1
|
Andreani M, Frola CE, Caceres DH, Canteros CE, Rolón MJ, Chiller T, Guelfand L. Validation of a Lateral Flow Assay for Rapid Diagnosis of Histoplasmosis in Advanced HIV Disease, Buenos Aires, Argentina. APPLIED MICROBIOLOGY (BASEL, SWITZERLAND) 2022; 2:950-955. [PMID: 39184036 PMCID: PMC11342866 DOI: 10.3390/applmicrobiol2040072] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2024]
Abstract
Histoplasmosis is a major cause of mortality in individuals with advanced human immunodeficiency virus (HIV) disease (AHD). We evaluated in patients with AHD a lateral flow assay (LFA) developed by MiraVista® Diagnostics (MVD LFA). Histoplasmosis was defined based on the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) case definitions. We also compared the results of this LFA with those obtained using a commercial enzyme immunoassay (EIA) developed by IMMY, Clarus Histoplasma GM EIA, IMMY (HGM EIA). A retrospective observational study was conducted at Hospital Juan A. Fernández, located in Buenos Aires, Argentina. The study included 48 urine specimens from patients aged >18 years with AHD. Urine specimens included 17 patients with disseminated histoplasmosis and 31 specimens from patients without evidence of histoplasmosis. Specimens were tested using the MVD LFA and the HGM EIA. The MVD LFA and the HGM EIA had similar analytical performance, with a sensitivity of 94%, specificity of 100%, positive predictive value of 100%, negative predictive value of 97%, and an accuracy of 98%. Comparison of the MVD LFA with the HGM EIA demonstrated a Kappa agreement index of 0.906. The LFA evaluated in this study had high analytical performance; it provided rapid diagnosis of histoplasmosis with minimal requirements for laboratory training, equipment, and laboratory infrastructure.
Collapse
Affiliation(s)
- Mariana Andreani
- División Laboratorio de Análisis Clínicos, Sección Microbiología, Sector Micología, Hospital Juan A. Fernández, Ciudad Autónoma de Buenos Aires C1425, Argentina
| | - Claudia E. Frola
- División Infectología, Hospital Juan A. Fernández, Ciudad Autónoma de Buenos Aires C1425, Argentina
| | - Diego H. Caceres
- Center of Expertise in Mycology Radboudumc/CWZ, 6525GA Nijmegen, The Netherlands
- Immuno-Mycologics (IMMY), Norman, OK 73069, USA
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota 1653, Colombia
| | - Cristina E. Canteros
- Departamento Micología, Instituto Nacional de Enfermedades Infecciosas (INEI), Administración Nacional de Laboratorios e Institutos de Salud (ANLIS) “Dr. Carlos G. Malbrán”, Buenos Aires 1281, Argentina
| | - María J. Rolón
- División Infectología, Hospital Juan A. Fernández, Ciudad Autónoma de Buenos Aires C1425, Argentina
| | - Tom Chiller
- Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Liliana Guelfand
- División Laboratorio de Análisis Clínicos, Sección Microbiología, Sector Micología, Hospital Juan A. Fernández, Ciudad Autónoma de Buenos Aires C1425, Argentina
| |
Collapse
|
2
|
Nacher M, Valdes A, Adenis A, Blaizot R, Ugo F, Abboud P, Demar M, Djossou F, Epelboin L, Misslin C, Blanchet D, Couppié P, Alsibai KD. Review of diagnostic methods and results for HIV-associated disseminated histoplasmosis: Pathologists are not sufficiently involved. Trop Med Int Health 2021; 26:1462-1469. [PMID: 34310800 DOI: 10.1111/tmi.13663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Disseminated histoplasmosis is a major killer of HIV-infected persons in Latin America. Antigen detection, fungal culture and Polymerase Chain Reaction are often not available, but cytology and histology are present in most hospitals and may offer a diagnostic alternative. In this study, we review 34 years of clinical experience to describe the roles of cytology and histology in diagnosing disseminated histoplasmosis. METHODS Retrospective multicentric study of 349 patients between 1 January 1981 and 1 October 2014 with confirmed disseminated histoplasmosis. RESULTS Around 32/214 (14.9%) of samples were screened using cytopathology, as were 10/101 (9.9%) bronchoalveolar lavage samples and 5/61 (8.2%) of spinal fluid samples. The samples most commonly sent to pathology were liver biopsies, lower digestive tract and lymphnode biopsies; the greatest proportion of positive results were found in lower digestive tract (43/59 (72.9%) positives), lymph node (39/63 (66.1%)), and liver (38/75 (50.7%)) samples. Overall, 97.2% of bone marrow and 97% of bronchoalveolar lavage samples were directly examined by a mycologist. Positive direct examination was independently associated with death (aHR = 1.5 (95%CI = 1-2.2)). CONCLUSIONS Opportunities for a rapid diagnosis were regularly missed, notably for bone marrow samples, which could have been examined using staining methods complementary to those of the mycologist.
Collapse
Affiliation(s)
- Mathieu Nacher
- CIC INSERM 1424, Centre Hospitalier Andree Rosemon Cayenne, Cayenne, French Guiana.,DFR Santé, Université de Guyane, Cayenne, French Guiana
| | - Audrey Valdes
- Equipe Opérationnelle d'hygiène hospitalière, Centre hospitalier Andree Rosemon Cayenne, Cayenne, French Guiana
| | - Antoine Adenis
- CIC INSERM 1424, Centre Hospitalier Andree Rosemon Cayenne, Cayenne, French Guiana.,DFR Santé, Université de Guyane, Cayenne, French Guiana
| | - Romain Blaizot
- DFR Santé, Université de Guyane, Cayenne, French Guiana.,Department of Dermatology, Centre Hospitalier Andree Rosemon Cayenne, Cayenne, French Guiana
| | - Françoise Ugo
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Andree Rosemon Cayenne, Cayenne, French Guiana
| | - Philippe Abboud
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Andree Rosemon Cayenne, Cayenne, French Guiana
| | - Magalie Demar
- Laboratory, Centre Hospitalier Andree Rosemon Cayenne, Cayenne, French Guiana.,UMR Tropical Biome and Immunopathology, Université de Guyane, Cayenne, French Guiana
| | - Félix Djossou
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Andree Rosemon Cayenne, Cayenne, French Guiana
| | - Loïc Epelboin
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Andree Rosemon Cayenne, Cayenne, French Guiana
| | - Caroline Misslin
- Service de Médecine, Centre Hospitalier de l'Ouest Guyanais, Saint Laurent du Maroni, French Guiana
| | - Denis Blanchet
- Laboratory, Centre Hospitalier Andree Rosemon Cayenne, Cayenne, French Guiana.,UMR Tropical Biome and Immunopathology, Université de Guyane, Cayenne, French Guiana
| | - Pierre Couppié
- DFR Santé, Université de Guyane, Cayenne, French Guiana.,Department of Dermatology, Centre Hospitalier Andree Rosemon Cayenne, Cayenne, French Guiana
| | - Kinan Drak Alsibai
- Department of Pathology, Centre Hospitalier Andrée Rosemon Cayenne, Cayenne, French Guiana
| |
Collapse
|