title: Rapid diagnosis of cryptococcosis using an antigen detection immunochromatographic test.
abstract: OBJECTIVE
  Current methods for cryptococcal antigen detection have some limitations. This study aimed at evaluating a lateral flow assay (LFA) for the diagnosis of cryptococcosis in a French University medical center.
  
  
  METHODS
  A retrospective study was performed on samples collected from patients with a definitive diagnosis of cryptococcosis (group I 66 samples; 28 patients) or with non-Cryptococcus invasive fungal infection (group II 18 samples; 17 patients). In addition, 274 samples from 205 consecutive patients, either suspected of cryptococcal infection or routinely screened during their follow-up, were prospectively tested (group III). Cryptococcal antigen was assayed using LFA and an EIA. A latex-based test was used for confirmation.
  
  
  RESULTS
  Sensitivity calculated on group I and specificity on group II, were respectively at 100% and 90.0%. Two false positives were related to Trichosporon fungemia. Per-sample analysis on group III revealed sensitivity, specificity, positive and negative predictive values all at 100% for CSF, and at 100%, 98.9%, 75% and 100%, respectively for serum samples. LFA enabled the diagnosis of two cases of asymptomatic cryptococcosis.
  
  
  CONCLUSIONS
  The excellent diagnostic value and practicality (visual reading results in 15 min) of LFA make it fully appropriate for the diagnosis of cryptococcosis in this particular setting.
authors.affiliation: Assistance Publique-Hôpitaux de Paris, Hôpital St Antoine, Service de Parasitologie-Mycologie, F-75012, Paris, France.
authors.forename: Diane
authors.initials: D
authors.lastname: Rivet-Dañon
authors.affiliation: Assistance Publique-Hôpitaux de Paris, Hôpital St Antoine, Service de Parasitologie-Mycologie, F-75012, Paris, France; Inserm, U1135, CIMI-Paris, 91 Bd de l'hôpital, F-75013, Paris, France; CNRS, ERL 8255, CIMI-Paris, 91 Bd de l'hôpital, F-75013, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), 91 Bd de l'hôpital, F-75013, Paris, France.
authors.forename: Juliette
authors.initials: J
authors.lastname: Guitard
authors.affiliation: Centre Hospitalier Régional Universitaire de Besançon, Service de Parasitologie-Mycologie, F-25030, Besançon, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Grenouillet
authors.affiliation: Inserm, U1135, CIMI-Paris, 91 Bd de l'hôpital, F-75013, Paris, France; CNRS, ERL 8255, CIMI-Paris, 91 Bd de l'hôpital, F-75013, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), 91 Bd de l'hôpital, F-75013, Paris, France; Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie-Mycologie, F-75013, Paris, France.
authors.forename: Frédérick
authors.initials: F
authors.lastname: Gay
authors.affiliation: Assistance Publique-Hôpitaux de Paris, Hôpital Ambroise Paré, Service de Microbiologie, F-92100, Boulogne-Billancourt, France.
authors.forename: Nawel
authors.initials: N
authors.lastname: Ait-Ammar
authors.affiliation: Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Service de Microbiologie, F-94270, Le Kremlin-Bicêtre, France.
authors.forename: Adela
authors.initials: A
authors.lastname: Angoulvant
authors.affiliation: Inserm, U1135, CIMI-Paris, 91 Bd de l'hôpital, F-75013, Paris, France; CNRS, ERL 8255, CIMI-Paris, 91 Bd de l'hôpital, F-75013, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), 91 Bd de l'hôpital, F-75013, Paris, France.
authors.forename: Carine
authors.initials: C
authors.lastname: Marinach
authors.affiliation: Assistance Publique-Hôpitaux de Paris, Hôpital St Antoine, Service de Parasitologie-Mycologie, F-75012, Paris, France; Inserm, U1135, CIMI-Paris, 91 Bd de l'hôpital, F-75013, Paris, France; CNRS, ERL 8255, CIMI-Paris, 91 Bd de l'hôpital, F-75013, Paris, France; Sorbonne Universités, UPMC Univ Paris 06, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), 91 Bd de l'hôpital, F-75013, Paris, France. Electronic address: christophe.hennequin@upmc.fr.
authors.forename: Christophe
authors.initials: C
authors.lastname: Hennequin
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D000946:Antigens, Fungal / Q000032:analysis* / Q000097:blood / Q000134:cerebrospinal fluid; D058070:Asymptomatic Diseases; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D002846:Chromatography, Affinity; D003453:Cryptococcosis / Q000175:diagnosis* / Q000382:microbiology; D056285:Cryptococcus gattii / Q000302:isolation & purification*; D003455:Cryptococcus neoformans / Q000276:immunology / Q000302:isolation & purification*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D000946:Antigens, Fungal
keywords: Cryptococcosis; Diagnosis; Lateral flow assay; Rapid diagnosis test; Serotype