title: Evaluation of Lionex TB kits and mycobacterial antigens for IgG and IgA detection in cerebrospinal fluid from tuberculosis meningitis patients.
abstract: To evaluate commercial Lionex TB together with four antigens of Mycobacterium tuberculosis (MPT-64, MT10.3, 16 kDa and 38 kDa) for IgG and IgA cerebrospinal fluid (CSF) detection in the diagnosis of tuberculosis meningitis (TBM) with CSF negative acid-fast bacilli staining, 19 cases of TBM, 64 cases of other infectious meningoencephalitis and 73 cases of other neurological disorders were tested by enzyme linked immunosorbent assay. IgA-MPT-64 and IgG Lionex showed the highest sensitivities, specificities, positive predictive value and negative predictive value (63.2%, 47.4%; 95%, 93.7%; 40%, 98% and 28.4%, 97.1%, respectively). However, while grey zone was 12.7% and 6%, respectively, lowering sensitivity but maintains high specificity (>or= 95%). High protein concentration in CSF was associated with antibody positivity CSF/HIV+ which did not influence the sensitivity of both tests. To our knowledge, this is the first description of IgA-MPT-64 and IgG Lionex antibodies in CSF-TBM and, although there is good specificity, adjustments are needed based on antigen composition to enhance sensitivity.
authors.affiliation: Laboratório de Microbiologia Celular, Instituto Oswaldo Cruz-Fiocruz, Av Brasil 4365, 21045-900 Rio de Janeiro, RJ, Brasil.
authors.forename: Isabela Gama
authors.initials: IG
authors.lastname: Sardella
authors.forename: Mahavir
authors.initials: M
authors.lastname: Singh
authors.forename: Susanne
authors.initials: S
authors.lastname: Kumpfer
authors.forename: Rafael Ribeiro
authors.initials: RR
authors.lastname: Heringer
authors.forename: Maria Helena Féres
authors.initials: MH
authors.lastname: Saad
authors.forename: Marzia Puccioni
authors.initials: MP
authors.lastname: Sohler
mesh_terms: D000907:Antibodies, Bacterial / Q000134:cerebrospinal fluid*; D000942:Antigens, Bacterial; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007070:Immunoglobulin A / Q000134:cerebrospinal fluid*; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid*; D009169:Mycobacterium tuberculosis / Q000276:immunology* / Q000302:isolation & purification; D011237:Predictive Value of Tests; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D014390:Tuberculosis, Meningeal / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000276:immunology
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D011933:Reagent Kits, Diagnostic