乳胶凝集法检测隐球菌荚膜多糖抗原在隐球菌性脑膜炎和隐球菌肺炎中的早期诊断价值

目的 研究乳胶凝集试验在隐球菌性脑膜炎和隐球菌肺炎中的早期诊断价值.方法 选取2005年1月至2006年4月广州市3家医院确诊的隐球菌性脑膜炎和隐球菌肺炎患者24例作为新生隐球菌组;选取念珠菌感染患者50例,细菌感染患者31例,怀疑隐球菌感染患者62例,正常者30名作为非新生隐球菌组,采用乳胶凝集试验检测隐球菌荚膜多糖抗原,并与培养和直接镜检方法相比较,评价其诊断的灵敏度和特异度.结果 乳胶凝集试验、培养和直接镜检3种方法诊断的灵敏度分别为96.2%、70.8%和83.3%,而特异度分别为99.4%、100.0%和100.0%.结论 乳胶凝集试验具有准确率高、快速简便的特点,可作为隐球菌性脑膜炎和隐球菌肺炎的早期诊断方法.

Detection of capsular polysaccharide antigens by latex agglutination test for early diagnosis of meningitis or pneumonia caused by Cryptococcus neoformans

Objective To investigate the early diagnostic value of capsular polysaccharide antigens detected by latex agglutination test for meningitis or pneumonia caused by Cryptococcus neoformans. Methods Cryptococcal capsular polysaccharide antigens were tested by latex agglutination in body fluids from 24 wall-defined patients with cryptococcal meningitis or pneumonia, 62 cryptococcosis suspected patients, 50 patients with candidasis, 31 patients with bacteria infection and 30 healthy controls. The sensitivity and specificity were compared with cultural method and direct microscopy examination. Results The sensitivity of latex agglutination, cultural method and direct microscopy examination for diagnosis of cryptococcosis was 96.2% , 70.8% and 83.3% respectively, and the specificity was 99.4% , 100.0%, 100.0% respectively. Conclusions Detection of cryptococcal antigens by latex agglutination test could be considered as an accurate and rapid test for early diagnosis of meningitis or pneumonia caused by Cryptococcus neoformans.