对无症状人群的筛查提供了有关Tropheryma whipplei无症状携带者的发生频率的概念,但对早期诊断和治疗没有影响。
血清阳性率检查
血清阳性率检查发现,无症状对照者体内有T whipplei抗体。[26]Bonhomme CJ, Renesto P, Nandi S, et al. Serological microarray for a paradoxical diagnostic of Whipple's disease. Eur J Clin Microbiol Infect Dis. 2008;27:959-968.http://www.ncbi.nlm.nih.gov/pubmed/18594884?tool=bestpractice.com[76]Kowalczewska M, Fenollar F, Lafitte D, et al. Identification of candidate antigen in Whipple's disease using a serological proteomic approach. Proteomics. 2006;6:3294-3305.http://www.ncbi.nlm.nih.gov/pubmed/16637011?tool=bestpractice.com这些对照者是自然接触环境中的T whipplei但没有疾病遗传倾向的人。
PCR 检查
健康人的十二指肠活检、痰液或粪便的 PCR 检查显示,1%~11% 是T whipplei健康携带者。[6]Fenollar F, Trani M, Davoust B, et al. Prevalence of asymptomatic Tropheryma whipplei carriage among humans and nonhuman primates. J Infect Dis. 2008;197:880-887.http://jid.oxfordjournals.org/content/197/6/880.fullhttp://www.ncbi.nlm.nih.gov/pubmed/18419351?tool=bestpractice.com[13]Fenollar F, Puechal X, Raoult D. Whipple's disease. N Engl J Med. 2007;356:55-66.高度暴露于污水的污水处理厂工人(25%),[4]Schoniger-Hekele M, Petermann D, Weber B, et al. Tropheryma whipplei in the environment: survey of sewage plant influxes and sewage plant workers. Appl Environ Microbiol. 2007;73:2033-2035.http://aem.asm.org/cgi/content/full/73/6/2033http://www.ncbi.nlm.nih.gov/pubmed/17277223?tool=bestpractice.com以及生活在塞内加尔卫生条件差地区的儿童携带率最高。[24]Fenollar F, Trape JF, Bassene H, et al. Tropheryma whipplei in fecal samples from children, Senegal. Emerg Infect Dis. 2009;15:922-924.http://wwwnc.cdc.gov/eid/article/15/6/09-0182_articlehttp://www.ncbi.nlm.nih.gov/pubmed/19523292?tool=bestpractice.com