Diagnostic usefulness of molecular detection of Coxiella burnetii from blood of patients with suspected acute Q fever

Moonsuk Bae, Choong Eun Jin, Joung Ha Park, Min Jae Kim, Yong Pil Chong, Sang Oh Lee, Sang Ho Choi, Yang Soo Kim, Jun Hee Woo, Yong Shin, Sung Han Kim, Leyi Wang

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4 Citations (Scopus)

Abstract

Diagnosis of Q fever is difficult due to the lack of distinct clinical features that distinguish it from other febrile diseases. Serologic testing is the gold standard method for diagnosing Q fever, but antibody formation may not be detectable for 2 to 3 weeks from symptom onset, limiting early diagnosis. We thus evaluated the diagnostic utility of polymerase chain reaction (PCR) to detect Coxellia burnetii DNA in serum from patients with suspected acute Q fever.All adult patients with suspected acute Q fever were prospectively enrolled at a tertiary-care hospital from January 2016 through July 2018. Acute Q fever was diagnosed using clinical and laboratory criteria: fever with at least one other symptoms (myalgia, headache, pneumonia, or hepatitis) and single phase II immunoglobulin G (IgG) antibody titers ≥1:200 or immunoglobulin M (IgM) antibody titer ≥1:50 (probable), or a fourfold increase or seroconversion in phase II IgG antibody titers as measured by indirect immunofluorescence assays between paired samples (confirmed). We performed PCR targeting the transposase gene insertion element IS1111a of C. burnetii.Of the 35 patients with suspected acute Q fever, 16 (46%) were diagnosed with acute Q fever including 8 probable and 8 confirmed cases; the remaining 19 (54%) were diagnosed with other febrile diseases. The proportion of males diagnosed with Q fever was higher than those diagnosed with other febrile diseases (88% vs 44%, P=.03), but there were no other significant differences in clinical characteristics between the 2 groups. The Q fever PCR sensitivity was 81% (95% confidence interval [CI], 54-96), specificity was 90% (95% CI, 67-99), positive predictive value was 87% (95% CI, 63-96), and negative predictive value was 85% (95% CI, 67-94).Q fever PCR testing using blood from patients with suspected acute Q fever seems to be a rapid and useful test for early diagnosis of Q fever.

Original languageEnglish
Article numbere15724
JournalMedicine (United States)
Volume98
Issue number23
DOIs
Publication statusPublished - 2019 Jun 1

Bibliographical note

Funding Information:
This study was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea (grant no. HI16C0272).

Publisher Copyright:
© 2019 Oxford University Press. All righs reserved.

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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