应用脑脊液侧流分析快速诊断隐球菌性脑膜炎：高剂量“钩状”效应的影响。
Rapid diagnosis of cryptococcal meningitis by use of lateral flow assay on cerebrospinal fluid samples: influence of the high-dose "hook" effect.
机构信息
Division of Medical Microbiology, Stellenbosch University, National Health Laboratory Services, Tygerberg Hospital, Cape Town, South Africa
Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom Botswana-University of Pennsylvania Partnership, Gaborone, Botswana University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
出版信息
J Clin Microbiol. 2014 Dec;52(12):4172-5. doi: 10.1128/JCM.01683-14. Epub 2014 Sep 17.
Abstract
Cryptococcal meningitis is the most frequent cause of meningitis and a major cause of mortality in HIV-infected adults in Africa. This study evaluated the performance of the lateral flow assay (LFA) on cerebrospinal fluid (CSF) samples for the diagnosis of cryptococcal meningitis against that of existing diagnostic tests. LFA performed on 465 undiluted CSF samples had a sensitivity of 91%. When the LFA was paired with Gram staining, a sensitivity of 100% was achieved after implementation of a dilution step for samples with negative LFA results and the presence of yeasts on microscopy. Microscopy is essential for preventing the reporting of false-negative results due to the high-dose "hook" effect.
摘要
隐球菌性脑膜炎是非洲 HIV 感染者中最常见的脑膜炎病因，也是主要的致死原因。本研究评估了侧向流动检测（LFA）在脑脊液（CSF）样本中用于诊断隐球菌性脑膜炎的性能，对比了现有的诊断检测方法。在 465 份未稀释的 CSF 样本上进行的 LFA 检测，其灵敏度为 91%。当 LFA 与革兰氏染色联合使用时，对于 LFA 结果为阴性且镜检有酵母的样本，实施稀释步骤后，灵敏度可达到 100%。由于高剂量的“钩状”效应，显微镜检查对于防止报告假阴性结果至关重要。
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