Indirect enzyme-linked immunosorbent assay for zygomycosis

A 2-h indirect enzyme-linked immunosorbent assay (ELISA) using homogenate antigens of Rhizopus arrhizus and Rhizomucor pusillus was developed and compared with the existing immunodiffusion (ID) test for zygomycosis, using homogenate antigens of R. arrhizus. Utilizing 1:400 as a minimally positive ELISA titer, 33 of 43 proven cases of zygomycosis were diagnosed. The sensitivity of the ELISA was 81%. The ID test, in contrast, detected only 21 cases and demonstrated a sensitivity of 66%. The specificity of the ELISA was 94%, whereas that of the ID test was 91%. Nonspecific ELISA reactivity was particularly evident with sera from patients with aspergillosis and candidiasis. With the antigens now available, the ELISA was unable to generically or specifically identify the etiologic agents.