Browsing by Subject "Penicillium marneffei"

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    Occult Talaromyces marneffei Infection Unveiled by the Novel Mp1p Antigen Detection Assay.
    (Open forum infectious diseases, 2020-11) Ly, Vo Trieu; Thanh, Nguyen Tat; Thu, Nguyen Thi Mai; Chan, Jasper; Day, Jeremy N; Perfect, John; Nga, Cao Ngoc; Vinh Chau, Nguyen Van; Le, Thuy
    Talaromyces marneffei causes fatal invasive mycosis in Southeast Asia. Diagnosis by culture has limited sensitivity and can result in treatment delay. We describe the use of a novel Mp1p enzyme immunoassay (EIA) to identify blood culture-negative talaromycosis, subsequently confirmed by bone marrow cultures. This EIA has the potential to speed diagnosis, enabling early therapy initiation.
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    Superiority of a novel Mp1p antigen detection enzyme immunoassay compared to standard BACTEC blood culture in the diagnosis of talaromycosis.
    (Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020-06-21) Thu, Nguyen TM; Chan, Jasper FW; Ly, Vo Trieu; Ngo, Hoa T; Hien, Ha TA; Lan, Nguyen PH; Chau, Nguyen VV; Cai, Jian-Piao; Woo, Patrick CY; Day, Jeremy N; van Doorn, Rogier; Thwaites, Guy; Perfect, John; Yuen, Kwok; Le, Thuy
    BACKGROUND:Talaromycosis is an invasive mycosis endemic in Southeast Asia and causes substantial morbidity and mortality in individuals with advanced HIV disease. Current diagnosis relies on isolating Talaromyces marneffei in cultures, which takes up to 14 days and is detectable only during late-stage infection, leading to high mortality. METHODS:In this retrospective case-control study, we assessed the accuracy of a novel Mp1p antigen-detecting enzyme immunoassay (EIA) in stored plasma samples of 372 patients who had culture-proven talaromycosis from blood or sterile body fluids(reference standard) and of 517 individuals without talaromycosis (338 healthy volunteers; 179 with other infections). All participants were recruited between 2011-2017 in Vietnam. RESULTS:66.1% and 75.4% of cases and controls were male; the median age was 33 and 37, respectively. All cases were HIV-infected; median CD4 count was 10 cells/mm3. At an optical density cut-off of 0.5, the specificity was 98.1% (95% CI: 96.3%-99.0%); the sensitivity was superior to blood culture, 86.3% (95% CI: 82.3%-89.5%) versus 72.8% (95% CI: 68.0%-77.2%), P<0.001, McNemar test. The time-to-diagnosis was 6 hours versus 6.6 ± 3.0 days for blood culture. Paired plasma and urine testing in the same patients (N=269) significantly increased sensitivity compared to testing plasma alone P<0.001, or testing urine alone P=0.02, McNemar tests. CONCLUSIONS:The Mp1p EIA is highly specific and is superior in sensitivity and time-to-diagnosis compared to blood culture for the diagnosis of talaromycosis. Paired plasma and urine testing further increases sensitivity, introducing a new tool for rapid diagnosis, enabling early treatment and potentially reducing mortality.