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

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. 無免疫功能缺陷的肺隱球菌病19例誤診分析. 臨床誤診誤治, 2016, 29(1): 50-52.
7.	賈軍, 田強, 曾明珍, 等. 新型隱球菌性腦膜炎四例誤診報告. 臨床誤診誤治, 2017, 30(5): 35-37.
8.	趙宇, 蔡紹曦, 汗金林, 等. 90例人類免疫缺陷病毒陰性宿主原發性肺隱球菌病的診斷分析. 中國呼吸與危重監護雜志, 2012, 11(6): 541-544.
9.	付雅捷, 楊青. 隱球菌莢膜多糖抗原膠體金法在肺隱球菌病診斷中的應用. 預防醫學, 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.	李文華, 劉增香, 羅金鳳. 隱球菌性腦膜炎腦脊液四種檢測方法的比較. 醫學理論與實踐, 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, 黃先琪, 李小菊, 等. 隱球菌抗原-膠體金免疫層析法在隱球菌性腦膜炎和隱球菌性肺炎診斷中的應用價值. 中華醫院感染學雜志, 2018, 28(9): 1281-1283, 1444.
16.	曹林, 沈繼錄. 隱球菌檢驗方法的應用. 中國感染與化療雜志, 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. 無免疫功能缺陷的肺隱球菌病19例誤診分析. 臨床誤診誤治, 2016, 29(1): 50-52.
7. 賈軍, 田強, 曾明珍, 等. 新型隱球菌性腦膜炎四例誤診報告. 臨床誤診誤治, 2017, 30(5): 35-37.
8. 趙宇, 蔡紹曦, 汗金林, 等. 90例人類免疫缺陷病毒陰性宿主原發性肺隱球菌病的診斷分析. 中國呼吸與危重監護雜志, 2012, 11(6): 541-544.
9. 付雅捷, 楊青. 隱球菌莢膜多糖抗原膠體金法在肺隱球菌病診斷中的應用. 預防醫學, 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. 李文華, 劉增香, 羅金鳳. 隱球菌性腦膜炎腦脊液四種檢測方法的比較. 醫學理論與實踐, 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, 黃先琪, 李小菊, 等. 隱球菌抗原-膠體金免疫層析法在隱球菌性腦膜炎和隱球菌性肺炎診斷中的應用價值. 中華醫院感染學雜志, 2018, 28(9): 1281-1283, 1444.
16. 曹林, 沈繼錄. 隱球菌檢驗方法的應用. 中國感染與化療雜志, 2018, 18(1): 113-117.

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