title: Evaluation of five conventional and molecular approaches for diagnosis of cryptococcal meningitis in non-HIV-infected patients.
abstract: Cryptococcal meningitis (CM) is a life-threatening mycosis primarily occurring in HIV-infected individuals. Recently, non-HIV-infected hosts were increasingly reported to form a considerable proportion. However, the majority of the reported studies on the diagnosis of CM patients were performed on HIV-infected patients. For evaluation of various diagnostic approaches for CM in non-HIV-infected patients, a range of conventional and molecular assays used for diagnosis of CM were verified on 85 clinical CSFs from non-HIV-infected CM patients, including India ink staining, culture, a newly developed loop-mediated isothermal amplification (LAMP), the lateral flow assay (LFA) of cryptococcal antigen detection and a qPCR assay. The LFA had the highest positive detection rate (97.6%; 95% CI, 91.8-99.7%) in non-HIV-infected CM patients, followed by the LAMP (87.1%; 95% CI, 78.0-93.4%), the qPCR (80.0%; 95% CI, 69.9-87.9%), India ink staining (70.6%; 95% CI, 59.7-80.0%) and culture (35.3%; 95% CI, 25.2-46.4%). All culture positive specimens were correctly identified by the LFA.
authors.affiliation: Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China.|CBS-KNAW Fungal Biodiversity Centre, Utrecht, the Netherlands.
authors.forename: Min
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Dermatology, Shanghai Seventh People's Hospital, Shanghai, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Pharmacy, General Hospital of Jinan Military Command, Jinan, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Sun
authors.affiliation: Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Wen J
authors.initials: WJ
authors.lastname: Fang
authors.affiliation: CBS-KNAW Fungal Biodiversity Centre, Utrecht, the Netherlands.|Directorate General of Health Services, Ministry of Health, Ibri Hospital, Ibri, Oman.
authors.forename: Abdullah M S
authors.initials: AM
authors.lastname: Al-Hatmi
authors.affiliation: Department of Biology, McMaster University, Hamilton, Canada.
authors.forename: Jianping
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China.|CBS-KNAW Fungal Biodiversity Centre, Utrecht, the Netherlands.
authors.forename: Teun
authors.initials: T
authors.lastname: Boekhout
authors.affiliation: Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Wan Q
authors.initials: WQ
authors.lastname: Liao
authors.affiliation: Department of Dermatology, Shanghai Key Laboratory of Molecular Medical Mycology, Shanghai Institute of Medical Mycology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Wei H
authors.initials: WH
authors.lastname: Pan
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D000946:Antigens, Fungal / Q000032:analysis* / Q000235:genetics; D002244:Carbon; D003454:Cryptococcus / Q000235:genetics / Q000254:growth & development / Q000302:isolation & purification*; D004271:DNA, Fungal / Q000302:isolation & purification; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D016919:Meningitis, Cryptococcal / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000382:microbiology; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D060888:Real-Time Polymerase Chain Reaction; D012680:Sensitivity and Specificity
chemical_list: D000935:Antifungal Agents; D000946:Antigens, Fungal; D004271:DNA, Fungal; C028433:chinese ink; D002244:Carbon
keywords: Cryptococcal meningitis; Diagnosis; non-HIV-infected host