Diagnosis of Penicillium marneffei infection by quantitation of urinary antigen by using an enzyme immunoassay

Penicillium marneffei is a major cause of opportunistic infection in patients with AIDS in north and north-eastern Thailand. A method for the quantitation of P. marneffei antigen in urine was developed by using fluorescein isothiocyanate-labelled purified rabbit hyperimmune immunoglobulin G in an en...

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Bibliographic Details
Main Authors: V. Desakorn, M. D. Smith, A. L. Walsh, A. J.H. Simpson, D. Sahassananda, A. Rajanuwong, V. Wuthiekanun, P. Howe, B. J. Angus, P. Suntharasamai, N. J. White
Other Authors: Mahidol University
Format: Article
Published: 2018
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/25767
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Institution: Mahidol University
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Summary:Penicillium marneffei is a major cause of opportunistic infection in patients with AIDS in north and north-eastern Thailand. A method for the quantitation of P. marneffei antigen in urine was developed by using fluorescein isothiocyanate-labelled purified rabbit hyperimmune immunoglobulin G in an enzyme-linked immunosorbent assay. This method was evaluated with 33 patients with culture-proven penicilliosis and 300 controls (52 healthy subjects, 248 hospitalized patients without penicilliosis) from the same area in which penicilliosis is endemic. Urinary antigen was found in all 33 (100%) patients with penicilliosis, with a median titer of 1:20,480. With undiluted samples, 67 (27%) of 248 hospital patients and 3 (6%) of 52 healthy controls were reactive. At a cutoff titer of 1:40, the urine antigen detection assay had a diagnostic sensitivity of 97% and specificity of 98% (positive predictive value, 84%; negative predictive value, 99.7%). This test offers a valuable and rapid method for the diagnosis of penicilliosis in patients with AIDS and could be a useful addition to conventional diagnostic methods in areas in which penicilliosis is endemic.