Clinical utility of the cryptococcal antigen lateral flow assay in a diagnostic mycology laboratory.

<h4>Background</h4>Cryptococcus neoformans causes life-threatening meningitis. A recently introduced lateral flow immunoassay (LFA) to detect cryptococcal antigen (CRAG) is reportedly more rapid and convenient than standard latex agglutination (LA), but has not yet been evaluated in a di...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Brendan J McMullan, Catriona Halliday, Tania C Sorrell, David Judd, Sue Sleiman, Debbie Marriott, Tom Olma, Sharon C-A Chen
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/663de49e29cf495ea0dc609e6196927e
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:663de49e29cf495ea0dc609e6196927e
record_format	dspace
spelling	oai:doaj.org-article:663de49e29cf495ea0dc609e6196927e2021-11-18T08:08:42ZClinical utility of the cryptococcal antigen lateral flow assay in a diagnostic mycology laboratory.1932-620310.1371/journal.pone.0049541https://doaj.org/article/663de49e29cf495ea0dc609e6196927e2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23166705/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Cryptococcus neoformans causes life-threatening meningitis. A recently introduced lateral flow immunoassay (LFA) to detect cryptococcal antigen (CRAG) is reportedly more rapid and convenient than standard latex agglutination (LA), but has not yet been evaluated in a diagnostic laboratory setting.<h4>Methods</h4>One hundred and six serum, 42 cerebrospinal fluid (CSF), and 20 urine samples from 92 patients with known or suspected cryptococcosis were tested by LA and LFA, and titres were compared. Results were correlated with laboratory-confirmed cryptococcosis. Serial samples were tested in nine treated patients.<h4>Results</h4>Twenty-five of 92 patients had confirmed cryptococcosis; all sera (n = 56) from these patients were positive by LFA (sensitivity 100%, 95% confidence interval (CI) 93.6-100%) compared with 51/56 positive by LA (sensitivity 91.1%, 95% CI 80.7-96.1%). Fifty sera from 67 patients without cryptococcosis tested negative in both assays. While LA yielded more false negative results (5/56) this did not reach statistical significance (p = 0.063). Nine CSF samples from patients with cryptococcal meningitis yielded positive results using both assays while 17/18 urine samples from patients with cryptococcosis were positive by the LFA. The LFA detected CRAG in C. gattii infection (n = 4 patients). Agreement between titres obtained by both methods (n = 38 samples) was imperfect; correlation between log-transformed titres (r) was 0.84. Turn-around-time was 20 minutes for the LFA and 2 h for LA. The cost per qualitative sample was 18USD and 91 USD, respectively and per quantitative sample was 38USD and 144USD, respectively.<h4>Conclusions</h4>Qualitative agreement between the LFA and LA assays performed on serum and CSF was good but agreement between titres was imperfect. Ease of performance of the LFA and the capacity for testing urine suggest it has a role in the routine laboratory as a rapid diagnostic test or point-of-care test.Brendan J McMullanCatriona HallidayTania C SorrellDavid JuddSue SleimanDebbie MarriottTom OlmaSharon C-A ChenPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 11, p e49541 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Brendan J McMullan Catriona Halliday Tania C Sorrell David Judd Sue Sleiman Debbie Marriott Tom Olma Sharon C-A Chen Clinical utility of the cryptococcal antigen lateral flow assay in a diagnostic mycology laboratory.
description	<h4>Background</h4>Cryptococcus neoformans causes life-threatening meningitis. A recently introduced lateral flow immunoassay (LFA) to detect cryptococcal antigen (CRAG) is reportedly more rapid and convenient than standard latex agglutination (LA), but has not yet been evaluated in a diagnostic laboratory setting.<h4>Methods</h4>One hundred and six serum, 42 cerebrospinal fluid (CSF), and 20 urine samples from 92 patients with known or suspected cryptococcosis were tested by LA and LFA, and titres were compared. Results were correlated with laboratory-confirmed cryptococcosis. Serial samples were tested in nine treated patients.<h4>Results</h4>Twenty-five of 92 patients had confirmed cryptococcosis; all sera (n = 56) from these patients were positive by LFA (sensitivity 100%, 95% confidence interval (CI) 93.6-100%) compared with 51/56 positive by LA (sensitivity 91.1%, 95% CI 80.7-96.1%). Fifty sera from 67 patients without cryptococcosis tested negative in both assays. While LA yielded more false negative results (5/56) this did not reach statistical significance (p = 0.063). Nine CSF samples from patients with cryptococcal meningitis yielded positive results using both assays while 17/18 urine samples from patients with cryptococcosis were positive by the LFA. The LFA detected CRAG in C. gattii infection (n = 4 patients). Agreement between titres obtained by both methods (n = 38 samples) was imperfect; correlation between log-transformed titres (r) was 0.84. Turn-around-time was 20 minutes for the LFA and 2 h for LA. The cost per qualitative sample was 18USD and 91 USD, respectively and per quantitative sample was 38USD and 144USD, respectively.<h4>Conclusions</h4>Qualitative agreement between the LFA and LA assays performed on serum and CSF was good but agreement between titres was imperfect. Ease of performance of the LFA and the capacity for testing urine suggest it has a role in the routine laboratory as a rapid diagnostic test or point-of-care test.
format	article
author	Brendan J McMullan Catriona Halliday Tania C Sorrell David Judd Sue Sleiman Debbie Marriott Tom Olma Sharon C-A Chen
author_facet	Brendan J McMullan Catriona Halliday Tania C Sorrell David Judd Sue Sleiman Debbie Marriott Tom Olma Sharon C-A Chen
author_sort	Brendan J McMullan
title	Clinical utility of the cryptococcal antigen lateral flow assay in a diagnostic mycology laboratory.
title_short	Clinical utility of the cryptococcal antigen lateral flow assay in a diagnostic mycology laboratory.
title_full	Clinical utility of the cryptococcal antigen lateral flow assay in a diagnostic mycology laboratory.
title_fullStr	Clinical utility of the cryptococcal antigen lateral flow assay in a diagnostic mycology laboratory.
title_full_unstemmed	Clinical utility of the cryptococcal antigen lateral flow assay in a diagnostic mycology laboratory.
title_sort	clinical utility of the cryptococcal antigen lateral flow assay in a diagnostic mycology laboratory.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/663de49e29cf495ea0dc609e6196927e
work_keys_str_mv	AT brendanjmcmullan clinicalutilityofthecryptococcalantigenlateralflowassayinadiagnosticmycologylaboratory AT catrionahalliday clinicalutilityofthecryptococcalantigenlateralflowassayinadiagnosticmycologylaboratory AT taniacsorrell clinicalutilityofthecryptococcalantigenlateralflowassayinadiagnosticmycologylaboratory AT davidjudd clinicalutilityofthecryptococcalantigenlateralflowassayinadiagnosticmycologylaboratory AT suesleiman clinicalutilityofthecryptococcalantigenlateralflowassayinadiagnosticmycologylaboratory AT debbiemarriott clinicalutilityofthecryptococcalantigenlateralflowassayinadiagnosticmycologylaboratory AT tomolma clinicalutilityofthecryptococcalantigenlateralflowassayinadiagnosticmycologylaboratory AT sharoncachen clinicalutilityofthecryptococcalantigenlateralflowassayinadiagnosticmycologylaboratory
_version_	1718422171338932224

Clinical utility of the cryptococcal antigen lateral flow assay in a diagnostic mycology laboratory.

Ejemplares similares