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 effe...

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Published in:Diagnostic microbiology and infectious disease 2013-05, Vol.76 (1), p.42-45
Main Authors: Chareonsirisuthigul, Takol, Khositnithikul, Rommanee, Intaramat, Akarin, Inkomlue, Ruchuros, Sriwanichrak, Kanchana, Piromsontikorn, Savittree, Kitiwanwanich, Sureewan, Lowhnoo, Tassanee, Yingyong, Wanta, Chaiprasert, Angkana, Banyong, Ramrada, Ratanabanangkoon, Kavi, Brandhorst, Tristan T, Krajaejun, Theerapong
Format: Article
Language:English
Subjects:
Antibodies, Fungal - blood
Antigens, Fungal - blood
Diagnosis
ELISA
Enzyme-Linked Immunosorbent Assay - methods
Hemagglutination
Humans
Immunochromatography
Immunochromatography - methods
Immunodiffusion
Immunodiffusion - methods
Infectious Disease
Internal Medicine
Pythiosis
Pythiosis - diagnosis
Pythiosis - microbiology
Pythium - immunology
Pythium - isolation & purification
Sensitivity and Specificity
Serologic Tests - methods
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Summary: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.
ISSN:0732-8893
1879-0070
DOI:10.1016/j.diagmicrobio.2013.02.025