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Comparing immunochromatography with latex antigen agglutination testing for the diagnosis of cryptococcosis in cats, dogs and koalas.
Medical Mycology ( IF 2.9 ) Pub Date : 2019-03-09 , DOI: 10.1093/mmy/myz010
Mark B Krockenberger 1 , Caroline Marschner 1 , Patricia Martin 1 , George Reppas 2 , Catriona Halliday 3 , Laura J Schmertmann 1 , Andrea M Harvey 4 , Richard Malik 5
Affiliation  

Although the point-of-care cryptococcal antigen lateral flow assay (LFA) has revolutionized the diagnosis of cryptococcosis in human patients, to date there has been no large-scale examination of this test in animals. We therefore assessed the LFA in cats, dogs and koalas suspected of having cryptococcosis. In sum, 528 serum specimens (129 from cats, 108 from dogs, 291 from koalas) were tested using the LFA and one of two commercially available latex cryptococcal antigen agglutination test (LCAT) kits. The LCAT is a proven and well-accepted method in veterinary patients and therefore taken as the "gold standard" against which the LFA was compared. The LFA achieved a sensitivity of 92%, 100%, and 98% in cats, dogs, and koalas, respectively, with corresponding negative predictive values of 94%, 100%, and 98%. The specificity of the LFA was 81%, 84%, and 62% for cats, dogs, and koalas, respectively, with corresponding positive predictive values of 76%, 48%, and 69%. These findings suggest the most appropriate role for the LFA is as a screening test to rule out a diagnosis of cryptococcosis in cats, dogs, and koalas. Point-of-care accessibility makes it equally suited for use in the field and as a cage-side test in veterinary hospitals. The suboptimal specificity of the LFA makes it less suited to definitive confirmation of cryptococcosis in animals; therefore, all LFA-positive test results should be confirmed by LCAT testing. The discrepancy between these observations and the high specificity of the LFA in humans may reflect differences in the host-pathogen interactions amongst the species.

中文翻译:

将免疫色谱法与乳胶抗原凝集试验进行比较,以诊断猫,狗和考拉的隐球菌病。

尽管即时护理隐球菌抗原侧向流动检测(LFA)彻底改变了人类患者隐球菌的诊断,但迄今为止,尚未在动物中对该试验进行大规模检查。因此,我们评估了怀疑患有隐球菌病的猫,狗和考拉的LFA。总之,使用LFA和两种市售乳胶隐球菌抗原凝集测试(LCAT)试剂盒之一,对528个血清样本(猫129,狗108,考拉291)进行了测试。LCAT是兽医患者公认的公认方法,因此被视为与LFA进行比较的“黄金标准”。在猫,狗和考拉中,LFA的灵敏度分别达到92%,100%和98%,相应的阴性预测值为94%,100%和98%。LFA对猫,狗和考拉的特异性分别为81%,84%和62%,相应的阳性预测值为76%,48%和69%。这些发现表明,LFA最合适的作用是作为筛查试验,以排除诊断猫,狗和考拉中隐球菌的能力。即时服务点可访问性使其同样适合在野外使用,也可作为兽医医院的笼子侧测试。LFA的次优特异性使其不适用于确定动物隐球菌病的确定性;因此,所有LFA阳性测试结果均应通过LCAT测试确认。这些观察结果之间的差异和人类LFA的高特异性可能反映了物种之间宿主-病原体相互作用的差异。相应的阳性预测值分别为76%,48%和69%。这些发现表明,LFA最合适的作用是作为筛查试验,以排除诊断猫,狗和考拉中隐球菌的能力。即时服务点可访问性使其同样适合在野外使用,也可作为兽医医院的笼子侧测试。LFA的次优特异性使其不太适合动物的隐球菌病的确诊;因此,所有LFA阳性测试结果均应通过LCAT测试确认。这些观察结果之间的差异和人类LFA的高特异性可能反映了物种之间宿主-病原体相互作用的差异。相应的阳性预测值分别为76%,48%和69%。这些发现表明,LFA最合适的作用是作为筛查试验,以排除诊断猫,狗和考拉中隐球菌的能力。即时服务点可访问性使其同样适合在野外使用,也可作为兽医医院的笼子侧测试。LFA的次优特异性使其不太适合动物的隐球菌病的确诊;因此,所有LFA阳性测试结果均应通过LCAT测试确认。这些观察结果之间的差异和人类LFA的高特异性可能反映了物种之间宿主-病原体相互作用的差异。这些发现表明,LFA最合适的作用是作为筛查试验,以排除诊断猫,狗和考拉中隐球菌的能力。即时服务点可访问性使其同样适合在野外使用,也可作为兽医医院的笼子侧测试。LFA的次优特异性使其不太适合动物的隐球菌病的确诊;因此,所有LFA阳性测试结果均应通过LCAT测试确认。这些观察结果之间的差异和人类LFA的高特异性可能反映了物种之间宿主-病原体相互作用的差异。这些发现表明,LFA最合适的作用是作为筛查试验,以排除诊断猫,狗和考拉中隐球菌的能力。即时服务点可访问性使其同样适合在野外使用,也可作为兽医医院的笼子侧测试。LFA的次优特异性使其不适用于确定动物隐球菌病的确定性;因此,所有LFA阳性测试结果均应通过LCAT测试确认。这些观察结果之间的差异和人类LFA的高特异性可能反映了物种之间宿主-病原体相互作用的差异。LFA的次优特异性使其不太适合动物的隐球菌病的确诊;因此,所有LFA阳性测试结果均应通过LCAT测试确认。这些观察结果之间的差异和人类LFA的高特异性可能反映了物种之间宿主-病原体相互作用的差异。LFA的次优特异性使其不太适合动物的隐球菌病的确诊;因此,所有LFA阳性测试结果均应通过LCAT测试确认。这些观察结果之间的差异和人类LFA的高特异性可能反映了物种之间宿主-病原体相互作用的差异。
更新日期:2020-04-17
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