Desakorn V, Smith M D, Walsh A L, Simpson A J, Sahassananda D, Rajanuwong A, Wuthiekanun V, Howe P, Angus B J, Suntharasamai P, White N J
Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand.
J Clin Microbiol. 1999 Jan;37(1):117-21. doi: 10.1128/JCM.37.1.117-121.1999.
Penicillium marneffei is a major cause of opportunistic infection in patients with AIDS in north and northeastern Thailand. A method for the quantitation of P. marneffei antigen in urine was developed by using fluorescein isothiocyanate-labelled purified rabbit hyperimmune immunoglobulin G in an enzyme-linked immunosorbent assay. This method was evaluated with 33 patients with culture-proven penicilliosis and 300 controls (52 healthy subjects, 248 hospitalized patients without penicilliosis) from the same area in which penicilliosis is endemic. Urinary antigen was found in all 33 (100%) patients with penicilliosis, with a median titer of 1:20,480. With undiluted samples, 67 (27%) of 248 hospital patients and 3 (6%) of 52 healthy controls were reactive. At a cutoff titer of 1:40, the urine antigen detection assay had a diagnostic sensitivity of 97% and specificity of 98% (positive predictive value, 84%; negative predictive value, 99.7%). This test offers a valuable and rapid method for the diagnosis of penicilliosis in patients with AIDS and could be a useful addition to conventional diagnostic methods in areas in which penicilliosis is endemic.
马尔尼菲青霉是泰国北部和东北部艾滋病患者机会性感染的主要病因。通过在酶联免疫吸附测定中使用异硫氰酸荧光素标记的纯化兔超免疫免疫球蛋白G，开发了一种定量尿液中马尔尼菲青霉抗原的方法。该方法在33例经培养证实患有青霉病的患者以及来自青霉病流行地区的300名对照者（52名健康受试者、248名未患青霉病的住院患者）中进行了评估。在所有33例（100%）青霉病患者中均发现尿液抗原，中位滴度为1:20480。对于未稀释的样本，248名住院患者中有67例（27%）以及52名健康对照者中有3例（6%）呈反应性。在截断滴度为1:40时，尿液抗原检测试验的诊断敏感性为97%，特异性为98%（阳性预测值为84%；阴性预测值为99.7%）。该检测为艾滋病患者青霉病的诊断提供了一种有价值且快速的方法，并且在青霉病流行地区可能是对传统诊断方法有用的补充。
