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Published on: December 12, 2011
Comparative evaluation of commercial Premier EIA and microimmunodiffusion and complement fixation tests for
L Kaufman1, A S Sekhon, N Moledina
1Division of Bacterial and Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Insights
The Premier Enzyme Immunoassay (EIA) effectively detects Coccidioides immitis antibodies (IgG and IgM) in coccidioidomycosis cases. However, this diagnostic method shows some cross-reactivity with other fungal infections.
Area of Science:
- Mycology
- Immunology
- Infectious Diseases
Background:
- Coccidioidomycosis diagnosis relies on serological tests.
- Conventional methods like complement fixation (CF) and immunodiffusion (ID) are used.
- Enzyme immunoassays (EIAs) offer potential for improved antibody detection.
Purpose of the Study:
- To evaluate the Premier EIA for detecting antibodies to Coccidioides immitis.
- To compare EIA performance with conventional serological assays (CF, ID).
- To assess the sensitivity and specificity of EIA for coccidioidomycosis diagnosis.
Main Methods:
- Tested 409 human serum and cerebrospinal fluid specimens.
- Utilized Premier EIA for immunoglobulin G (IgG) and IgM detection.
- Compared EIA results with conventional complement fixation (CF) and immunodiffusion (ID) assays.
Main Results:
- All 47 confirmed coccidioidomycosis cases were positive by EIA (IgG and IgM) and conventional tests.
- EIA demonstrated high sensitivity when detecting both IgG and IgM antibodies.
- Some false-positive reactions were observed with sera from blastomycosis and other non-coccidioidal diseases.
Conclusions:
- EIA is a sensitive method for detecting Coccidioides immitis antibodies, especially when both IgG and IgM are measured.
- Maximal diagnostic sensitivity for coccidioidomycosis is achieved by detecting both antibody types.
- The EIA's specificity requires further investigation due to observed cross-reactivity.
Abstract:
A total of 409 serum and cerebrospinal fluid specimens from human subjects with proven coccidioidomycosis, with other infections, or with no apparent illness were tested for antibodies to Coccidioides immitis by the Premier EIA (Meridian Diagnostics, Inc., Cincinnati, Ohio), which tests for immunoglobulin G (IgG) and IgM responses to coccidioidal antigens, and by the conventional complement fixation (CF) or immunodiffusion (ID) assays for antibodies corresponding to those detected by the tube precipitin (TP) or CF tests. Of the 409 specimens, 47 were from persons with confirmed coccidioidomycosis and all were positive for C. immitis antibodies in IDCF tests and enzyme immunoassays (EIAs) for both IgG and IgM. The EIA for detecting both IgG and IgM antibodies proved to be sensitive for detecting coccidioidomycosis case sera positive by the IDCF, IDTP, and CF tests. Maximal sensitivity for diagnosing coccidioidomycosis is dependent upon detection of both IgG and IgM antibodies in the EIA. The EIA, however, was not absolutely specific, since some sera from patients with confirmed blastomycosis and some from patients with noncoccidioidal disease produced false-positive reactions.
