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Journal of Clinical Microbiology, June 2008, p. 2038-2044, Vol. 46, No. 6
0095-1137/08/$08.00+0     doi:10.1128/JCM.01874-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Comparison of PCR, Immunofluorescence Assay, and Pathogen Isolation for Diagnosis of Q Fever in Humans with Spontaneous Abortions{triangledown}

V. M. Vaidya,1* S. V. S. Malik,1 Simranpreet Kaur,1 Satish Kumar,2 and S. B. Barbuddhe3

Division of Veterinary Public Health,1 National Biotechnology Centre, Indian Veterinary Research Institute, Izatnagar 243 122, India,2 ICAR Research Complex for Goa, Ela, Old Goa 403 402, India3

Received 20 September 2007/ Returned for modification 8 November 2007/ Accepted 15 April 2008

Coxiella burnetii, an obligate intracellular parasite with a worldwide distribution, is the causative agent of Q fever in humans. We tested a total of 368 samples (placental bits, genital swabs, fecal swabs, and urine and serum samples) collected from women (n = 74) with spontaneous abortions for C. burnetii by a PCR assay targeting IS1111, the repetitive transposon-like region of C. burnetii (trans-PCR); real-time PCR; an indirect immunofluorescence assay (IFA); and the isolation of the pathogen. The IFA showed seropositivity for 25.68% of the women with spontaneous abortions, whereas trans-PCR and real-time PCR each detected the pathogen in 21.62% of cases. Overall, 25.68% of the subjects were positive by one or more assays. Real-time PCR showed a slightly higher level of sensitivity than trans-PCR. With the IFA as the reference, the two PCR assays showed a higher level of sensitivity (84.21%) than pathogen isolation (26.31%), while both the PCR assays and pathogen isolation were specific (100%). The detection of high numbers of C. burnetii cells in clinical samples and the frequent association of the pathogen with cases of spontaneous abortions observed in this study revealed that Q fever remains underdiagnosed and that the prevalence in India is underestimated.

* Corresponding author. Mailing address: Department of Veterinary Public Health, Veterinary College, Karnataka Veterinary and Fishery Sciences University, Bidar 585 401, India. Phone: (91) 94802 40093. Fax: (91) 8482 245 107. E-mail: drvilasmvaidya{at}rediffmail.com

{triangledown} Published ahead of print on 30 April 2008.

Journal of Clinical Microbiology, June 2008, p. 2038-2044, Vol. 46, No. 6
0095-1137/08/$08.00+0     doi:10.1128/JCM.01874-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.





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