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Penicillium marneffei is a major cause of opportunistic infection in patients with AIDS in north and northeastern Thailand. A method for the quantitation of P. marneffei antigen in urine was developed by using fluorescein isothiocyanate-labelled purified rabbit hyperimmune immunoglobulin G in an enzyme-linked immunosorbent assay. This method was evaluated with 33 patients with culture-proven penicilliosis and 300 controls (52 healthy subjects, 248 hospitalized patients without penicilliosis) from the same area in which penicilliosis is endemic. Urinary antigen was found in all 33 (100%) patients with penicilliosis, with a median titer of 1:20,480. With undiluted samples, 67 (27%) of 248 hospital patients and 3 (6%) of 52 healthy controls were reactive. At a cutoff titer of 1:40, the urine antigen detection assay had a diagnostic sensitivity of 97% and specificity of 98% (positive predictive value, 84%; negative predictive value, 99.7%). This test offers a valuable and rapid method for the diagnosis of penicilliosis in patients with AIDS and could be a useful addition to conventional diagnostic methods in areas in which penicilliosis is endemic.

Type

Journal article

Journal

Journal of Clinical Microbiology

Publication Date

01/1999

Volume

37

Pages

117 - 121

Addresses

Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand.

Keywords

Humans, Penicillium, Mycoses, Fluorescein-5-isothiocyanate, Antigens, Fungal, Immunoassay, Enzyme-Linked Immunosorbent Assay, Microbiological Techniques, Sensitivity and Specificity, Prospective Studies, Endemic Diseases, Adult, Thailand, Evaluation Studies as Topic