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Revista do Instituto de Medicina Tropical de São Paulo

On-line version ISSN 1678-9946

Rev. Inst. Med. trop. S. Paulo vol.33 no.6 São Paulo Nov./Dec. 1991

http://dx.doi.org/10.1590/S0036-46651991000600011 

SOROLOGIA

 

Avaliação da contraimunoeletroforese com antígenos dos sorovars icterohaemorrhagiae E patoc no diagnóstico sorológico da leptospirose humana

 

Evaluation of counterimmunoeletrophoresis with the serovars icterohaemorrhagiae and patoc antigens in the diagnosis of human leptospirosis

 

 

Paulo H. YasudaI; Elena E. SakataII; Maria Aparecida Shikanai-YasudaIII; Silvio de Arruda VasconcelosIV; Eliete C. RomeroII; Marcos Vinícius da SilvaII; Solange CarrascoI

IInstituto de Ciências Biomédicas da USP, Depto. de Microbiología. Av. Prof. Lineu Prestes, 1374. 05508 São Paulo, SP, Brasil
IIInstituto Adolfo Lutz. Av. Dr. Arnaldo, 351. CEP 01246 São Paulo, SP, Brasil
IIIFaculdade de Medicina da USP. Av. Dr. Arnaldo, 455. CEP 01246 São Paulo, SP, Brasil
IVFaculdade de Medicina Veterinária e Zootecnia da USP. Av. Corifeu de Azevedo Marques, 2720. CEP 05340 São Paulo, SP, Brasil

 

 


RESUMO

Avaliou-se o desempenho da contraimunoeletroforese (CIE) no diagnóstico sorológico da leptospirose humana utilizando três tipos de antígenos derivados da L. interrogans sorovar icterohaemorrhagiae e do sorovar patoc da L. biflexa. Comparou-se os resultados obtidos na CIE com a prova de referência a soroaglutinação microscópica (SAM).
Soros pareados de 135 pacientes com leptospirose foram subdivididos em 4 grupos de acordo com os resultados da SAM. Como controle coletou-se sangue de 69 indivíduos sadios.
A concordância entre as duas técnicas variou de 92,64 a 94,11%. Os resultados obtidos pela CIE com os antígenos do sorovar icterohaemorrhagiae foram mais favoráveis do que aqueles derivados do patoc. Ressaltam-se as características de elevada sensibilidade detectando anticorpos antileptospiras mais precocemente do que a microaglutinação.
As características encontradas no presente estudo credenciam o emprego da CIE como um método útil e prático para o diagnóstico da leptospirose humana na fase aguda da doença.

Unitermos: Leptospirose humana; icterohaemorrhagiae; patoc; antígenos; contraimunoeletroforese.


SUMMARY

Counterimmunoelectrophoresis (CIE) was applied on paired sera from 135 pacients with leptospirosis and on 69 sera from a control group. The sera from pacients were subdivided in 4 groups according to the results obtained by the Microscopic Agglutination Test (MAT).
The first samples sera from 58 pacientes were non reagent by MAT. Six monthly samples of sera were taken from 7 patients to follow-up and to determine the level of agglutinin and precipitin antibodies present using MAT and CIE.
Serovars icterohaemorrhagie and patoc were used as antigens. Three types of antigens were compared, 1) Triton-X-100 extracted; 2) heat extacted and 3) a pool of them. The CIE using icterohaemorrhagiae derivated antigens types agreed with MAT in 92.64, 92.64 and 94.11% of the leptospirosis sera. The patoc antigens types reacted with the control group in 7.24, 86.95 and 84.05% of the samples, and consequently were eliminated from the present study.
The icterohaemorrhagiae CIE reaction become positive earlier than MAT negative sera, and reverted to negative earlier in the follow-up samples from the pacients.
The CIE was sensitive and specific, gave rapid results and was easy to perform.


 

 

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REFERÊNCIAS BIBLIOGRÁFICAS

1. ADLER, B.; CHAPPEL, R.J. & FAINE, S. - The sensitivities of different immunoassays for detecting leptospiral antigen. Zbl. Bakt. Mikrobiol. Hyg., 1 ABT. Orig. A, 252: 405-413, 1982.         [ Links ]

2. ADLER, B. & FAINE, S. - The antibodies involved in the human immune response to leptospiral infection. J. med. Microbiol., 11: 387-400, 1978.         [ Links ]

3. BUCK, A.A. & GART, J.J. - Comparison of a screening test and a reference test in epidemiologic studies. I. Indices of agreement and their relation to prevalence. Amer. J. Epidem., 83: 596-692, 1966.         [ Links ]

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6. GALEN, R.S. & GAMBINO, S.R. - Beyond normality: the predictive value and eficiecy of medical diagnosis. New York, John Wiley, 1975. 237 p.         [ Links ]

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8. MYERS, D.M. - Serodiagnosis of human leptospirosis by counterimmunoeletrophoresis. J. clin. Microbiol., 25: 897-899, 1987.         [ Links ]

9. PALIT, A. & GULASEKHARAM, J. - Genus-specific leptospiral antigen and its possible use in laboratory diagnosis. J. clin. Path., 26: 7-16, 1973.         [ Links ]

10. TERPSTRA, W.J.; SCHOONE, G.J. & LIGTHART, G.S. - Counterimmunoelectrophoresis in the diagnosis of human leptospirosis. Zbl. Bakt. Mikrobiol. Hyg. ABT 1. Orig. A, 244: 285-290, 1979.         [ Links ]

11. ZAR, J.H. - Biostatistical analysis. 2nd. ed. Englewood, Prentice Hall, 1984.         [ Links ]

 

 

Recebido para publicação em 12/03/1991.
Aceito para publicação em 06/06/1991.
O trabalho contou com o apoio financeiro da FAPESP - Fundação de Amparo à Pesquisa do Estado de São Paulo - Proc. Biomedicina 88/2301-4.

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