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PEMERIKSAAN CRYPTOCOCCAL ANTIGEN ANTARA METODE SISTEM AGLUTINASI LATEKS ANTIGEN KRIPTOKOKUS DAN LATERAL FLOW ASSAY DI PASIEN AIDS (Cryptococcal Antigen of Acquired Immune Deficiency Syndrome with Lateral Flow Assay and Cryptococcus Antigen Latex Agglutination System) Artiti Aditya; Indrati AR; Ganiem AR
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 1 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i1.1258

Abstract

Cryptococcosis is the fourth most common opportunistic infection among Acquired Immune Deficiency Syndrome (AIDS) patients.About 100% mortality has been reported within two weeks in patient with cryptococcal meningitis but without specific treatment. Theaim of the study was to compare Cryptococcal antigen (CrAg) detection between Cryptococcus Antigen Latex Agglutination System(CALAS) and Lateral Flow Assay (LFA) among AIDS patients. This research was designed as comparative analytic with cross sectionalstudy on 56 serum derived from AIDS patient who visited Teratai Clinic before ARV therapy initiation and who had never been diagnosedas Cryptococcal meningitis. Each sample was tested for CrAg with CALAS and LFA according to the manufacturer instructions. Thisstudy was conducted in the Clinical Pathology Laboratory at Dr. Hasan Sadikin Hospital/Centre Research Unit (CRU) Medical Faculty,Padjajaran University between December 2012March2013. The statistical analysis was done using Chi square test. The result showed thatthere was no significant difference between CALAS and LFA method with p=0.596 (p>0.05), the positive probability of CrAg detectionusing LFA was 0.75 times compared to the CALAS method. For the CrAg detection in the AIDS patients there was no significant differencebetween CALAS and LFA and the positive probability of CrAg for LFA was detected about 0.75 times compared to the CALAS method.
KESAHIHAN PEMERIKSAAN COMPLEX SPECIFIC COCKTAIL ANTIGEN TB (ESAT-6, CFP-10, MPT-64) METODE CEPAT IMMUNOCHROMATOGRAPHY PADA CAIRAN SEREBROSPINAL PASIEN MENINGITIS TUBERKULOSIS {Validity of Rapid Immunochromatography Complex Specific Cocktail Antigen TB (Esat-6, Cfp-10, Mpt-64) Using Cerebrospinal Fluid of Tuberculous Meningitis Patient} Livia Noviani; Ida Parwati; Ganiem AR; Turbawati DK
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 1 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i1.1222

Abstract

The early diagnosis of definite tuberculous meningitis (TBM) is very important in reducing its mortality. The current gold standard ofTBM relies on the isolation of M. tuberculosis from cerebrospinal fluid (CSF) either with direct staining or M. tuberculosis culture, but theseexamination have a low sensitivity due to the pausibasilary condition. Recently there is an assay using rapid Immunochromatography(ICT) cocktail antigen TB in CSF to diagnose TBM. This method can detect ESAT-6, CFP-10 and MPT-64 antigen as an important virulencefactor for the spreading of bacteria to extra pulmonary which is secreted by M. tuberculosis in CSF from TBM patient. The aim of thisstudy was to know the validity of rapid ICT cocktail antigen TB using CSF against MODS culture and acid-fast bacili as a gold standardto diagnose TBM by analyzing. This study iscarried out by a descriptive observational study using cross sectional study design. Thesubjects are patients who were diagnosed as suspected TBM based on Marais criteria and were obtained from the Department of NeurologyHospital Dr. Hasan Sadikin. The examination was done at the Clinical Microbiology Department of Clinical Pathology Dr. Hasan Sadikinhospital since January 2014 until May 2014. A total of 41 subjects which consisted of six (6) subjects with a definite diagnosis of TBM,26 with probable TBM and nine (9) with possible TBM were enrolled in this study. The result of this assay againts acid-fast bacili has the100% sensitivity, 64.1% specificity, 12.5% PPV, 100% NPV, LR(+) 2.78, LR(–)0 and 65.8% accuracy. The result of this assay againtsM. tuberculosis culture has the 83.3% sensitivity, 68.5% specificity, PPV 31.2%, NPV 96%, LR(+) 2.65, LR(–)0.24, accuracy 70.7% andprevalence ratio 7.8. Based on this study, it can be concluded that the validity of this assay againts acid-fast bacili has a high sensitivity,moderate specificity, low PPV, high NPV and moderate accuracy. The result of this assay againts M. tuberculosis culture has a moderatesensitivity and specificity, low PPV, high NPV and moderate accuracy.