Clinical value of cryptococcal capsular polysaccharide antigen detection by lateral chromatography in the diagnosis of cryptococcal infection_West China Medical Journal

Authors：

YUAN Yu , WANG Yuanfang , SHU Ling , LIU Ya , KANG Mei ,  MA Ying

Clinical Microbiology Laboratory, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

MA Ying, Email: majiying72@hotmail.com

Keywords：

Cryptococcal capsular polysaccharide antigen; Lateral chromatography; Sensitivity; Specificity; Positive rate

DOI：

10.7507/1002-0179.202007025

Video：

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Objective To investigate the diagnostic value of lateral chromatography for cryptococcal capsular polysaccharide antigen in cryptococcal infection.Methods The data of patients who detected cryptococcal capsular polysaccharide antigen in West China Hospital of Sichuan University in 2018 were collected. The sensitivity, specificity, positive predictive value and negative predictive value of cryptococcal capsular polysaccharide antigen detected by lateral chromatography were analyzed. The samples with positive lateral chromatography and definite clinical diagnosis were compared with the results of ink staining and fungal culture.Results A total of 721 cases were detected. The sensitivity, specificity, positive predictive value and negative predictive value of lateral chromatography detection were 100.00%, 99.39%, 93.93%, 100.00%, respectively. The positive rates of ink staining, fungal culture and cryptococcal capsular polysaccharide antigen for cryptococcal infection were 63.46%, 48.00% and 100.00%, respectively. Sixty-two patients were clinically diagnosed, including 45 cases of cryptococcal meningitis (72.58%), 16 cases of cryptococcal pneumonia (25.81%), and 1 case of bone cryptococcal infection (1.61%).Conclusions Lateral chromatography detection for cryptococcal capsular polysaccharide antigen shows well performing sensitivity and specificity in the diagnosis of cryptococcal infection. Considering its rapid and simple pre-operation, cryptococcal capsular polysaccharide antigen detection with lateral chromatography has good application value for early diagosis of cryptococcal infection.

Citation： YUAN Yu, WANG Yuanfang, SHU Ling, LIU Ya, KANG Mei, MA Ying. Clinical value of cryptococcal capsular polysaccharide antigen detection by lateral chromatography in the diagnosis of cryptococcal infection. West China Medical Journal, 2021, 36(8): 1044-1047. doi: 10.7507/1002-0179.202007025 Copy

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2.	Shah HS, Patel DA, Vegad MM. Evaluation of conventional and serological methods for rapid diagnosis of cryptococcal meningitis in HIV seropositive patients at tertiary care hospital. Natl J Community Med, 2011, 2(3): 354-357.
3.	Johnston SA, May RC. Cryptococcus interactions with macrophages: evasion and manipulation of the phagosome by a fungal pathogen. Cell Microbiol, 2013, 15(3): 403-411.
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6.	梅周芳, 秦欣宇, 潘星月, 等. 无免疫功能缺陷的肺隐球菌病19例误诊分析. 临床误诊误治, 2016, 29(1): 50-52.
7.	贾军, 田强, 曾明珍, 等. 新型隐球菌性脑膜炎四例误诊报告. 临床误诊误治, 2017, 30(5): 35-37.
8.	赵宇, 蔡绍曦, 汗金林, 等. 90例人类免疫缺陷病毒阴性宿主原发性肺隐球菌病的诊断分析. 中国呼吸与危重监护杂志, 2012, 11(6): 541-544.
9.	付雅捷, 杨青. 隐球菌荚膜多糖抗原胶体金法在肺隐球菌病诊断中的应用. 预防医学, 2017, 29(5): 539-540.
10.	McMullan BJ, Halliday C, Sorrell TC, et al. Clinical utility of the cryptococcal antigen lateral flow assay in a diagnostic mycology laboratory. PLos One, 2012, 7(11): e49541.
11.	Wang H, Yuan X, Zhang L. Latex agglutination: diagnose the early Cryptococcus neoformans test of capsular polysaccharide antigen. Pak J Pjarm Sci, 2015, 28(Suppl 1): 307-311.
12.	Perfect JR, Bicanic T. Cryptococcosis diagnosis and treatment: what do we know now. Fungal Genet Biol, 2015, 78: 49-54.
13.	李文华, 刘增香, 罗金凤. 隐球菌性脑膜炎脑脊液四种检测方法的比较. 医学理论与实践, 2015, 28(15): 1971-1972, 1974.
14.	Chen M, Zhou J, Li J, et al. Evaluation of five conventional and molecular approaches for diagnosis of cryptococcal meningitis in non- HIV-infected patients. Mycoses, 2016, 59(8): 494-502.
15.	魏丹丹, 黄先琪, 李小菊, 等. 隐球菌抗原-胶体金免疫层析法在隐球菌性脑膜炎和隐球菌性肺炎诊断中的应用价值. 中华医院感染学杂志, 2018, 28(9): 1281-1283, 1444.
16.	曹林, 沈继录. 隐球菌检验方法的应用. 中国感染与化疗杂志, 2018, 18(1): 113-117.

