Chronic Q Fever: Different Serological Results in 3 Countries-Results of a Follow-up Study 6 Years After a Point Source Outbreak
Identifieur interne : 001D19 ( PascalFrancis/Corpus ); précédent : 001D18; suivant : 001D20Chronic Q Fever: Different Serological Results in 3 Countries-Results of a Follow-up Study 6 Years After a Point Source Outbreak
Auteurs : Brendan Healy ; Hugo Van Woerden ; Didier Raoult ; Stephen Graves ; James Pitman ; Graham Lloyd ; Nigel Brown ; Meirion LlewelynSource :
- Clinical infectious diseases [ 1058-4838 ] ; 2011.
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- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
Background. Acute and chronic Q fever/Coxiella burnetii infection is diagnosed principally by serology. The management of patients who have serological evidence of chronic Q fever but no other manifestation of chronic infection is challenging. Methods. This paper describes a follow-up study of individuals 6 years after a point source outbreak. The study compares serological and polymerase chain reaction (PCR) results between 3 international reference laboratories in a well-defined cohort of Q fever patients. Results. Concordance in microimmunofluorescence result interpretation from the 3 centers was only 35%. Australian and UK results had the greatest concordance and French and UK results the lowest. Serological testing revealed no chronic serological profiles when tested in either France or Australia but 10 when tested in the UK. Serological results from a patient with treated Q fever endocarditis suggested treated (France), chronic (UK), and borderline chronic (Australia) infection. PCR results on blood were universally negative. Conclusions. This study has shown that the results from Q fever micro-immunofluorescence vary according to the center in which they are carried out. This has implications for the interpretation of such tests, raises questions regarding the validity of using serological criteria alone as a means of diagnosing chronic Q fever, and affects the interpretation of epidemiological studies. We recommend that all results are interpreted according to the clinical picture and particular caution is applied in the interpretation of chronic serological profiles. In order to further our understanding of Q fever infection we propose that an international standard of Q fever serological investigation be developed.
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| NO : | PASCAL 11-0256995 INIST |
|---|---|
| ET : | Chronic Q Fever: Different Serological Results in 3 Countries-Results of a Follow-up Study 6 Years After a Point Source Outbreak |
| AU : | HEALY (Brendan); VAN WOERDEN (Hugo); RAOULT (Didier); GRAVES (Stephen); PITMAN (James); LLOYD (Graham); BROWN (Nigel); LLEWELYN (Meirion) |
| AF : | Public Health Wales, Microbiology Department, UHW Heath Park/Cardiff/Royaume-Uni (1 aut.); Department of Primary Care and Public Health, Cardiff University/Cardiff, Wales/Royaume-Uni (2 aut.); Faculté de Médecine, Unité des Rickettsies, WHO Collaborative Center for Rickettsial Reference and Research/Marseille/France (3 aut.); Australian Rickettsial Reference Laboratory, Barwon Biomedical Research, Barwon Health, Geelong Hospital/Geelong/Australie (4 aut.); Special Pathogens Reference Unit, Centre for Applied Microbiological Research, Porton Down/Salisbury, Wiltshire/Royaume-Uni (5 aut., 6 aut.); Department of Cardiology, Royal Gwent Hospital/Cardiff Road, Newport/Royaume-Uni (7 aut.); Department of Medicine, Royal Gwent Hospital/Cardiff Road, Newport/Royaume-Uni (8 aut.) |
| DT : | Publication en série; Niveau analytique |
| SO : | Clinical infectious diseases; ISSN 1058-4838; Coden CIDIEL; Royaume-Uni; Da. 2011; Vol. 52; No. 8; Pp. 1013-1019; Bibl. 29 ref. |
| LA : | Anglais |
