Document 0840
 DOCN  M9460840
 TI    Cryptococcal antigen detection from the urine of AIDS patients.
 DT    9404
 AU    Chapin-Robertson K; Bechtel C; Waycott S; Kontnick C; Edberg SC;
       Clinical Microbiology Laboratory, Yale-New Haven Hospital, CT; 06504.
 SO    Diagn Microbiol Infect Dis. 1993 Oct;17(3):197-201. Unique Identifier :
       AIDSLINE MED/94155524
 AB    Cryptococcal disease occurs in < or = 10% of AIDS patients. Detection of
       the capsular polysaccharide antigen of the yeast in spinal fluid or
       serum is used to establish the diagnosis. In addition, cryptococcal
       antigen (CAg) analysis is used to adjust treatment and evaluate
       recurrence of active disease. A specimen such as urine, obtained
       noninvasively, would be optimum for this evaluation. Urine,
       cerebrospinal fluid (CSF), and serum for CAg analysis, and culture of
       urine and CSF, were obtained for 103 sets of specimens from 92 patients.
       CSF and urine specimens for CAg were analyzed with and without pronase
       treatment; serum was analyzed with pronase only. Twenty percent (21 of
       103) of specimen sets showed CAg from eight patients. In all cases,
       patients with positive CSF and/or serum titers also had positive urine
       titers. Titers were always serum > CSF > urine, with ranges of 1:
       64-65000; 1: 64-6250; and 1: 2-512, respectively. Pronase treatment did
       not affect CSF titers, but 14 of 23 titers from urine treated with
       pronase were at least one dilution higher than those without treatment.
       No false-positive reactions were observed during the study. CSF cultures
       were positive from seven of eight, and urine cultures were positive from
       five of eight patients with CAg. These results indicate that urine can
       be used as a specimen for detection of CAg in AIDS patients and that use
       of pronase may increase its sensitivity.
 DE    Antigens, Fungal/BLOOD/CEREBROSPINAL FLUID/*URINE  AIDS-Related
       Opportunistic Infections/*DIAGNOSIS  Comparative Study
       Cryptococcosis/*DIAGNOSIS  Cryptococcus neoformans/*IMMUNOLOGY/ISOLATION
       & PURIF  Double-Blind Method  Human  Latex Fixation Tests
       Polysaccharides/BLOOD/CEREBROSPINAL FLUID/*URINE  Pronase  Sensitivity
       and Specificity  CLINICAL TRIAL  JOURNAL ARTICLE

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