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(Referência obtida automaticamente do Web of Science, por meio da informação sobre o financiamento pela FAPESP e o número do processo correspondente, incluída na publicação pelos autores.)

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

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Autor(es):
Martinelli Vidal, Monica Scarpelli [1, 2, 3] ; Barbaro Del Negro, Gilda Maria [1, 2, 3] ; Vicentini, Adriana Pardini [4] ; Estivalet Svidzinski, Teresinha Inez [5] ; Mendes-Giannini, Maria Jose [6] ; Fusco Almeida, Ana Marisa [6] ; Martinez, Roberto [7] ; de Camargo, Zoilo Pires [8] ; Taborda, Carlos Pelleschi [1, 2, 3, 9] ; Benard, Gil [1, 2, 3]
Número total de Autores: 10
Afiliação do(s) autor(es):
[1] Univ Sao Paulo, Sch Med, Clin Hosp, Med Mycol Lab IMTSP, BR-09500900 Sao Paulo - Brazil
[2] Univ Sao Paulo, Sch Med, Clin Hosp, LIM 53, BR-09500900 Sao Paulo - Brazil
[3] Univ Sao Paulo, Inst Trop Med, BR-09500900 Sao Paulo - Brazil
[4] Sao Paulo IAL SP, Adolfo Lutz Inst, Mycoses Immunodiag Lab, Sao Paulo - Brazil
[5] Lab Teaching & Res Clin Anal Maringa LEPAC, Med Mycol Lab, Maringa, Parana - Brazil
[6] Sao Paulo State Univ UNESP, Sch Pharmaceut Sci, Clin Mycol Lab, Araraquara, SP - Brazil
[7] Ribeirao Preto Sch Med FMRPUSP, Clin Hosp, Serol Lab, Ribeirao Preto, SP - Brazil
[8] Fed Univ Sao Paulo UNIFESP, Dept Microbiol Immunol & Parasitol, Mycoserol Lab, Sao Paulo - Brazil
[9] Univ Sao Paulo, Dept Microbiol, Inst Biomed Sci, BR-09500900 Sao Paulo - Brazil
Número total de Afiliações: 9
Tipo de documento: Artigo Científico
Fonte: PLoS Neglected Tropical Diseases; v. 8, n. 9 SEP 2014.
Citações Web of Science: 16
Resumo

Background: 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. (AU)

Processo FAPESP: 11/22467-2 - Estudo interlaboratorial para avaliação do diagnóstico sorológico da paracoccidioidomicose
Beneficiário:Carlos Pelleschi Taborda
Linha de fomento: Auxílio à Pesquisa - Regular