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Journal of Clinical Microbiology, November 2005, p. 5555-5559, Vol. 43, No. 11
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.11.5555-5559.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

New Criteria for Immunofluorescence Assay for Q Fever Diagnosis in Japan

A. Setiyono,1,3 M. Ogawa,1* Y. Cai,1 S. Shiga,1 T. Kishimoto,1 and I. Kurane2

Laboratory of Rickettsia and Chlamydia,1 Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-Ku, Tokyo 162-8640, Japan,2 Laboratory of Pathology, Department of Parasitology and Pathology, Faculty of Veterinary Medicine, Bogor Agricultural University, Jl. Agatis, Kampus IPB Darmaga Bogor 16680, Indonesia3

Received 26 October 2004/ Returned for modification 24 January 2005/ Accepted 9 August 2005

A study was made to evaluate the cutoff value of indirect immunofluorescent-antibody (IFA) test for Q fever diagnosis in Japan. We used 346 sera, including 16 from confirmed Q fever cases, 304 from Japanese pneumonia patients, and 26 from negative cases. Thirteen sera from the confirmed Q fever cases with an immunoglobulin M (IgM) titer of ≥1:128 and/or IgG titer of ≥1:256 by the IFA test were positive by both enzyme-linked immunosorbent assay (ELISA) and Western blotting assay (WBA), whereas 298 sera from pneumonia patients and 26 negative sera with an IgM titer of ≤1:16 and an IgG titer of ≤1:32 by the IFA test were negative by both ELISA and WBA. In the proposed "equivocal area," with an IgM titer of ≥1:32 and ≤1:64 and/or an IgG titer of ≥1:64 and ≤1:128, we found 9 sera, 3 from confirmed Q fever cases and 6 from Japanese pneumonia patients, by the IFA test. Three sera from the confirmed Q fever cases and one of the sera from pneumonia patients were IgM and/or IgG positive by both ELISA and WBA. These results suggest that a single cutoff value for the IFA test may cause false-positive and false-negative results. In conclusion, this study showed that an "equivocal area" should be used for the IFA test rather than a single cutoff value and that sera in the equivocal area should be tested by additional serological assays for confirmation.

* Corresponding author. Mailing address: Laboratory of Rickettsia and Chlamydia, Department of Virology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-Ku, Tokyo 162-8640, Japan. Phone: 81-3-5285-1111, ext. 2563. Fax: 81-3-5285-1208. E-mail: ogawam{at}nih.go.jp.

Journal of Clinical Microbiology, November 2005, p. 5555-5559, Vol. 43, No. 11
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.11.5555-5559.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Vaidya, V. M., Malik, S. V. S., Kaur, S., Kumar, S., Barbuddhe, S. B. (2008). Comparison of PCR, Immunofluorescence Assay, and Pathogen Isolation for Diagnosis of Q Fever in Humans with Spontaneous Abortions. J. Clin. Microbiol. 46: 2038-2044 [Abstract] [Full Text]  


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