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Comparison of Urine Antigen Assays for the Diagnosis of Histoplasma capsulatum Infection.
J Appl Lab Med 2019; 4(3):370-382JA

Abstract

BACKGROUND

Urine antigen testing is a rapid sensitive method for detecting active infection with the endemic fungi Histoplasma capsulatum and Blastomyces dermatitidis. Herein, we compared the performance of the MiraVista Diagnostics (MVista) Histoplasma urine antigen assay with the Niche Diagnostics (ND) Histoplasma urine antigen assay for the detection of histoplasmosis and blastomycosis.

METHODS

Two hundred fifty urine samples from 234 patients previously tested by the MVista Histoplasma urine antigen assay as part of routine care were tested by the ND Histoplasma and Blastomyces urine antigen assays. The electronic medical records of all patients whose samples were tested were retrospectively reviewed to identify patients with a clinical diagnosis of and/or treatment for histoplasmosis or blastomycosis, and the diagnostic workup undertaken to support these diagnoses.

RESULTS

The MVista and ND Histoplasma urine antigen assays were highly concordant, showing 99% overall agreement (90.5% positive agreement and 99.6% negative agreement). Three specimens collected after antifungal therapy returned discrepant results, with the MVista assay positive in 2 of these and the ND assay positive in 1; in each case, the antigen concentration was near the lower quantification limit. Both Histoplasma assays were positive in all patients with culture-proven blastomycosis (n = 3).

CONCLUSIONS

The MVista and ND Histoplasma urine antigen assays performed similarly in identifying histoplasmosis cases encountered in routine clinical practice, with discrepancies affecting posttreatment specimens. Given the paucity of Blastomyces-positive samples, further studies are needed to better compare the utility of the MVista and ND Histoplasma urine antigen assays in diagnosing blastomycosis.

Authors+Show Affiliations

Division of Laboratory and Genomic Medicine, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO.Niche Diagnostics, Gorham, ME.Division of Laboratory and Genomic Medicine, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO.Division of Laboratory and Genomic Medicine, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO; nwanderson@wustl.edu.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31659074

Citation

Persaud, Stephen P., et al. "Comparison of Urine Antigen Assays for the Diagnosis of Histoplasma Capsulatum Infection." The Journal of Applied Laboratory Medicine, vol. 4, no. 3, 2019, pp. 370-382.
Persaud SP, Lawton T, Burnham CD, et al. Comparison of Urine Antigen Assays for the Diagnosis of Histoplasma capsulatum Infection. J Appl Lab Med. 2019;4(3):370-382.
Persaud, S. P., Lawton, T., Burnham, C. D., & Anderson, N. W. (2019). Comparison of Urine Antigen Assays for the Diagnosis of Histoplasma capsulatum Infection. The Journal of Applied Laboratory Medicine, 4(3), pp. 370-382. doi:10.1373/jalm.2018.028910.
Persaud SP, et al. Comparison of Urine Antigen Assays for the Diagnosis of Histoplasma Capsulatum Infection. J Appl Lab Med. 2019;4(3):370-382. PubMed PMID: 31659074.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of Urine Antigen Assays for the Diagnosis of Histoplasma capsulatum Infection. AU - Persaud,Stephen P, AU - Lawton,Trebor, AU - Burnham,Carey-Ann D, AU - Anderson,Neil W, Y1 - 2019/06/26/ PY - 2018/12/20/received PY - 2019/03/26/accepted PY - 2019/10/30/entrez PY - 2019/10/30/pubmed PY - 2019/10/30/medline SP - 370 EP - 382 JF - The journal of applied laboratory medicine JO - J Appl Lab Med VL - 4 IS - 3 N2 - BACKGROUND: Urine antigen testing is a rapid sensitive method for detecting active infection with the endemic fungi Histoplasma capsulatum and Blastomyces dermatitidis. Herein, we compared the performance of the MiraVista Diagnostics (MVista) Histoplasma urine antigen assay with the Niche Diagnostics (ND) Histoplasma urine antigen assay for the detection of histoplasmosis and blastomycosis. METHODS: Two hundred fifty urine samples from 234 patients previously tested by the MVista Histoplasma urine antigen assay as part of routine care were tested by the ND Histoplasma and Blastomyces urine antigen assays. The electronic medical records of all patients whose samples were tested were retrospectively reviewed to identify patients with a clinical diagnosis of and/or treatment for histoplasmosis or blastomycosis, and the diagnostic workup undertaken to support these diagnoses. RESULTS: The MVista and ND Histoplasma urine antigen assays were highly concordant, showing 99% overall agreement (90.5% positive agreement and 99.6% negative agreement). Three specimens collected after antifungal therapy returned discrepant results, with the MVista assay positive in 2 of these and the ND assay positive in 1; in each case, the antigen concentration was near the lower quantification limit. Both Histoplasma assays were positive in all patients with culture-proven blastomycosis (n = 3). CONCLUSIONS: The MVista and ND Histoplasma urine antigen assays performed similarly in identifying histoplasmosis cases encountered in routine clinical practice, with discrepancies affecting posttreatment specimens. Given the paucity of Blastomyces-positive samples, further studies are needed to better compare the utility of the MVista and ND Histoplasma urine antigen assays in diagnosing blastomycosis. SN - 2475-7241 UR - https://www.unboundmedicine.com/medline/citation/31659074/Comparison_of_Urine_Antigen_Assays_for_the_Diagnosis_of_Histoplasma_capsulatum_Infection_ L2 - http://jalm.aaccjnls.org/cgi/pmidlookup?view=long&pmid=31659074 DB - PRIME DP - Unbound Medicine ER -