Serological Diagnosis of Paracoccidioidomycosis: High Rate of Inter-laboratorial Variability among Medical Mycology Reference Centers

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dc.contributor.authorMartinelli Vidal, Monica Scarpelli
dc.contributor.authorBarbaro Del Negro, Gilda Maria
dc.contributor.authorVicentini, Adriana Pardini
dc.contributor.authorEstivalet Svidzinski, Teresinha Inez
dc.contributor.authorMendes-Giannini, Maria José Soares [UNESP]
dc.contributor.authorAlmeida, Ana Marisa Fusco [UNESP]
dc.contributor.authorMartinez, Roberto
dc.contributor.authorCamargo, Zoilo Pires de
dc.contributor.authorTaborda, Carlos Pelleschi
dc.contributor.authorBenard, Gil
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionSao Paulo IAL SP
dc.contributor.institutionLab Teaching & Res Clin Anal Maringa LEPAC
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.date.accessioned2015-03-18T15:56:00Z
dc.date.available2015-03-18T15:56:00Z
dc.date.issued2014-09-01
dc.description.abstractBackground: Serological tests have long been established as rapid, simple and inexpensive tools for the diagnosis and follow-up of PCM. However, different protocols and antigen preparations are used and the few attempts to standardize the routine serological methods have not succeeded.Methodology/Principal findings: We compared the performance of six Brazilian reference centers for serological diagnosis of PCM. Each center provided 30 sera of PCM patients, with positive high, intermediate and low titers, which were defined as the "reference'' titers. Each center then applied its own antigen preparation and serological routine test, either semiquantitative double immunodifusion or counterimmmunoelectrophoresis, in the 150 sera from the other five centers blindly as regard to the "reference'' titers. Titers were transformed into scores: 0 (negative), 1 (healing titers), 2 (active disease, low titers) and 3 (active disease, high titers) according to each center's criteria. Major discordances were considered between scores indicating active disease and scores indicating negative or healing titers; such discordance when associated with proper clinical and other laboratorial data, may correspond to different approaches to the patient's treatment. Surprisingly, all centers exhibited a high rate of "major'' discordances with a mean of 31 (20%) discordant scores. Alternatively, when the scores given by one center to their own sera were compared with the scores given to their sera by the remaining five other centers, a high rate of major discordances was also found, with a mean number of 14.8 sera in 30 presenting a discordance with at least one other center. The data also suggest that centers that used CIE and pool of isolates for antigen preparation performed better.Conclusion: There are inconsistencies among the laboratories that are strong enough to result in conflicting information regarding the patients' treatment. Renewed efforts should be promoted to improve standardization of the serological diagnosis of PCM.en
dc.description.affiliationUniv Sao Paulo, Sch Med, Clin Hosp, Med Mycol Lab IMTSP, BR-09500900 Sao Paulo, Brazil
dc.description.affiliationUniv Sao Paulo, Sch Med, Clin Hosp, LIM 53, BR-09500900 Sao Paulo, Brazil
dc.description.affiliationUniv Sao Paulo, Inst Trop Med, BR-09500900 Sao Paulo, Brazil
dc.description.affiliationSao Paulo IAL SP, Adolfo Lutz Inst, Mycoses Immunodiag Lab, Sao Paulo, Brazil
dc.description.affiliationLab Teaching & Res Clin Anal Maringa LEPAC, Med Mycol Lab, Maringa, Parana, Brazil
dc.description.affiliationSao Paulo State Univ UNESP, Sch Pharmaceut Sci, Clin Mycol Lab, Araraquara, SP, Brazil
dc.description.affiliationRibeirao Preto Sch Med FMRPUSP, Clin Hosp, Serol Lab, Ribeirao Preto, SP, Brazil
dc.description.affiliationFed Univ Sao Paulo UNIFESP, Dept Microbiol Immunol & Parasitol, Mycoserol Lab, Sao Paulo, Brazil
dc.description.affiliationUniv Sao Paulo, Dept Microbiol, Inst Biomed Sci, BR-09500900 Sao Paulo, Brazil
dc.description.affiliationUnespSao Paulo State Univ UNESP, Sch Pharmaceut Sci, Clin Mycol Lab, Araraquara, SP, Brazil
dc.description.sponsorshipFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
dc.description.sponsorshipIdFAPESP: 11/22467-2
dc.format.extent6
dc.identifierhttp://dx.doi.org/10.1371/journal.pntd.0003174
dc.identifier.citationPlos Neglected Tropical Diseases. San Francisco: Public Library Science, v. 8, n. 9, 6 p., 2014.
dc.identifier.doi10.1371/journal.pntd.0003174
dc.identifier.fileWOS000342796600052.pdf
dc.identifier.issn1935-2735
dc.identifier.orcid0000-0002-8059-0826
dc.identifier.urihttp://hdl.handle.net/11449/117387
dc.identifier.wosWOS:000342796600052
dc.language.isoeng
dc.publisherPublic Library Science
dc.relation.ispartofPlos Neglected Tropical Diseases
dc.relation.ispartofjcr4.367
dc.relation.ispartofsjr2,589
dc.rights.accessRightsAcesso aberto
dc.sourceWeb of Science
dc.titleSerological Diagnosis of Paracoccidioidomycosis: High Rate of Inter-laboratorial Variability among Medical Mycology Reference Centersen
dc.typeArtigo
dcterms.rightsHolderPublic Library Science
unesp.author.lattes3716273524139678[6]
unesp.author.orcid0000-0002-2971-7983[8]
unesp.author.orcid0000-0001-9928-9809[9]
unesp.author.orcid0000-0002-8059-0826[5]
unesp.author.orcid0000-0002-9321-0909[3]
unesp.author.orcid0000-0002-2115-8988[6]
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Ciências Farmacêuticas, Araraquarapt

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