| EA : | Background. Acute and chronic Q fever/Coxiella burnetii infection is diagnosed principally by serology. The management of patients who have serological evidence of chronic Q fever but no other manifestation of chronic infection is challenging. Methods. This paper describes a follow-up study of individuals 6 years after a point source outbreak. The study compares serological and polymerase chain reaction (PCR) results between 3 international reference laboratories in a well-defined cohort of Q fever patients. Results. Concordance in microimmunofluorescence result interpretation from the 3 centers was only 35%. Australian and UK results had the greatest concordance and French and UK results the lowest. Serological testing revealed no chronic serological profiles when tested in either France or Australia but 10 when tested in the UK. Serological results from a patient with treated Q fever endocarditis suggested treated (France), chronic (UK), and borderline chronic (Australia) infection. PCR results on blood were universally negative. Conclusions. This study has shown that the results from Q fever micro-immunofluorescence vary according to the center in which they are carried out. This has implications for the interpretation of such tests, raises questions regarding the validity of using serological criteria alone as a means of diagnosing chronic Q fever, and affects the interpretation of epidemiological studies. We recommend that all results are interpreted according to the clinical picture and particular caution is applied in the interpretation of chronic serological profiles. In order to further our understanding of Q fever infection we propose that an international standard of Q fever serological investigation be developed. |
| CC : | 002B05B02L8 |
| FD : | Fièvre Q; Chronique; Etude longitudinale; Epidémie |
| FG : | Rickettsiose; Rickettsialose; Bactériose; Infection |
| ED : | Q fever; Chronic; Follow up study; Epidemic |
| EG : | Rickettsial infection; Rickettsialosis; Bacteriosis; Infection |
| SD : | Fiebre Q; Crónico; Estudio longitudinal; Epidemia |
| LO : | INIST-18407.354000192120760090 |
| ID : | 11-0256995 |
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Graham" sort="Lloyd, Graham" uniqKey="Lloyd G" first="Graham" last="Lloyd">Graham Lloyd</name><affiliation><inist:fA14 i1="05"><s1>Special Pathogens Reference Unit, Centre for Applied Microbiological Research, Porton Down</s1><s2>Salisbury, Wiltshire</s2><s3>GBR</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Brown, Nigel" sort="Brown, Nigel" uniqKey="Brown N" first="Nigel" last="Brown">Nigel Brown</name><affiliation><inist:fA14 i1="06"><s1>Department of Cardiology, Royal Gwent Hospital</s1><s2>Cardiff Road, Newport</s2><s3>GBR</s3><sZ>7 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Llewelyn, Meirion" sort="Llewelyn, Meirion" uniqKey="Llewelyn M" first="Meirion" last="Llewelyn">Meirion Llewelyn</name><affiliation><inist:fA14 i1="07"><s1>Department of Medicine, Royal Gwent Hospital</s1><s2>Cardiff Road, Newport</s2><s3>GBR</s3><sZ>8 aut.</sZ></inist:fA14></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">11-0256995</idno><date when="2011">2011</date><idno type="stanalyst">PASCAL 11-0256995 INIST</idno><idno type="RBID">Pascal:11-0256995</idno><idno type="wicri:Area/PascalFrancis/Corpus">001D19</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Chronic Q Fever: Different Serological Results in 3 Countries-Results of a Follow-up Study 6 Years After a Point Source Outbreak</title><author><name sortKey="Healy, Brendan" sort="Healy, Brendan" uniqKey="Healy B" first="Brendan" last="Healy">Brendan Healy</name><affiliation><inist:fA14 i1="01"><s1>Public Health Wales, Microbiology Department, UHW Heath Park</s1><s2>Cardiff</s2><s3>GBR</s3><sZ>1 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Van Woerden, Hugo" sort="Van Woerden, Hugo" uniqKey="Van Woerden H" first="Hugo" last="Van Woerden">Hugo Van Woerden</name><affiliation><inist:fA14 i1="02"><s1>Department of Primary Care and Public Health, Cardiff University</s1><s2>Cardiff, Wales</s2><s3>GBR</s3><sZ>2 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Raoult, Didier" sort="Raoult, Didier" uniqKey="Raoult D" first="Didier" last="Raoult">Didier Raoult</name><affiliation><inist:fA14 i1="03"><s1>Faculté de Médecine, Unité des Rickettsies, WHO Collaborative Center for Rickettsial Reference and Research</s1><s2>Marseille</s2><s3>FRA</s3><sZ>3 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Graves, Stephen" sort="Graves, Stephen" uniqKey="Graves S" first="Stephen" last="Graves">Stephen Graves</name><affiliation><inist:fA14 i1="04"><s1>Australian Rickettsial Reference Laboratory, Barwon Biomedical Research, Barwon Health, Geelong Hospital</s1><s2>Geelong</s2><s3>AUS</s3><sZ>4 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Pitman, James" sort="Pitman, James" uniqKey="Pitman J" first="James" last="Pitman">James