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A monoclonal antibody-based urine Histoplasma antigen enzyme immunoassay (IMMY®) for the diagnosis of histoplasmosis in cats.
J Vet Intern Med. 2019 Mar; 33(2):603-610.JV

Abstract

BACKGROUND

An in-house Histoplasma urine antigen test for cats might be desirable in certain situations.

OBJECTIVE

To validate and compare the diagnostic performance of a monoclonal antibody-based IMMY urine Histoplasma antigen enzyme immunoassay (IMMY EIA) to the commercially available urine Histoplasma antigen enzyme immunoassay (MiraVista Diagnostics, MV EIA).

ANIMALS

One hundred ninety-three urine samples from 105 client-owned and purpose-bred research cats.

METHODS

Cats were classified as Histoplasma positive or negative based on diagnostic investigation. The IMMY EIA and MV EIA were performed on all urine samples. Correlation and agreement between the assays were determined. Diagnostic performance was determined and compared between assays.

RESULTS

The IMMY EIA, with a 0.25 ng/mL diagnostic cutoff, provided a diagnostic sensitivity (DSe), diagnostic specificity (DSp), and diagnostic accuracy (DAc) of 89% (95% confidence interval [CI]; 73%-97%), 80% (67%-89%), and 83% (74%-90%), respectively. The IMMY EIA, with a 1.1 ng/mL diagnostic cutoff, provided a DSe, DSp, and DAc of 77% (95% CI 60%-90%), 97% (88%-100%), and 89% (81%-95%), respectively. The MV EIA provided a DSe, DSp, and DAc of 94% (95% CI 81%-99%), 97% (89%-100%), and 96% (90%-99%), respectively. Moderate overall agreement was found between MV EIA and IMMY EIA using the 0.25 ng/mL cut-off (к = 0.44; 95% CI 0.31-0.57) and the 1.1 ng/mL cut-off (к = 0.43, 95% CI, 0.31-0.56).

CONCLUSIONS AND CLINICAL IMPORTANCE

The IMMY EIA might be useful as a diagnostic test for histoplasmosis in cats. Further modifications of the IMMY EIA are required to achieve the diagnostic performance of the MV EIA.

Authors+Show Affiliations

Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, Oklahoma.Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, Oklahoma.Department of Statistics, Oklahoma State University, Stillwater, Oklahoma.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

30557457

Citation

Rothenburg, Lana, et al. "A Monoclonal Antibody-based Urine Histoplasma Antigen Enzyme Immunoassay (IMMY®) for the Diagnosis of Histoplasmosis in Cats." Journal of Veterinary Internal Medicine, vol. 33, no. 2, 2019, pp. 603-610.
Rothenburg L, Hanzlicek AS, Payton ME. A monoclonal antibody-based urine Histoplasma antigen enzyme immunoassay (IMMY®) for the diagnosis of histoplasmosis in cats. J Vet Intern Med. 2019;33(2):603-610.
Rothenburg, L., Hanzlicek, A. S., & Payton, M. E. (2019). A monoclonal antibody-based urine Histoplasma antigen enzyme immunoassay (IMMY®) for the diagnosis of histoplasmosis in cats. Journal of Veterinary Internal Medicine, 33(2), 603-610. https://doi.org/10.1111/jvim.15379
Rothenburg L, Hanzlicek AS, Payton ME. A Monoclonal Antibody-based Urine Histoplasma Antigen Enzyme Immunoassay (IMMY®) for the Diagnosis of Histoplasmosis in Cats. J Vet Intern Med. 2019;33(2):603-610. PubMed PMID: 30557457.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A monoclonal antibody-based urine Histoplasma antigen enzyme immunoassay (IMMY®) for the diagnosis of histoplasmosis in cats. AU - Rothenburg,Lana, AU - Hanzlicek,Andrew S, AU - Payton,Mark E, Y1 - 2018/12/17/ PY - 2018/07/20/received PY - 2018/11/13/accepted PY - 2018/12/18/pubmed PY - 2019/6/30/medline PY - 2018/12/18/entrez KW - feline KW - fungal KW - histoplasmosis KW - mycosis SP - 603 EP - 610 JF - Journal of veterinary internal medicine JO - J Vet Intern Med VL - 33 IS - 2 N2 - BACKGROUND: An in-house Histoplasma urine antigen test for cats might be desirable in certain situations. OBJECTIVE: To validate and compare the diagnostic performance of a monoclonal antibody-based IMMY urine Histoplasma antigen enzyme immunoassay (IMMY EIA) to the commercially available urine Histoplasma antigen enzyme immunoassay (MiraVista Diagnostics, MV EIA). ANIMALS: One hundred ninety-three urine samples from 105 client-owned and purpose-bred research cats. METHODS: Cats were classified as Histoplasma positive or negative based on diagnostic investigation. The IMMY EIA and MV EIA were performed on all urine samples. Correlation and agreement between the assays were determined. Diagnostic performance was determined and compared between assays. RESULTS: The IMMY EIA, with a 0.25 ng/mL diagnostic cutoff, provided a diagnostic sensitivity (DSe), diagnostic specificity (DSp), and diagnostic accuracy (DAc) of 89% (95% confidence interval [CI]; 73%-97%), 80% (67%-89%), and 83% (74%-90%), respectively. The IMMY EIA, with a 1.1 ng/mL diagnostic cutoff, provided a DSe, DSp, and DAc of 77% (95% CI 60%-90%), 97% (88%-100%), and 89% (81%-95%), respectively. The MV EIA provided a DSe, DSp, and DAc of 94% (95% CI 81%-99%), 97% (89%-100%), and 96% (90%-99%), respectively. Moderate overall agreement was found between MV EIA and IMMY EIA using the 0.25 ng/mL cut-off (к = 0.44; 95% CI 0.31-0.57) and the 1.1 ng/mL cut-off (к = 0.43, 95% CI, 0.31-0.56). CONCLUSIONS AND CLINICAL IMPORTANCE: The IMMY EIA might be useful as a diagnostic test for histoplasmosis in cats. Further modifications of the IMMY EIA are required to achieve the diagnostic performance of the MV EIA. SN - 1939-1676 UR - https://www.unboundmedicine.com/medline/citation/30557457/A_monoclonal_antibody_based_urine_Histoplasma_antigen_enzyme_immunoassay__IMMY��__for_the_diagnosis_of_histoplasmosis_in_cats_ L2 - https://doi.org/10.1111/jvim.15379 DB - PRIME DP - Unbound Medicine ER -