title: Diagnosis of Penicillium marneffei infection by quantitation of urinary antigen by using an enzyme immunoassay.
abstract: 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.
authors.affiliation: Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand.
authors.forename: V
authors.initials: V
authors.lastname: Desakorn
authors.forename: M D
authors.initials: MD
authors.lastname: Smith
authors.forename: A L
authors.initials: AL
authors.lastname: Walsh
authors.forename: A J
authors.initials: AJ
authors.lastname: Simpson
authors.forename: D
authors.initials: D
authors.lastname: Sahassananda
authors.forename: A
authors.initials: A
authors.lastname: Rajanuwong
authors.forename: V
authors.initials: V
authors.lastname: Wuthiekanun
authors.forename: P
authors.initials: P
authors.lastname: Howe
authors.forename: B J
authors.initials: BJ
authors.lastname: Angus
authors.forename: P
authors.initials: P
authors.lastname: Suntharasamai
authors.forename: N J
authors.initials: NJ
authors.lastname: White
mesh_terms: D000328:Adult; D000946:Antigens, Fungal / Q000652:urine*; D019353:Endemic Diseases; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D005069:Evaluation Studies as Topic; D016650:Fluorescein-5-isothiocyanate; D006801:Humans; D007118:Immunoassay; D008828:Microbiological Techniques; D009181:Mycoses / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000652:urine; D010407:Penicillium / Q000276:immunology / Q000302:isolation & purification*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013785:Thailand / Q000453:epidemiology
chemical_list: D000946:Antigens, Fungal; D016650:Fluorescein-5-isothiocyanate