Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, 30333, USA.
Center of Expertise in Mycology Radboudumc/CWZ, Nijmegen, The Netherlands.
Mycopathologia. 2020 Oct;185(5):867-880. doi: 10.1007/s11046-020-00452-x. Epub 2020 May 26.
Fungal pathogens can affect humans, animals, and plants, and they can be found in the environment or as part of the host microbiome. Fungal diseases present a broad clinical spectrum, ranging from superficial to invasive infections, and can cause outbreaks. During an outbreak investigation, the laboratory plays an essential role in verifying the diagnosis and helping to confirm the source of the outbreak. Immunodiagnostic assays are important tools and often relied upon for the diagnosis of fungal infections, since the gold standard assays of culture and histopathology are time-consuming and often require invasive procedures. Immunodiagnostic assays range from complement fixation and immunodiffusion to enzyme immunoassays and, most recently, to point-of-care lateral flow devices. In general, these assays provide results faster and offer good analytical performance. These characteristics make immunodiagnostic assays good laboratory tools for outbreak investigations. The aim of this review is to describe the principles, advantages, limitations, and availability of immunodiagnostics assays in outbreak investigations, based on the experience of a reference laboratory.
真菌病原体可以影响人类、动物和植物,它们可以存在于环境中,也可以作为宿主微生物组的一部分。真菌病具有广泛的临床谱,从浅表感染到侵袭性感染都有,并且可能引起暴发。在暴发调查中,实验室在验证诊断和帮助确认暴发源方面发挥着至关重要的作用。免疫诊断检测是诊断真菌感染的重要工具,通常依赖于这些检测,因为培养和组织病理学的金标准检测耗时且通常需要侵入性操作。免疫诊断检测从补体固定和免疫扩散到酶免疫测定,最近又发展到即时检测侧向流设备。总的来说,这些检测提供的结果更快,并且具有良好的分析性能。这些特性使得免疫诊断检测成为暴发调查中的良好实验室工具。本综述旨在根据参考实验室的经验,描述免疫诊断检测在暴发调查中的原理、优点、局限性和可用性。