Pitman</name><affiliation><inist:fA14 i1="05"><s1>Special Pathogens Reference Unit, Centre for Applied Microbiological Research, Porton Down</s1><s2>Salisbury, Wiltshire</s2><s3>GBR</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Lloyd, Graham" sort="Lloyd, Graham" uniqKey="Lloyd G" first="Graham" last="Lloyd">Graham Lloyd</name><affiliation><inist:fA14 i1="05"><s1>Special Pathogens Reference Unit, Centre for Applied Microbiological Research, Porton Down</s1><s2>Salisbury, Wiltshire</s2><s3>GBR</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Brown, Nigel" sort="Brown, Nigel" uniqKey="Brown N" first="Nigel" last="Brown">Nigel Brown</name><affiliation><inist:fA14 i1="06"><s1>Department of Cardiology, Royal Gwent Hospital</s1><s2>Cardiff Road, Newport</s2><s3>GBR</s3><sZ>7 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Llewelyn, Meirion" sort="Llewelyn, Meirion" uniqKey="Llewelyn M" first="Meirion" last="Llewelyn">Meirion Llewelyn</name><affiliation><inist:fA14 i1="07"><s1>Department of Medicine, Royal Gwent Hospital</s1><s2>Cardiff Road, Newport</s2><s3>GBR</s3><sZ>8 aut.</sZ></inist:fA14></affiliation></author></analytic><series><title level="j" type="main">Clinical infectious diseases</title><title level="j" type="abbreviated">Clin. infect. dis.</title><idno type="ISSN">1058-4838</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Clinical infectious diseases</title><title level="j" type="abbreviated">Clin. infect. dis.</title><idno type="ISSN">1058-4838</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Chronic</term><term>Epidemic</term><term>Follow up study</term><term>Q fever</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Fièvre Q</term><term>Chronique</term><term>Etude longitudinale</term><term>Epidémie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background. Acute and chronic Q fever/Coxiella burnetii infection is diagnosed principally by serology. The management of patients who have serological evidence of chronic Q fever but no other manifestation of chronic infection is challenging. Methods. This paper describes a follow-up study of individuals 6 years after a point source outbreak. The study compares serological and polymerase chain reaction (PCR) results between 3 international reference laboratories in a well-defined cohort of Q fever patients. Results. Concordance in microimmunofluorescence result interpretation from the 3 centers was only 35%. Australian and UK results had the greatest concordance and French and UK results the lowest. Serological testing revealed no chronic serological profiles when tested in either France or Australia but 10 when tested in the UK. Serological results from a patient with treated Q fever endocarditis suggested treated (France), chronic (UK), and borderline chronic (Australia) infection. PCR results on blood were universally negative. Conclusions. This study has shown that the results from Q fever micro-immunofluorescence vary according to the center in which they are carried out. This has implications for the interpretation of such tests, raises questions regarding the validity of using serological criteria alone as a means of diagnosing chronic Q fever, and affects the interpretation of epidemiological studies. We recommend that all results are interpreted according to the clinical picture and particular caution is applied in the interpretation of chronic serological profiles. In order to further our understanding of Q fever infection we propose that an international standard of Q fever serological investigation be developed.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>1058-4838</s0></fA01><fA02 i1="01"><s0>CIDIEL</s0></fA02><fA03 i2="1"><s0>Clin. infect. dis.</s0></fA03><fA05><s2>52</s2></fA05><fA06><s2>8</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Chronic Q Fever: Different Serological Results in 3 Countries-Results of a Follow-up Study 6 Years After a Point Source Outbreak</s1></fA08><fA11 i1="01" i2="1"><s1>HEALY (Brendan)</s1></fA11><fA11 i1="02" i2="1"><s1>VAN WOERDEN (Hugo)</s1></fA11><fA11 i1="03" i2="1"><s1>RAOULT (Didier)</s1></fA11><fA11 i1="04" i2="1"><s1>GRAVES (Stephen)</s1></fA11><fA11 i1="05" i2="1"><s1>PITMAN (James)</s1></fA11><fA11 i1="06" i2="1"><s1>LLOYD (Graham)</s1></fA11><fA11 i1="07" i2="1"><s1>BROWN (Nigel)</s1></fA11><fA11 i1="08" i2="1"><s1>LLEWELYN (Meirion)</s1></fA11><fA14 i1="01"><s1>Public Health Wales, Microbiology Department, UHW Heath Park</s1><s2>Cardiff</s2><s3>GBR</s3><sZ>1 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Primary Care and Public Health, Cardiff University</s1><s2>Cardiff, Wales</s2><s3>GBR</s3><sZ>2 aut.