Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, Oklahoma, USA.
J Vet Intern Med. 2021 Jan;35(1):284-293. doi: 10.1111/jvim.16006. Epub 2020 Dec 24.
Commercially available, noninvasive testing options for histoplasmosis are limited outside of the United States.
To describe the diagnostic performance of a novel Histoplasma antigen enzyme immunoassay (IM EIA) for the diagnosis of histoplasmosis in dogs.
Twenty dogs with histoplasmosis, 79 dogs without histoplasmosis, and 11 unclassified dogs providing 202 urine samples.
This a prospective study using stored urine samples. Samples were analyzed with the IM EIA and with the commercially available Histoplasma antigen EIA (MV EIA). Dogs were classified based on final proven diagnosis and performance of the IM EIA was described and compared with the MiraVista enzyme immunoassay (MV EIA).
The diagnostic sensitivity (DSe), specificity (DSp), and accuracy (DAc) of the IM EIA were 70% (51%-89%), 99% (97%-100%), and 93% (81%-100%), respectively. The DSe, DSp, and DAc for the MV EIA were 95% (85%-100%), 99% (97%-100%), and 98% (95%-100%), respectively. The area under the receiver operator characteristic curve was significantly smaller for IM EIA (0.87) as compared with MV EIA (0.97, P = .03). This was primarily due to 6 false negative IM EIA results, 4 from dogs with disease localized to the gastrointestinal tract. The MV EIA was positive in 5/6 of these dogs.
The IM EIA might be useful for the diagnosis of disseminated histoplasmosis in dogs, but clinical usefulness will be limited in dogs with histoplasmosis localized to the GI tract.
在美国以外地区,用于诊断组织胞浆菌病的商用非侵入性检测方法有限。
描述一种新型组织胞浆菌抗原酶免疫测定法(IM EIA)在诊断犬组织胞浆菌病中的诊断性能。
20 只患有组织胞浆菌病的犬、79 只未患组织胞浆菌病的犬和 11 只分类不明的犬,共提供 202 份尿液样本。
这是一项前瞻性研究,使用存储的尿液样本。使用 IM EIA 和市售的组织胞浆菌抗原酶免疫测定法(MV EIA)对样本进行分析。根据最终确诊结果对犬进行分类,并描述和比较 IM EIA 的性能与 MiraVista 酶免疫测定法(MV EIA)。
IM EIA 的诊断敏感度(DSe)、特异性(DSp)和准确性(DAc)分别为 70%(51%-89%)、99%(97%-100%)和 93%(81%-100%)。MV EIA 的 DSe、DSp 和 DAc 分别为 95%(85%-100%)、99%(97%-100%)和 98%(95%-100%)。IM EIA 的受试者工作特征曲线下面积显著小于 MV EIA(0.87 比 0.97,P =.03)。这主要是由于 6 份 IM EIA 检测结果为假阴性,其中 4 份来自胃肠道局部受累的犬。在这 6 只犬中,MV EIA 均为阳性。
IM EIA 可能有助于诊断犬的全身性组织胞浆菌病,但在胃肠道局部受累的犬中,其临床应用将受到限制。