Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo, 162-8640, Japan,
J Infect Chemother. 2013 Oct;19(5):999-1003. doi: 10.1007/s10156-013-0548-2. Epub 2013 Jan 24.
Histoplasmosis is a fungal infection that, although not endemic in Japan, has seen a rise in the number of Japanese cases since the mid-1980s. Diagnosis of the disease is not straightforward, and the main method of detection, fungal culture (which has biosafety-related issues), is of low sensitivity in general. Alternative methods that depend on antibody or antigen detection have had limited use. We have developed a histoplasmosis detection method based on PCR amplification of the Histoplasma capsulatum M antigen gene. We compared this method with fungal culture and serological diagnostic techniques. Among five cases that were finally diagnosed as histoplasmosis, the fungal culture method was only successful in identifying one such case. Although the presence of anti-H. capsulatum antibodies was confirmed in three cases, our PCR method identified four of five cases of histoplasmosis. The performance of our PCR method could not be compared with the antigen detection method, which is used in the United States but is not routinely used in Japan. However, the PCR method was shown to have high sensitivity and specificity for H. capsulatum. Although the number of histoplasmosis cases examined in this study was small, our data suggest that the molecular diagnosis technique has potential for increasing the reliability of histoplasmosis diagnosis when used in combination with established methods.
组织胞浆菌病是一种真菌感染，尽管在日本非地方性疾病，但自 20 世纪 80 年代中期以来，日本的病例数量有所增加。该疾病的诊断并不简单，主要的检测方法真菌培养（具有与生物安全相关的问题）通常灵敏度较低。依赖抗体或抗原检测的替代方法的使用受到限制。我们已经开发了一种基于组织胞浆菌荚膜抗原基因 PCR 扩增的组织胞浆菌检测方法。我们将该方法与真菌培养和血清学诊断技术进行了比较。在最终诊断为组织胞浆菌病的五例病例中，真菌培养方法仅成功识别了一例。尽管在三例病例中证实存在抗组织胞浆菌抗体，但我们的 PCR 方法鉴定了五例组织胞浆菌病中的四例。我们的 PCR 方法的性能无法与在美国使用但在日本未常规使用的抗原检测方法进行比较。然而，PCR 方法对组织胞浆菌具有高灵敏度和特异性。尽管本研究中检查的组织胞浆菌病病例数量较少，但我们的数据表明，当与既定方法结合使用时，分子诊断技术有可能提高组织胞浆菌病诊断的可靠性。