</sZ></fA14><fA14 i1="03"><s1>Faculté de Médecine, Unité des Rickettsies, WHO Collaborative Center for Rickettsial Reference and Research</s1><s2>Marseille</s2><s3>FRA</s3><sZ>3 aut.</sZ></fA14><fA14 i1="04"><s1>Australian Rickettsial Reference Laboratory, Barwon Biomedical Research, Barwon Health, Geelong Hospital</s1><s2>Geelong</s2><s3>AUS</s3><sZ>4 aut.</sZ></fA14><fA14 i1="05"><s1>Special Pathogens Reference Unit, Centre for Applied Microbiological Research, Porton Down</s1><s2>Salisbury, Wiltshire</s2><s3>GBR</s3><sZ>5 aut.</sZ><sZ>6 aut.</sZ></fA14><fA14 i1="06"><s1>Department of Cardiology, Royal Gwent Hospital</s1><s2>Cardiff Road, Newport</s2><s3>GBR</s3><sZ>7 aut.</sZ></fA14><fA14 i1="07"><s1>Department of Medicine, Royal Gwent Hospital</s1><s2>Cardiff Road, Newport</s2><s3>GBR</s3><sZ>8 aut.</sZ></fA14><fA20><s1>1013-1019</s1></fA20><fA21><s1>2011</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>18407</s2><s5>354000192120760090</s5></fA43><fA44><s0>0000</s0><s1>© 2011 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>29 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>11-0256995</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Clinical infectious diseases</s0></fA64><fA66 i1="01"><s0>GBR</s0></fA66><fC01 i1="01" l="ENG"><s0>Background. Acute and chronic Q fever/Coxiella burnetii infection is diagnosed principally by serology. The management of patients who have serological evidence of chronic Q fever but no other manifestation of chronic infection is challenging. Methods. This paper describes a follow-up study of individuals 6 years after a point source outbreak. The study compares serological and polymerase chain reaction (PCR) results between 3 international reference laboratories in a well-defined cohort of Q fever patients. Results. Concordance in microimmunofluorescence result interpretation from the 3 centers was only 35%. Australian and UK results had the greatest concordance and French and UK results the lowest. Serological testing revealed no chronic serological profiles when tested in either France or Australia but 10 when tested in the UK. Serological results from a patient with treated Q fever endocarditis suggested treated (France), chronic (UK), and borderline chronic (Australia) infection. PCR results on blood were universally negative. Conclusions. This study has shown that the results from Q fever micro-immunofluorescence vary according to the center in which they are carried out. This has implications for the interpretation of such tests, raises questions regarding the validity of using serological criteria alone as a means of diagnosing chronic Q fever, and affects the interpretation of epidemiological studies. We recommend that all results are interpreted according to the clinical picture and particular caution is applied in the interpretation of chronic serological profiles. In order to further our understanding of Q fever infection we propose that an international standard of Q fever serological investigation be developed.</s0></fC01><fC02 i1="01" i2="X"><s0>002B05B02L8</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Fièvre Q</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Q fever</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Fiebre Q</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Chronique</s0><s5>07</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Chronic</s0><s5>07</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Crónico</s0><s5>07</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Etude longitudinale</s0><s5>08</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Follow up study</s0><s5>08</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Estudio longitudinal</s0><s5>08</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Epidémie</s0><s5>09</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Epidemic</s0><s5>09</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Epidemia</s0><s5>09</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Rickettsiose</s0></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Rickettsial