Efficiency of various serological techniques for diagnosing Coxiella burnetii infection

An indirect immunofluorescence assay (IFA) using a recently developed commercial kit for detecting antibodies against Coxiella burnetii (C.b.), the etiological agent of Q fever, has been evaluated using human field serum samples. The IFA was compared with an ELISA and a complement fixation test (CFT). The IFA was based on the corpuscular C.b. phase I and phase II antigens specific to anti-C.b. phase I and II antibodies, respectively. Fifty sera from persons with symptoms of Q fever were examined in this study. The IFA compared with the ELISA showed the sensitivities of 97.7% and 87.2% for IgG and 66.7% and 60.0% for IgM phase II and I antibodies, respectively and the specificities of 100% and 90.0% for IgG and 75.9% and 64.7% for IgM phase II and phase I antibodies, respectively. Due to a limited number of sera positive in the IgA antibody testing, the data presented should be considered with caution. It appears that the IFA strikes a very good balance between high specificity and sensitivity with phase II and phase I IgG antibodies and a less satisfactory one with IgM antibodies. The CFT failed in one of the above aspects showing a good specificity but a poor sensitivity, especially for phase I antibodies. The study demonstrated that the IFA is suitable for diagnosing Q fever and its therapeutic follow-up and is a good candidate for screening sera in large numbers. A certain limitation, especially in testing early stages of the chronic disease, could be a low fluorescence intensity of the IgA positive control in comparison with the IgA negative one.