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Bifidobacterium lipoteichoic acid and false ELISA reactivity in aspergillus antigen detection
Monique A S H Mennink-Kersten1, Rocus R Klont, Adilia Warris
1Department of Medical Microbiology, University Medical Centre Nijmegen, Netherland.
Abstract:
A major difficulty with the detection of circulating galactomannan, a cell-wall polysaccharide released by Aspergillus sp during growth, in the serodiagnosis of invasive aspergillosis is the occurrence of false-positive ELISA results, especially in neonates and infants. On the basis of molecule similarity, we postulate that a lipoteichoic acid of Bifidobacterium sp can act as epitope for the monoclonal antibody used in the ELISA. The neonatal gut is heavily colonised with Bifidobacterium sp and these bacteria or their lipoteichoic acid might cause ELISA reactivity with serum after translocation because of immaturity of the intestinal mucosa. If our hypothesis is correct, we might find a method to discriminate between false-positive and true-positive ELISA results and thereby prevent unnecessary pre-emptive treatment of patients.
Insights
False-positive ELISA tests for invasive aspergillosis in infants may be caused by Bifidobacterium lipoteichoic acid. This study investigates this link to improve diagnostic accuracy and prevent unnecessary treatments.
Area of Science:
- Medical diagnostics
- Mycology
- Microbiology
Background:
- Invasive aspergillosis diagnosis relies on detecting galactomannan, but false positives occur.
- Neonates and infants are particularly susceptible to false-positive ELISA results.
- Aspergillus galactomannan shares molecular similarities with bacterial components.
Purpose of the Study:
- To investigate the hypothesis that Bifidobacterium lipoteichoic acid causes false-positive ELISA results for invasive aspergillosis.
- To explore a method for differentiating true from false-positive ELISA results in infants.
- To reduce unnecessary preemptive treatments in pediatric patients.
Main Methods:
- Postulating molecular mimicry between Aspergillus galactomannan and Bifidobacterium lipoteichoic acid.
- Considering the high colonization of Bifidobacterium in the neonatal gut.
- Examining potential translocation of bacterial components across immature intestinal mucosa.
Main Results:
- The study hypothesizes that Bifidobacterium lipoteichoic acid may act as an epitope for the ELISA monoclonal antibody.
- Immature intestinal mucosa in neonates may permit translocation of bacterial components.
- This translocation could lead to false-positive ELISA reactivity.
Conclusions:
- Bifidobacterium lipoteichoic acid is a potential cause of false-positive galactomannan ELISA results in infants.
- Identifying this cross-reactivity could lead to improved diagnostic specificity.
- This may prevent over-treatment of invasive aspergillosis in vulnerable pediatric populations.
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