In:
PLOS Neglected Tropical Diseases, Public Library of Science (PLoS), Vol. 17, No. 3 ( 2023-3-6), p. e0011140-
Abstract:
Cryptococcosis is a devastating opportunistic infection in immunocompromised individuals, primarily in people living with HIV/AIDS. This study evaluated a protocol for the early diagnosis of meningitis due to C . neoformans , utilizing established molecular techniques from serum and CSF samples. Methods The 18S and 5.8S (rDNA-ITS) sequence-specific nested PCR assays were compared with direct India ink staining and the latex agglutination test for detection of C . neoformans in serum and cerebrospinal fluid (CSF) from 49 Brazilian suspected meningitis patients. Results were validated with samples obtained from 10 patients negative for cryptococcosis and HIV, and by analysis of standard C . neoformans strains. Principal findings The 5.8S DNA-ITS PCR was more sensitive (89–100%) and specific (100%) than the 18S rDNA PCR and conventional tests (India ink staining and latex agglutination) for identification of C . neoformans . While the 18S PCR exhibited a sensitivity (72%) similar to that of the latex agglutination assay in serum samples, it was superior to the latex agglutination assay when testing CSF, with a sensitivity of 84%. However, the latex agglutination was superior to the 18SrDNA PCR in specificity in CSF (92%). The 5.8S DNA-ITS PCR yielded the highest levels of accuracy (96–100%) of any test for detection (serological and mycological) of C . neoformans in both serum and CSF. Conclusion Use of the nested 5.8S PCR was superior to other techniques for the diagnosis of cryptococcosis. The possibility of using serum, a non-invasively collected material, in a targeted 5.8S PCR analysis to identify Cryptococcus spp. is recommended, especially in immunosuppressed patients. Our results indicate that nested 5.8S PCR can increase the diagnostic capability of cryptococcosis, and we suggest its use to monitor patients in the future.
Type of Medium:
Online Resource
ISSN:
1935-2735
DOI:
10.1371/journal.pntd.0011140
DOI:
10.1371/journal.pntd.0011140.t001
DOI:
10.1371/journal.pntd.0011140.t002
DOI:
10.1371/journal.pntd.0011140.t003
DOI:
10.1371/journal.pntd.0011140.t004
DOI:
10.1371/journal.pntd.0011140.s001
DOI:
10.1371/journal.pntd.0011140.s002
DOI:
10.1371/journal.pntd.0011140.s003
DOI:
10.1371/journal.pntd.0011140.r001
DOI:
10.1371/journal.pntd.0011140.r002
DOI:
10.1371/journal.pntd.0011140.r003
DOI:
10.1371/journal.pntd.0011140.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2023
detail.hit.zdb_id:
2429704-5
Permalink