caa a22 4500 475832248 CHVBK 20180406123843.0 cr unu---uuuuu 170329e20000501xx s 000 0 eng 10.1007/s100960050473 doi (NATIONALLICENCE)springer-10.1007/s100960050473 Measurement of Serum Antigen Concentration by Ultrasound-Enhanced Immunoassay and Correlation with Clinical Outcome in Meningococcal Disease [Elektronische Daten] [M. A. Sobanski, R. A. Barnes, S. J. Gray, A. D. Carr, E. B. Kaczmarski, A. O'Rourke, K. Murphy, M. Cafferkey, R. W. Ellis, K. Pidcock, P. Hawtin, W. T. Coakley]  The distribution of Neisseria meningitidis serogroup B and C polysaccharide antigen in blood and the prognostic significance of antigen concentration was examined by ultrasound-enhanced immunoagglutination of coated microparticles. Specimens (169 sera/plasma from 145 patients with confirmed meningococcal disease) were tested retrospectively. The ultrasonic immunoassay detected serum antigen in 136 samples from 112 patients. Titration of antigen-positive specimens allowed estimation of blood antigen concentration. The modal blood antigen titre was 1/16, corresponding to an estimated polysaccharide concentration of 0.85 μg/ml. The lowest mean blood antigen concentration found ultrasonically was 0.05 μg/ml; compared to the 1.98 μg/ml found by conventional latex agglutination, this represents an approximately 30-fold improvement in sensitivity. Three grades of outcome were correlated with the presenting antigen titre in 83 patients: (i) <2 weeks hospitalisation, (ii) ≥2 weeks hospitalisation and (iii) mortality. High polysaccharide concentrations correlated with mortality. Nine of 15 patients with a serum antigen titre of 1/64 or greater (≥3.4 μg/ml polysaccharide) died, whereas no patient with titres equal to or less than 1/4 (≤0.21 μg/ml) died, including those patients in whom antigen was undetectable by ultrasonic immunoassay. Increasing antigen concentration significantly correlated with severity of outcome (P<0.001). Ultrasound-enhanced agglutination provides a rapid prognostic indicator by sensitive measurement of serum antigen level. Springer-Verlag Berlin Heidelberg, 2000 Sobanski M. A. School of Biosciences, Cardiff University, PO Box 915, Cardiff CF1 3TL, UK, GB aut Barnes R. A. Department of Medical Microbiology and Public Health Laboratory Service, University of Wales College of Medicine, Cardiff CF4 4XN, UK, GB aut Gray S. J. Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester M20 2LR, UK, GB aut Carr A. D. Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester M20 2LR, UK, GB aut Kaczmarski E. B. Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester M20 2LR, UK, GB aut O'Rourke A. Meningococcal Reference Laboratory, The Childrens Hospital, Temple Street, Dublin 1, Ireland, IE aut Murphy K. Meningococcal Reference Laboratory, The Childrens Hospital, Temple Street, Dublin 1, Ireland, IE aut Cafferkey M. Meningococcal Reference Laboratory, The Childrens Hospital, Temple Street, Dublin 1, Ireland, IE aut Ellis R. W. Department of Medical Microbiology, City Hospital National Health Service Trust, Dudley Road, Birmingham B18 7QH, UK, GB aut Pidcock K. Public Health Laboratory Service, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK, GB aut Hawtin P. Public Health Laboratory Service, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK, GB aut Coakley W. T. School of Biosciences, Cardiff University, PO Box 915, Cardiff CF1 3TL, UK, GB aut https://doi.org/10.1007/s100960050473 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s100960050473 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sobanski M. A. School of Biosciences, Cardiff University, PO Box 915, Cardiff CF1 3TL, UK, GB aut NATIONALLICENCE 700 1- Barnes R. A. Department of Medical Microbiology and Public Health Laboratory Service, University of Wales College of Medicine, Cardiff CF4 4XN, UK, GB aut NATIONALLICENCE 700 1- Gray S. J. Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester M20 2LR, UK, GB aut NATIONALLICENCE 700 1- Carr A. D. Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester M20 2LR, UK, GB aut NATIONALLICENCE 700 1- Kaczmarski E. B. Meningococcal Reference Unit, Public Health Laboratory Service, Withington Hospital, Manchester M20 2LR, UK, GB aut NATIONALLICENCE 700 1- O'Rourke A. Meningococcal Reference Laboratory, The Childrens Hospital, Temple Street, Dublin 1, Ireland, IE aut NATIONALLICENCE 700 1- Murphy K. Meningococcal Reference Laboratory, The Childrens Hospital, Temple Street, Dublin 1, Ireland, IE aut NATIONALLICENCE 700 1- Cafferkey M. Meningococcal Reference Laboratory, The Childrens Hospital, Temple Street, Dublin 1, Ireland, IE aut NATIONALLICENCE 700 1- Ellis R. W. Department of Medical Microbiology, City Hospital National Health Service Trust, Dudley Road, Birmingham B18 7QH, UK, GB aut NATIONALLICENCE 700 1- Pidcock K. Public Health Laboratory Service, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK, GB aut NATIONALLICENCE 700 1- Hawtin P. Public Health Laboratory Service, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK, GB aut NATIONALLICENCE 700 1- Coakley W. T. School of Biosciences, Cardiff University, PO Box 915, Cardiff CF1 3TL, UK, GB aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer