Sandin R L, Hall G S, Longworth D L, Washington J A
Department of Microbiology, Cleveland Clinic Foundation, Ohio 44195-5140.
Am J Clin Pathol. 1993 May;99(5):542-5. doi: 10.1093/ajcp/99.5.542.
Colonial and microscopic features of five fungal isolates from three patients suggested Blastomyces dermatitidis. Extracts from the mold forms of all isolates were tested on several occasions with commercially available Exoantigen immunodiffusion culture-confirmation test reagents and Nolan reagents. All three isolates from patient 1 were negative on four separate attempts with Exoantigen reagents using conventional ("slant") and "broth" extraction methods, and were also negative on one attempt with the Nolan reagents. The isolate from patient 3 was negative on three attempts using both reagent kits. The isolate from patient 2 was negative on four of five attempts with Exoantigen test reagents and positive on one attempt with Nolan reagents. Commercially prepared chemiluminescence-labeled DNA probes (Gen-Probe, San Diego, CA) directed at ribosomal RNA from B. dermatitidis and Histoplasma capsulatum confirmed all five isolates as B. dermatitidis. The cost and labor of the exoantigen and DNA Probe culture confirmation tests were evaluated. New methods for confirming the identity of cultural isolates of B. dermatitidis that are sensitive, specific, and commercially available are greatly needed.
从三名患者身上分离出的五株真菌的菌落和微观特征提示为皮炎芽生菌。对所有分离株霉菌形态的提取物多次使用市售的外抗原免疫扩散培养确认试验试剂和诺兰试剂进行检测。患者1的所有三株分离株在使用传统（“斜面”）和“肉汤”提取方法的四次单独试验中，外抗原试剂检测均为阴性，在一次诺兰试剂试验中也为阴性。患者3的分离株在使用两种试剂盒的三次试验中均为阴性。患者2的分离株在五次外抗原试验中有四次为阴性，在一次诺兰试剂试验中为阳性。针对皮炎芽生菌和荚膜组织胞浆菌核糖体RNA的市售化学发光标记DNA探针（基因探针公司，加利福尼亚州圣地亚哥）确认所有五株分离株均为皮炎芽生菌。对外抗原和DNA探针培养确认试验的成本和工作量进行了评估。非常需要新的方法来确认皮炎芽生菌培养分离株的身份，这些方法要灵敏、特异且可市售。