infection</s0></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Rickettsiosis</s0></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Rickettsialose</s0></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Rickettsialosis</s0></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Rickettsialosis</s0></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Bactériose</s0></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Bacteriosis</s0></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Bacteriosis</s0></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Infection</s0></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Infection</s0></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Infección</s0></fC07><fN21><s1>171</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard><server><NO>PASCAL 11-0256995 INIST</NO><ET>Chronic Q Fever: Different Serological Results in 3 Countries-Results of a Follow-up Study 6 Years After a Point Source Outbreak</ET><AU>HEALY (Brendan); VAN WOERDEN (Hugo); RAOULT (Didier); GRAVES (Stephen); PITMAN (James); LLOYD (Graham); BROWN (Nigel); LLEWELYN (Meirion)</AU><AF>Public Health Wales, Microbiology Department, UHW Heath Park/Cardiff/Royaume-Uni (1 aut.); Department of Primary Care and Public Health, Cardiff University/Cardiff, Wales/Royaume-Uni (2 aut.); Faculté de Médecine, Unité des Rickettsies, WHO Collaborative Center for Rickettsial Reference and Research/Marseille/France (3 aut.); Australian Rickettsial Reference Laboratory, Barwon Biomedical Research, Barwon Health, Geelong Hospital/Geelong/Australie (4 aut.); Special Pathogens Reference Unit, Centre for Applied Microbiological Research, Porton Down/Salisbury, Wiltshire/Royaume-Uni (5 aut., 6 aut.); Department of Cardiology, Royal Gwent Hospital/Cardiff Road, Newport/Royaume-Uni (7 aut.); Department of Medicine, Royal Gwent Hospital/Cardiff Road, Newport/Royaume-Uni (8 aut.)</AF><DT>Publication en série; Niveau analytique</DT><SO>Clinical infectious diseases; ISSN 1058-4838; Coden CIDIEL; Royaume-Uni; Da. 2011; Vol. 52; No. 8; Pp. 1013-1019; Bibl. 29 ref.</SO><LA>Anglais</LA><EA>Background. Acute and chronic Q fever/Coxiella burnetii infection is diagnosed principally by serology. The management of patients who have serological evidence of chronic Q fever but no other manifestation of chronic infection is challenging. Methods. This paper describes a follow-up study of individuals 6 years after a point source outbreak. The study compares serological and polymerase chain reaction (PCR) results between 3 international reference laboratories in a well-defined cohort of Q fever patients. Results. Concordance in microimmunofluorescence result interpretation from the 3 centers was only 35%. Australian and UK results had the greatest concordance and French and UK results the lowest. Serological testing revealed no chronic serological profiles when tested in either France or Australia but 10 when tested in the UK. Serological results from a patient with treated Q fever endocarditis suggested treated (France), chronic (UK), and borderline chronic (Australia) infection. PCR results on blood were universally negative. Conclusions. This study has shown that the results from Q fever micro-immunofluorescence vary according to the center in which they are carried out. This has implications for the interpretation of such tests, raises questions regarding the validity of using serological criteria alone as a means of diagnosing chronic Q fever, and affects the interpretation of epidemiological studies. We recommend that all results are interpreted according to the clinical picture and particular caution is applied in the interpretation of chronic serological profiles. In order to further our understanding of Q fever infection we propose that an international standard of Q fever serological investigation be developed.</EA><CC>002B05B02L8</CC><FD>Fièvre Q; Chronique; Etude longitudinale; Epidémie</FD><FG>Rickettsiose; Rickettsialose; Bactériose; Infection</FG><ED>Q fever; Chronic; Follow up study; Epidemic</ED><EG>Rickettsial infection; Rickettsialosis; Bacteriosis; Infection</EG><SD>Fiebre Q; Crónico; Estudio longitudinal; Epidemia</SD><LO>INIST-18407.354000192120760090</LO><ID>11-0256995</ID></server></inist></record>Pour manipuler ce document sous Unix (Dilib)
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