Zhu Ning, Lin Shanhong, Weng Xingbei, Sun Weijie, Chen Xueqin
Department of Respiratory and Critical Care Medicine, Ningbo First Hospital, Ningbo, China.
Department of Ultrasound, Ningbo First Hospital, Ningbo, China.
Can J Infect Dis Med Microbiol. 2022 Jul 9;2022:7876030. doi: 10.1155/2022/7876030. eCollection 2022.
This study aimed to investigate the efficacy of the colloidal gold immunochromatography method in the detection of antigen in bronchoalveolar lavage fluid (BALF) for pulmonary cryptococcosis (PC) diagnosis.
A total of 111 patients with clinically suspected PC who were finally diagnosed with nonhuman immunodeficiency virus infection and hospitalized in the Ningbo First Hospital from March 2017 to December 2021 were retrospectively analyzed. All the confirmed cases were divided into two groups as follows: the PC group (33 cases) and the non-PC group (78 cases). All the patients were subjected to serum and BALF cryptococcal capsular polysaccharide antigen-lateral flow immunochromatographic assay (CrAg-LFA) and etiological culturing.
In the PC group, serum CrAg-LFA was positive for 24 and negative for 9 cases, serum culture was positive for 1 and negative for 32 cases, BALF CrAg-LFA was positive for 31 and negative for 2 cases, and BALF culture was positive for 9 and negative for 24 cases. In the non-PC group, serum CrAg-LFA was positive for 1 and negative for 77 cases, serum culture was negative in all the cases, and both BALF CrAg-LFA and culture were negative in all the cases. The sensitivity, specificity, and accuracy of BALF CrAg-LFA for PC diagnosis were 93.9%, 100%, and 98.2%, respectively, whereas those of BALF culture were 27.3%, 100%, and 78.4%, respectively. The sensitivity and accuracy of BALF CrAg-LFA were higher than that of serum CrAg-LFA and BALF etiological culture with statistically significant differences ( < 0.05).
The diagnostic value of BALF CrAg-LFA for PC is superior to that of serum CrAg-LFA and BALF etiological culture.
本研究旨在探讨胶体金免疫层析法检测支气管肺泡灌洗液（BALF）中抗原用于肺隐球菌病（PC）诊断的效能。
回顾性分析2017年3月至2021年12月在宁波市第一医院住院的111例临床疑似PC且最终诊断为非人类免疫缺陷病毒感染的患者。所有确诊病例分为两组：PC组（33例）和非PC组（78例）。所有患者均接受血清和BALF隐球菌荚膜多糖抗原侧向流动免疫层析测定（CrAg-LFA）及病原学培养。
PC组中，血清CrAg-LFA阳性24例，阴性9例；血清培养阳性1例，阴性32例；BALF CrAg-LFA阳性31例，阴性2例；BALF培养阳性9例，阴性24例。非PC组中，血清CrAg-LFA阳性1例，阴性77例；血清培养均为阴性；BALF CrAg-LFA和培养均为阴性。BALF CrAg-LFA诊断PC的敏感性、特异性和准确性分别为93.9%、100%和98.2%，而BALF培养的分别为27.3%丶100%和78.4%。BALF CrAg-LFA的敏感性和准确性高于血清CrAg-LFA及BALF病原学培养，差异有统计学意义（<0.05）。
BALF CrAg-LFA对PC的诊断价值优于血清CrAg-LFA及BALF病原学培养。
