Evaluation of a Cryptococcal antigen Lateral Flow Assay in serum and cerebrospinal fluid for rapid diagnosis of cryptococcosis in Colombia

Cáceres, Diego H.; Zuluaga, Alejandra; Tabares, Angela; Chiller, Tom; González, Ángel; Gómez, Beatriz L.

doi:10.1590/s1678-9946201759076

Cited by 10 publications

(14 citation statements)

References 9 publications

(11 reference statements)

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“…The first report, long before the point-of-care tests were launched, was done in 2002 by Lizarazo et al, who suggested that patients with CD4 count <100 cells/mm 3 are at risk of developing the disease, in which the presence of this mycotic infection could be established even in the absence of symptoms [ 38 ]. More recently, two retrospective analyses have been done with Colombian samples, in which the usefulness of the commercially rapid test available for the screening of the disease was evidenced over the common detection of the cryptococcal antigen by latex agglutination [ 39 , 40 ]. Despite these reports, the usefulness of this test has not been recognized by the public health authorities in Colombia and is only sporadically requested by physicians.…”

Section: Discussionmentioning

confidence: 99%

Cryptococcosis in Colombia: Compilation and Analysis of Data from Laboratory-Based Surveillance

Escandón

Lizarazo

Agudelo

et al. 2018

JoF

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The passive and voluntary surveillance of cryptococcosis in Colombia since 1997 has seen an increasing participating rate, revealing its importance to both in immunosuppressed and immunocompetent people. The present work details the national data gathered in 1997–2016, through a retrospective analysis of the information collected in the survey. From a total of 1974 cases reported, an overall incidence of 0.23 cases per 100,000 people was found. This incidence rose to 1.1 cases per 1000 people in the Acquired Immunodeficiency Syndrome (AIDS) population. Cryptococcosis was most common in male young adults (26–40 years), with a male:female ratio of 3.9:1 in the general population and 5.4:1 in Human Immunodeficiency Virus (HIV) patients. Culture was the most common form of diagnosis in 96.3% of cases, recovering C. neoformans species in 87.5% and C. gattii in 3.1% of samples. VNI was the most prevalent (96.1%) molecular type, while VGII predominated in C. gattii isolates (54.3%). Early mortality was reported as the outcome in 47.5% of patients. Cryptococcosis remains an important opportunistic disease in Colombia and is gaining status as a primary pathogen in apparently immunocompetent patients. Our findings show the importance of including cryptococcosis as a notifiable disease, which will allow for improving opportune diagnosis and treatment, resulting in better patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Cryptococcosis in Colombia: Compilation and Analysis of Data from Laboratory-Based Surveillance

Escandón

Lizarazo

Agudelo

et al. 2018

JoF

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“…11 The LFA is widely used as a rapid and cheap method for diagnosing cryptococcosis, with both 100% sensitivity and specificity. 12 The LFA test requires minimal laboratory equipment; thus, it can be easily performed in many laboratories. In our patient, the C. neoformans blood culture and the positive LFA result for the CSF revealed that the patient had disseminated cryptococcosis.…”

Section: Discussionmentioning

confidence: 99%

<p>False-Negative Serum Cryptococcal Antigen Lateral Flow Immunoassay Result for a Patient with Disseminated Cryptococcal Disease</p>

Xu¹,

Xia²,

Ni³

2020

IDR

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Cryptococcus neoformans (C. neoformans) is an opportunistic fungal pathogen to humans, which can be acquired from environmental sources. Its most important virulence factor is its polysaccharide capsule, which can be used for diagnostic tests that identify the cryptococcal antigen (CrAg). The CrAg lateral flow assay (LFA) is a dipstick immunochromatographic assay with high sensitivity and specificity; however, several false-negative cases have been reported. Here, we present a case of a false-negative serum CrAg LFA, in which the blood culture from a matched sample was positive for C. neoformans, thus demonstrating the postzone phenomenon.

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“…The diagnosis of cryptococcosis in most cases, used culture and capsular antigen detection simultaneously. It is important to highlight that antigen detection techniques, such as latex particle agglutination (LA) and lateral flow immunochromatographic assay (LFA), have sensitivity and specificity values greater than 95% in serum, plasma, and CSF [37][38][39][40]. Additionally, the ability to detect circulating antigen in asymptomatic patients has been reported.…”

Section: Discussionmentioning

confidence: 99%

Frequency of Invasive Fungal Disease in Adults: Experience of a Specialized Laboratory in Medellín, Colombia (2009–2015)

Valencia

Cáceres

Bedout

et al. 2020

JoF

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Invasive fungal diseases (IFD) contribute significantly to worldwide morbidity and mortality, but their frequency is not well-described in some countries. The present work describes the frequency of IFD in a specialized laboratory in Colombia. A retrospective, descriptive study was implemented between March 2009 and December 2015. Results: 13,071 patients with clinical suspicion of IFD were referred during the study period, from which 33,516 biological samples were processed and analyzed using 14 laboratory methods. Diagnosis was confirmed in 1425 patients (11%), distributed according to the mycoses of interest analyzed here: histoplasmosis in 641/11,756 patients (6%), aspergillosis in 331/10,985 patients (3%), cryptococcosis in 239/8172 patients (3%), pneumocystosis in 111/1651 patients (7%), paracoccidioidomycosis in 60/10,178 patients (0.6%), and invasive candidiasis in 48/7525 patients (0.6%). From the first year of the study period to the last year, there was a 53% increase in the number of cases of IFD diagnosed. Our laboratory experienced a high frequency of IFD diagnosis, possibly attributable to the availability of a greater range of diagnostic tools. Frequency of IFD in this study was atypical compared with other studies, probably as a result of the single laboratory-site analysis. This demonstrates that implementing educational strategies helps to create a high index of clinical suspicion, while the availability and utilization of appropriate diagnostic assays assure greater reliability in identification of these cases.

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Evaluation of a Cryptococcal antigen Lateral Flow Assay in serum and cerebrospinal fluid for rapid diagnosis of cryptococcosis in Colombia

Cited by 10 publications

References 9 publications

Cryptococcosis in Colombia: Compilation and Analysis of Data from Laboratory-Based Surveillance

Cryptococcosis in Colombia: Compilation and Analysis of Data from Laboratory-Based Surveillance

<p>False-Negative Serum Cryptococcal Antigen Lateral Flow Immunoassay Result for a Patient with Disseminated Cryptococcal Disease</p>

Frequency of Invasive Fungal Disease in Adults: Experience of a Specialized Laboratory in Medellín, Colombia (2009–2015)

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