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Clinical and Diagnostic Laboratory Immunology, May 2000, p. 477-485, Vol. 7, No. 3
Mycotic Diseases Branch, Division of
Bacterial and Mycotic Diseases, National Center for Infectious
Diseases, Centers for Disease Control and Prevention, Atlanta,
Georgia 30333
Received 1 November 1999/Returned for modification 29 December
1999/Accepted 17 February 2000
A commercial latex agglutination assay (LA) and a sandwich enzyme
immunoassay (SEIA) (Sanofi Diagnostics Pasteur, Marnes-la-Coquette, France) were compared with a competitive binding inhibition assay (enzyme immunoassay [EIA]) to determine the potential uses and limitations of these antigen detection tests for the sensitive, specific, and rapid diagnosis of invasive aspergillosis (IA). Toward
this end, well-characterized serum and urine specimens were obtained by
using a rabbit model of IA. Serially collected serum or urine specimens
were obtained daily from control rabbits or from rabbits
immunosuppressed and infected systemically with Aspergillus
fumigatus. By 4 days after infection, EIA, LA, and SEIA detected
antigen in the sera of 93, 93, and 100% of A. fumigatus-infected rabbits, respectively, whereas antigen was
detected in the urine of 93, 100, and 100% of the rabbits,
respectively. False-positive results for non-A.
fumigatus-infected rabbits for EIA, LA, and SEIA were as follows:
for serum, 14, 11, and 23%, respectively; for urine, 14, 84, and 90%,
respectively. Therefore, although the sensitivities of all three tests
were similar, the specificity was generally greater for EIA than for LA
or SEIA. Infection was also detected earlier by EIA, by which the serum
of 53% of A. fumigatus-infected rabbits was positive as
early as 1 day after infection, whereas the serum of only 27% of the
rabbits tested by LA was positive. Although the serum of 92% of
A. fumigatus-infected rabbits was positive by SEIA as early
as 1 day after infection, the serum of a high percentage (50%) was
false positive before infection. The urine of 21% of A. fumigatus-infected rabbits was positive by EIA as early as 1 day
after infection, and the urine of none of the rabbits was false
positive before infection. When EIA results for urine specimens were
combined with those for serum, sensitivity was improved (i.e., 67% of
rabbits were positive by 1 day after infection and only one rabbit gave
a false-positive result). A total of 93% of A. fumigatus-infected rabbits were positive for antigen in urine as
early as 1 day after infection and the urine of 100% of the rabbits
was positive by SEIA. However, before infection, 79% of A. fumigatus-infected rabbits were false positive for antigen in
urine by LA and 90% were false positive for antigen in urine by SEIA.
These data indicate that the EIA has the potential to be used to
diagnose IA with both serum and urine specimens and to detect a greater
number of infections earlier with greater specificity than the
specificities achieved with the commercial tests.
1071-412X/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
Comparison of Commercial Latex Agglutination and Sandwich Enzyme
Immunoassays with a Competitive Binding Inhibition Enzyme Immunoassay
for Detection of Antigenemia and Antigenuria in a Rabbit Model
of Invasive Aspergillosis

*
Corresponding author. Mailing address: Mailstop G-11,
Centers for Disease Control and Prevention, 1600 Clifton Rd., NE,
Atlanta, GA 30333. Phone: (404) 639-3098. Fax: (404) 639-3546. E-mail: cjm3{at}cdc.gov.
Present address: Center for Medical Mycology, University Hospitals
of Cleveland/Case Western Reserve University, Cleveland, OH 44106.
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