and London: Taylor & Francis Group; 2006:126-146.
- [9]Klutts JS, Ford BA, Perez NR, Gronowski AM: Evidence-based approach for interpretation of Epstein–Barr virus serological patterns. J Clin Microbiol 2009, 47(10):3204-3210.
- [10]Martins TB, Litwin CM, Hill HR: Evaluation of a multiplex fluorescent microsphere immunoassay for the determination of Epstein–Barr virus serologic status. Am J Clin Pathol 2008, 129(1):34-41.
- [11]De Paschale M, Agrappi C, Manco MT, Mirri P, Viganò EF, Clerici P: Seroepidemiology of EBV and Interpretation of the “Isolated VCA IgG” Pattern. J Med Virol 2009, 81:325-331.
- [12]Guidance for Industry and FDA Staff: Statistical Guidance on Reporting Results from Studies Evaluating Diagnostic Tests. 2007. [U.S. Department of Health and Human Services Food and Drug Administration Center for Devices and Radiological Health. Diagnostic Devices Branch, Division of Biostatistics. Office of Surveillance and Biometrics] http://www.fda.gov/downloads/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm071287.pdf webcite
- [13]Gutiérrez J, Vergara MJ, Piédrola G, Maroto MC: Clinical reliability of IgG, IgA, and IgM antibodies in detecting Epstein–Barr virus at different stages of infection with a commercial nonrecombinant polyantigenic ELISA. J Clin Lab Anal 1999, 13(2):65-68.
- [14]Kleines M, Scheithauer S, Ritter K, Häusler M: Sensitivity of the Enzygnost anti-EBV/IgG for the determination of the Epstein–Barr virus immune status in pediatric patients. Diagn Microbiol Infect Dis 2006, 55(3):247-249.
- [15]Bruu AL, Hjetland R, Holter E, Mortensen L, Natås O, Petterson W: Evaluation of 12 commercial tests for detection of Epstein–Barr virus-specific and heterophile antibodies. Clin Diagn Lab Immunol 2000, 7(3):451-456.
- [16]Gärtner BC, Fischinger JM, Roemer K, Mak M, Fleurent B, Mueller-Lantzsch N: Evaluation of a recombinant line blot for diagnosis of Epstein–Barr Virus compared with ELISA, using immunofluorescence as reference method. J Virol Methods 2001, 93(1–2):89-96.
- [17]García T, Tormo N, Gimeno C, Navarro D: Assessment of Epstein–Barr virus (EBV) serostatus by enzyme immunoassays: plausibility of the isolated EBNA-1 IgG positive serological profile. J Infect 2008, 57(4):351-353.
- [18]Nystad TW, Myrmel H: Prevalence of primary versus reactivated Epstein–Barr virus infection in patients with VCA IgG-, VCA IgM- and EBNA-1-antibodies and suspected infectious mononucleosis. J Clin Virol 2007, 38(4):292-297.
- [19]Debyser Z, Reynders M, Goubau P, Desmyter J: Comparative evaluation of three ELISA techniques and an indirect immunofluorescence assay for the serological diagnosis of Epstein–Barr virus infection. Clin Diagn Virol 1997, 8(1):71-81.
- [20]Weissbrich B: The Use of Semi-Automated EBV IgG Avidity Determination for the Diagnosis of Infectious Mononucleosis. J Med Virol 1998, 54:145-153.
- [21]Hess RD: Routine Epstein–Barr Virus Diagnostics from the Laboratory Perspective: Still Challenging after 35 Years. J Clin Microbiol 2004, 42(8):3381-3387.
- [22]De Paschale M, Clerici P: Serological diagnosis of Epstein–Barr virus infection: Problems and solutions. World J Virol 2012, 1(1):31-43.
- [23]Epstein–Barr Virus and Infectious Mononucleosis. [Center for Disease Control, National Center for Infectious Diseases] http://www.cdc.gov/ncidod/diseases/ebv.htm webcite