Sekhon A S, Kaufman L, Kobayashi G S, Moledina N, Jalbert M, Notenboom R H
National Centre for Human Mycotic Diseases, University of Alberta Hospital, Edmonton, Canada.
Mycoses. 1994 Sep-Oct;37(9-10):313-6. doi: 10.1111/myc.1994.37.9-10.313.
A total of 178 sera, including 68 from proven cases of histoplasmosis (65 positive for the presence of Histoplasma capsulatum var. capsulatum antibodies and three positive for antigen), 93 from patients with suspected histoplasmosis but with no laboratory evidence of H. capsulatum var. capsulatum infection, 14 from humans with heterologous fungal and non-fungal infections and three from normal individuals, were tested for IgG H. capsulatum antibodies and M or M and H precipitins by enzyme immunoassay (EIA) (Meridian Diagnostics, Cincinnati, OH, USA) and microimmunodiffusion (MID) respectively. Sixty-three of the 68 histoplasmosis case sera demonstrated IgG antibody, and 65 of 68 demonstrated the presence of specific precipitins in the MID test. Nine positive case sera, when tested with the Laboratory Branch complement fixation (LBCF) test, reacted positively to whole yeast and histoplasmin antigens (titres 1:8 to 1:512). Three histoplasmosis case sera repeatedly tested negative for IgG, specific precipitins and complement-fixing antibodies, whereas they were positive for Histoplasma antigen. Eighteen of 95 sera from patients without evidence of histoplasmosis demonstrated IgG antibody in the EIA only. Among these positive sera, three out of three cases of aspergillosis and three out of five cases of blastomycosis were confirmed. Sera from HIV-infected and healthy individuals did not show IgG or M and/or H antibodies to H. capsulatum. Ninety-three sera were negative by both EIA and MID. The EIA for IgG was less sensitive (97%) than MID (100%). The specificity of EIA and MID was 84% and 100% respectively.
共有178份血清样本接受检测，其中包括68份组织胞浆菌病确诊病例的血清（65份荚膜组织胞浆菌变种抗体检测呈阳性，3份抗原检测呈阳性）、93份疑似组织胞浆菌病但无荚膜组织胞浆菌变种感染实验室证据患者的血清、14份患有异源真菌和非真菌感染的人类血清以及3份正常人的血清，分别采用酶免疫测定法（EIA，美国俄亥俄州辛辛那提市Meridian Diagnostics公司产品）检测荚膜组织胞浆菌IgG抗体，采用微量免疫扩散法（MID）检测M或M和H沉淀素。68份组织胞浆菌病病例血清中，63份显示IgG抗体阳性，68份中有65份在MID检测中显示存在特异性沉淀素。9份阳性病例血清采用实验室分部补体结合试验（LBCF）检测时，对全酵母和组织胞浆菌素抗原呈阳性反应（效价为1:8至1:512）。3份组织胞浆菌病病例血清的IgG、特异性沉淀素和补体结合抗体检测反复呈阴性，但组织胞浆菌抗原检测呈阳性。95份无组织胞浆菌病证据患者的血清中，18份仅在EIA检测中显示IgG抗体阳性。在这些阳性血清中，3例曲霉病中的3例以及5例芽生菌病中的3例得到确诊。HIV感染个体和健康个体的血清未显示针对荚膜组织胞浆菌的IgG或M和/或H抗体。93份血清的EIA和MID检测均为阴性。IgG的EIA检测敏感性（97%）低于MID检测（100%）。EIA和MID检测的特异性分别为84%和100%。
