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ARTICLE 8 MSAT A SCREENING TEST FOR LEPTOSPIROSIS Microscopic agglutination test (MAT) and IgM ELISA are the

e important tests used for serodiagnosis of Leptospirosis. But these tests can be done only in specialized microbiological laboratories. Therefore, there is a need for a simple screening test for diagnosis of current infection. We have evaluated the

Macroscopic Slide Agglutination Test (MSAT) as a screening test and shall discuss out experience with it. At the Institute of Microbiology, Chennai Medical College, serum samples obtained from patients with clinical features suggestive of Leptospirosis during the period Jan Dec. 1995 were tested by a) Macroscopic slide Agglutination Test (MSAT) using Patoc, Icterohaemorrhagiae and Autumnalis antigens, b) IgM ELISA and c) Microscopic Agglutination Test (MAT). The diagnosis of current leptospiral infection was made by a titre of > 40 by IgM ELISA. MSAT was compared with IgM ELISA and MAT. MAT and IgM ELISA were done by standard procedures as reported by us earlier.1 MSAT was done using a dense suspension of killed Leptospirosis was mixed with a drop of serum on a slide and rotated on a rotator (120 rpm) for 4 min. It was then examined by naked eye for presence of agglutination. A 4+ agglutination titre was considered significant.2-4 Of the 592 samples received, 317 were positive by IgM ELISA. Among these, MSAT was positive in 310. (Sensitivity 97.8%). 303 samples had MAT titres of > 80. In all these patients, the MSAT was positive. 14 samples, which

INDIAN JOURNAL OF MEDICAL MICROBIOLOGY, 15(2)(1997):84

had MAT titres of 40, were positive by IgM ELISA. Of these, the MSAT was positive in seven. Autumnalis was the most common serogroup (59.9%)

followed by Icterohaemorrhagiae (15.5%). 275 samples, which were negative by IgM ELISA, were also negative by MSAT. correlation with both IgM ELISA and MAT.
Test Positive Patients (n = 568) Samples (n = 592)

The MSAT has shown good

IgM ELISA MSAT MAT (> 1: 80)

293 286 279

317 310 303

Rapid slide agglutination tests for Leptospirosis are well established and have been used satisfactorily. Galton et al used 9 cultures and divided them into 3 groups (pooled 3 antigens in each group) and found MSAT to be a sensitive as MAT.2 The Patoc Slide Agglutination test of Mazzonelli et al modified by Coghlan utilizing Patoc as a single antigen, is also a sensitive test.3,4 These tests are valuable in the diagnosis of current infection. The main advantage of these slide agglutination tests is that they are simple to perform and do not needsophisticated instruments. To conclude, MSAT is a valuable and simple screening test. The

sensitivity of this test was enhanced by adding the locally prevalent serovars. This was an important modification done by us over the PSAT (Patoc Slide Agglutination Test).1 As this test does not require sophisticated equipments, conjugates and substrates, it would be an ideal test for screening current leptospiral infection.
* G.SUMATHI * K.S. CHINARI PRADEEP **S. SHIVAKUMAR *Institute of Microbiology and **Institute of Internal Medicine Madras Medical College, Chennai 600 003

INDIAN JOURNAL OF MEDICAL MICROBIOLOGY, 15(2)(1997):84

REFERENCES:

1. Sumathi G, Subudhi CPK, Manuel HPS, shivakumar KS, Rajendran S and Muthusethupathi MA. Serodiagnosis of Leptospirosis. Indian J of Med. Microbiol (1995) 13(4): 192-195. 2. Galton MM, Powers DK, Hall AD and Cornell RG. A rapid

macroscopic slide screening test for the serodiaganosis of Leptospirosis. Am J Vet Res (1958) 19:505-512. 3. Mazzonelli J, Dorta de Mazzonelli G and Mailloux M. Possibilite de de diagnostic serologique macroscopique des leptospires a Paide d;un antigene unique. Medecine et Maladies Infectieuses (1974) 4:252-254. 4. Coghlan JD, Leptospira, Borrelia, Mackie and McCartney. Practical

Medical Microbiology, Thirteenth Edition (Churchill Livingstone, London) (1989) 671.

INDIAN JOURNAL OF MEDICAL MICROBIOLOGY, 15(2)(1997):84