组织胞浆和胚芽抗原检测试验是常用的诊断工具。然而,这些抗原之间的高水平交叉反应性阻止了单独通过这些测定进行确定的病原体鉴定。对3,529名患者进行组织胞浆和胚芽抗原检测的回顾性分析在相同的血清样品上产生了99.3%的总体一致性(3,529中的3,506;κ:0.859)。这表明使用单一检测方法来检测两种抗原可能是另一种诊断方法.我们评估了GothamBioTech胚芽抗原(GBA)酶免疫测定(EIA)的性能(波特兰,Maine)用于检测血清中的胚芽和组织胞浆抗原。与MiraVista诊断胚芽(MVB)EIA的比较显示100%阳性(24个中的24个),负(57of57),总体上(81/81)同意。此外,171份血清用于比较GBAEIA和MiraVista诊断组织学(MVH)EIA,显示91.3%(69个中的63个),98%(102个中的100个),和95.3%(171个中的163个)阳性,负,和总体百分比协议,分别。在8例GBA/MVHEIA结果不一致的患者中,七人进行了额外的真菌测试,结果表明,两个和五个样本的MVH和GBA结果不准确,分别。总的来说,这项研究表明,GBAEIA与两种常用的EIA有很高的一致性,个体胚芽和组织胞浆抗原EIA。通过利用胚芽和组织胞浆抗原EIA之间的高水平交叉反应性,对这些真菌使用单一抗原检测分析提供了一个机会,以优化测试利用率并降低患者成本,同时保持高水平的诊断准确性。
Histoplasma and
Blastomyces antigen detection assays are commonly used diagnostic tools. However, a high level of cross-reactivity between these antigens prevents definitive pathogen identification by these assays alone. Retrospective analysis of 3,529 patients with Histoplasma and
Blastomyces antigen testing performed on the same serum sample yielded an overall percent agreement of 99.3% (3,506 of 3,529; kappa: 0.859) between the two assays, suggesting that use of a single assay to detect both antigens may be an alternative diagnostic approach. We assessed performance of the Gotham BioTech Blastomyces antigen (GBA) enzyme immunoassay (EIA) (Portland, Maine) for detection of
Blastomyces and Histoplasma antigens in serum. Comparison to the MiraVista Diagnostics
Blastomyces (MVB) EIA showed 100% positive (24 of 24), negative (57 of 57), and overall (81 of 81) percent agreement. Additionally, 171 sera were used to compare the GBA EIA to the MiraVista Diagnostics Histoplasma (MVH) EIA, which showed 91.3% (63 of 69), 98% (100 of 102), and 95.3% (163 of 171) positive, negative, and overall percent agreement, respectively. Among eight patients with discordant GBA/MVH EIA results, seven had additional fungal testing performed, and results suggested that the MVH and GBA results were inaccurate for two and five samples, respectively. Overall, this study suggests that the GBA EIA has a high level of agreement with both of the commonly used, individual Blastomyces and Histoplasma antigen EIAs. By taking advantage of the high level of cross-reactivity between
Blastomyces and Histoplasma antigen EIAs, utilization of a single antigen detection assay for these fungi provides an opportunity to optimize test utilization and decrease patient cost while maintaining a high level of diagnostic accuracy.