Pseudomonas aeruginosa IgG antibodies

Immunology

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Description

Cystic fibrosis (CF) is the most common inherited disease and is due to a defect in the Cystic fibrosis transmembrane conductance regulator (CFTR). There are over 11,000 patients in the UK with CF. A complication of the CFTR defect is that sticky mucus is present in the lungs which restricts airway flow. This can lead to increased risk of infection, particularly with Pseudomonas aeruginosa (PA).
Established chronic pulmonary infection in CF patients is difficult to eradicate. With early therapeutic intervention it is possible to eliminate infection from the airways and delay the progression of pulmonary disease.
Detection of PA is performed through sputum culture. Treatment for the CFTR defect includes modulator drugs (potentiators and correctors), such as Kaftrio. These drugs improve lung health and reduce sputum volume so most people with CF are no longer expectorating sputum.
Serological tests have been developed which detect PA IgG antibodies from different strains or enzymes contained on the surface of the bacteria. These assays can be used to compliment sputum testing or as an alternative where sputum cannot be obtained.

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Indications

The test is of use in the investigation chronic Pseudomonas infection in cystic fibrosis (CF) patients.

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Sample Type

2mL Serum (Gel 5ml Yellow). Requests from outside Sheffield: Transport at ambient temperature via Royal Mail or Courier.

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Reference Range

Cut-offs or >4.25 EU or >7.35 EU may be used. Interpret alongside the clinical scenario.

The >7.35 EU cut-off was established by Hoiby, et al using the same assay design and gives sensitivity of 0.53 and specificity of 0.79.

Local clinical correlation shows that using a cut-off of >4.25 EU gives sensitivity of 0.73 and specificity of 1.00.

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Turnaround Time

10 Days

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Testing Frequency

Weekly

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References

Mauch R M, Rossi C L, Ribeiro J D, et al. Assessment of IgG antibodies to Pseudomonas aeruginosa in patients with cystic fibrosis by an enzyme-linked immunosorbent assay (ELISA). Diagnostic Pathology, 2014; 9:158 [Ref 1].

Hoo Z H, Edenborough F P, Curley R, et al. Understanding Pseudomonas status among adults with cystic fibrosis: a real-world comparison of the Leeds criteria against clinicians’ decisions. European Journal of Clinical Microbiology & Infectious Diseases, 2018; 37:7 35-743 [Ref 2].

Proesmans M, Balinska-Miskiewicz L, Dupont L, et al. Evaluating the “Leeds criteria” or Pseudomonas aeruginosa infection in a cystic fibrosis centre. Eur Respir J, 2006; 27: 937-943. [Ref 3].

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