Comparison of two commercial ELISA assays for detection of Strongyloides stercoralis antibodies


C kleine Tank2; E A Lieshout1; P Daemen2; J de Vries1F Stelma2
1 Leiden University Medical Centre, Netherlands;  2 Radboudumc, Netherlands


Background: Infection withthe helminthStrongyloides stercoralis can persist for many years due to autoinfection and may cause hyperinfection syndrome in immune compromised patients. Screening for antibodies can be used to indicate past exposure to this parasite, which is important in patients prior to immunosuppressive therapy. This study evaluates the diagnostic performance of two commercial immunoassays testing for S.stercoralis specific antibodies. Methods: Two sample panels were used to evaluate the NovaLisa Strongyloides ELISA (NovaTec Immundiagnostica GmbH, Dietzenbach, Germany) and the Anti-Strongyloides IgG ELISA (Euroimmun AG, Lubeck, Germany). The first panel (n≤44) was defined by an LUMC in-house Strongyloides ELISA which characterised the samples as being strongly-positive (n≤11) , weakly-positive (n≤5) or negatives (n≤28). Among the negatives, n≤17 were seroreactive to other parasitic worm infections. The second panel (n≤30) was selected from the Radboudumc serumbank being assumedly seronegative to strongyloides spp. of which n≤22 were selected because of seropositivity to common cross-reactive antigens (rheumatoid factor, Epstein Barr virus, HBs antigen and Borrelia spp.) and n≤8 were selected from a panel of Dutch infants between 1 and 2 years. Results: The NovaTec and the Euroimmun assay tested positive in 11 and 12 of the 16 LUMC positive samples, respectively, both missing one of the strongly-positives. The NovaTec assay showed false positive reactivity in two Schistosoma reactive samples. Both commercial assays remained seronegative when testing the LUMC confirmed Strongyloides negative samples and the Radboudumc negative panel. Conclusions: The Euroimmun assay seems the most suitable commercial alternative for an in-house ELISA immunoassays testing for Strongyloides specific antibodies.

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