Author(s): Martinelli Vidal, Monica Scarpelli ; Barbaro Del Negro, Gilda Maria ; Vicentini, Adriana Pardini ; Estivalet Svidzinski, Teresinha Inez ; Mendes-Giannini, Maria José Soares [UNESP] ; Almeida, Ana Marisa Fusco [UNESP] ; Martinez, Roberto ; Camargo, Zoilo Pires de ; Taborda, Carlos Pelleschi ; Benard, Gil
Date: 2015
Persistent ID: http://hdl.handle.net/11449/117387
Origin: Oasisbr
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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.
Univ Sao Paulo, Sch Med, Clin Hosp, Med Mycol Lab IMTSP, BR-09500900 Sao Paulo, Brazil
Univ Sao Paulo, Sch Med, Clin Hosp, LIM 53, BR-09500900 Sao Paulo, Brazil
Univ Sao Paulo, Inst Trop Med, BR-09500900 Sao Paulo, Brazil
Sao Paulo IAL SP, Adolfo Lutz Inst, Mycoses Immunodiag Lab, Sao Paulo, Brazil
Lab Teaching & Res Clin Anal Maringa LEPAC, Med Mycol Lab, Maringa, Parana, Brazil
Sao Paulo State Univ UNESP, Sch Pharmaceut Sci, Clin Mycol Lab, Araraquara, SP, Brazil
Ribeirao Preto Sch Med FMRPUSP, Clin Hosp, Serol Lab, Ribeirao Preto, SP, Brazil
Fed Univ Sao Paulo UNIFESP, Dept Microbiol Immunol & Parasitol, Mycoserol Lab, Sao Paulo, Brazil
Univ Sao Paulo, Dept Microbiol, Inst Biomed Sci, BR-09500900 Sao Paulo, Brazil
Sao Paulo State Univ UNESP, Sch Pharmaceut Sci, Clin Mycol Lab, Araraquara, SP, Brazil
FAPESP: 11/22467-2