1. Ranjan R, Jain D, Singh L, et al. Differentiation of histoplasma and cryptococcus in cytology smears: a diagnostic dilemma in severely necrotic cases. Cytopathology, 2015, 26(4): 244-249.
2. Shah HS, Patel DA, Vegad MM. Evaluation of conventional and serological methods for rapid diagnosis of cryptococcal meningitis in HIV seropositive patients at tertiary care hospital. Natl J Community Med, 2011, 2(3): 354-357.
3. Johnston SA, May RC. Cryptococcus interactions with macrophages: evasion and manipulation of the phagosome by a fungal pathogen. Cell Microbiol, 2013, 15(3): 403-411.
4. Xu J, Eastman AJ, Flaczyk A, et al. Disruption of early tumor necrosis factor alpha signaling prevents classical activation of dendritic cells in lung-associated lymph nodes and development of protective immunity against cryptococcal infection. mBio, 2016, 7(4): e00510-00516.
5. Cáceres DH, Zuluaga A, Tabares ÁM, et al. Evaluation of a cryptococcal antigen lateral flow assay in serum and cerebrospinal fluid for rapid diagnosis of cryptococcosis in Colombia. Rev Inst Med Trop Sao Paulo, 2017, 59: e76.
6. 梅周芳, 秦欣宇, 潘星月, 等. 无免疫功能缺陷的肺隐球菌病19例误诊分析. 临床误诊误治, 2016, 29(1): 50-52.
7. 贾军, 田强, 曾明珍, 等. 新型隐球菌性脑膜炎四例误诊报告. 临床误诊误治, 2017, 30(5): 35-37.
8. 赵宇, 蔡绍曦, 汗金林, 等. 90例人类免疫缺陷病毒阴性宿主原发性肺隐球菌病的诊断分析. 中国呼吸与危重监护杂志, 2012, 11(6): 541-544.
9. 付雅捷, 杨青. 隐球菌荚膜多糖抗原胶体金法在肺隐球菌病诊断中的应用. 预防医学, 2017, 29(5): 539-540.
10. McMullan BJ, Halliday C, Sorrell TC, et al. Clinical utility of the cryptococcal antigen lateral flow assay in a diagnostic mycology laboratory. PLos One, 2012, 7(11): e49541.
11. Wang H, Yuan X, Zhang L. Latex agglutination: diagnose the early Cryptococcus neoformans test of capsular polysaccharide antigen. Pak J Pjarm Sci, 2015, 28(Suppl 1): 307-311.
12. Perfect JR, Bicanic T. Cryptococcosis diagnosis and treatment: what do we know now. Fungal Genet Biol, 2015, 78: 49-54.
13. 李文华, 刘增香, 罗金凤. 隐球菌性脑膜炎脑脊液四种检测方法的比较. 医学理论与实践, 2015, 28(15): 1971-1972, 1974.
14. Chen M, Zhou J, Li J, et al. Evaluation of five conventional and molecular approaches for diagnosis of cryptococcal meningitis in non- HIV-infected patients. Mycoses, 2016, 59(8): 494-502.
15. 魏丹丹, 黄先琪, 李小菊, 等. 隐球菌抗原-胶体金免疫层析法在隐球菌性脑膜炎和隐球菌性肺炎诊断中的应用价值. 中华医院感染学杂志, 2018, 28(9): 1281-1283, 1444.
16. 曹林, 沈继录. 隐球菌检验方法的应用. 中国感染与化疗杂志, 2018, 18(1): 113-117.

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