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Latex Agglutination
test
Introduction
The latex agglutination for Cryptococcus Neoformans antigen is a simple and
rapid procedure for the diagnosis of cryptococcal meningitis. Since the test is
sensitive, care must be taken to prevent contamination of the sample, resulting in
false-positive results. This test detect the capsular antigen of Cryptococcus
Neoformans in cerebrospial fluid (CSF) and serum.
Principle
1. Add 100 ul of specimen diluent to each test tubes labeled 1-10 and place
in a rack (1:2 through 1:1024). Additional dilutions may be necessary if
the specimen is positive at 1:1024.
2. Add 100 ul of patient’s specimen to tube #1 and mix well.
3. Transfer 100 ul from tube #1 to and mix well.
4. Transfer 100 ul from tube #1 to tube # 2 and mix well. Continue this
dilution up to tube #10.
5. Add 25 ul of Cryptococcus Positive , negative control and each specimen
dilution onto separate rings of the ring slide.
6. Add 25 ul of Cryptococcus Latex to each ring.
7. Place the ring slide on a rotator set to 100 RPM (+/- 25) for 5 minutes at
room temperature.
8. Read the reactions immediately.
Results
• Reporting:
negative (-) : a homogeneous suspension of particles with no visible clumping.
Two plus (2+) : small but definite clumps against a slightly cloudy background.
Three plus (3+) : large and small clumps against clear background.
Cryptococcus fungi
Cryptococcus found
on the lung of patient
with AIDS.
False Positive Cryptococcal Antigen
Agglutination caused by Disinfectants
and soaps
• Summary:
Five disinfectants or soaps were tested to
determine if any could be responsible for false-
positive results obtain with the Latex Antigen
detection system kit (Immuno-Mycologics, Inc).
Three disinfectants or soaps produced false-
positive agglutination after repeated washing or
ring slides during testing of a known negative
CSF specimen
Cryptococcal Antigen Test Revisited:
Significance for Cryptococcal Therapy
monitoring in a Tertiary Chinese hospital
• Summary:
For a total of 29 non-human immunodeficiency virus 1
cryptococcal meningitis cases, titer changes in the latex
agglutination test before and after therapy were reviewed
along with the clinical manifestations, laboratory findings,
and therapy regimens. The cryptococcal antigen titer
decreased for every cased after therapy and was correlated
to fungal clearance as defined by the fungus smear and
after/or culture. However, cryptococcal antigen can remain
at low titers for long periods of time after therapy, even when
fungus smears and/or cultures become negative.
False positive Reactions in the Latex
Agglutination Test for Cryptococcus
neoformans Antigen
• Summary:
The Latex Agglutination Test for Cryptococcus neoformans Antigen
is a simple and rapid procedure for the diagnosis of cryptococcal
meningitis. Since the test is sensitive, care must taken to
prevent the contamination which may lead to false-positive
results. It was discovered in the laboratory that immersion
substances of a platinum inoculating wire loop into a sample of
CSF prior to testing introduced interfering substances leading to
nonspecific agglutination. After further studies, it was
determined that trace amounts of surface condensation
(syneresis fluid) from agar, either added to the CSF or adhering
to the loop were the probable source of contamination. It is
suggested that the Latex Agglutination test for C. neoformans
antigen be performed prior to culture or on a separate sample.