Comparison of enzyme-linked immunosorbent assay and complement fixation and indirect fluorescent-antibody tests for detection of Coxiella burnetii antibody

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Abstract
An enzyme-linked immunosorbent assay (ELISA) was developed to detect immunoglobulin G to Coxiella burnetii phase II. Serum samples from 213 patients who had had Q fever 1 year previously and from 301 blood donors from six localities in Switzerland were tested by ELISA and by indirect fluorescent-antibody (IFA) and complement fixation (CF) tests. The ELISA and the IFA and CF tests detected antibody to C. burnetii in 202 (94.8%), 193 (90.6%), and 166 (77.8%) of the 213 Q fever patients, respectively. With the serum samples from blood donors, the ELISA yielded a higher percentage of positive sera than did the IFA and CF tests. The high specificity of the three tests was confirmed by analyzing paired serum samples from 36 patients suffering from acute pneumonia of viral or bacterial origin. In these cases, the serological results were negative by the three tests, except for three Q-fever cases included as positive control.