title: Performance comparison of immunodiffusion, enzyme-linked immunosorbent assay, immunochromatography and hemagglutination for serodiagnosis of human pythiosis.
abstract: Pythiosis is a life-threatening infectious disease caused by the fungus-like organism Pythium insidiosum. Morbidity and mortality rates of pythiosis are high. The treatment of choice for pythiosis is surgical debridement of infected tissue. Early and accurate diagnosis is critical for effective treatment. In-house serodiagnostic tests, including immunodiffusion (ID), enzyme-linked immunosorbent assay (ELISA), immunochromatography (ICT) and hemagglutination (HA) have been developed to detect antibodies against P. insidiosum in sera. This study compares the diagnostic performance of ID, ELISA, ICT, and HA, using sera from 37 pythiosis patients and 248 control subjects. ICT and ELISA showed optimal diagnostic performance (100% sensitivity, specificity, positive predictive value and negative predictive value). ICT was both rapid and user-friendly. ELISA results were readily quantitated. ID is relatively insensitive. HA was rapid, but diagnostic performance was poor. Understanding the advantages offered by each assay facilitates selection of an assay that is circumstance-appropriate. This will promote earlier diagnoses and improved outcomes for patients with pythiosis.
authors.affiliation: Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Takol
authors.initials: T
authors.lastname: Chareonsirisuthigul
authors.forename: Rommanee
authors.initials: R
authors.lastname: Khositnithikul
authors.forename: Akarin
authors.initials: A
authors.lastname: Intaramat
authors.forename: Ruchuros
authors.initials: R
authors.lastname: Inkomlue
authors.forename: Kanchana
authors.initials: K
authors.lastname: Sriwanichrak
authors.forename: Savittree
authors.initials: S
authors.lastname: Piromsontikorn
authors.forename: Sureewan
authors.initials: S
authors.lastname: Kitiwanwanich
authors.forename: Tassanee
authors.initials: T
authors.lastname: Lowhnoo
authors.forename: Wanta
authors.initials: W
authors.lastname: Yingyong
authors.forename: Angkana
authors.initials: A
authors.lastname: Chaiprasert
authors.forename: Ramrada
authors.initials: R
authors.lastname: Banyong
authors.forename: Kavi
authors.initials: K
authors.lastname: Ratanabanangkoon
authors.forename: Tristan T
authors.initials: TT
authors.lastname: Brandhorst
authors.forename: Theerapong
authors.initials: T
authors.lastname: Krajaejun
mesh_terms: D000908:Antibodies, Fungal / Q000097:blood*; D000946:Antigens, Fungal / Q000097:blood*; D002846:Chromatography, Affinity / Q000379:methods; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D006384:Hemagglutination; D006801:Humans; D005779:Immunodiffusion / Q000379:methods; D058968:Pythiosis / Q000175:diagnosis* / Q000382:microbiology; D011775:Pythium / Q000276:immunology* / Q000302:isolation & purification; D012680:Sensitivity and Specificity; D012698:Serologic Tests / Q000379:methods*
chemical_list: D000908:Antibodies, Fungal; D000946:Antigens, Fungal