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Kinetics of the autologous red cell agglutination test.

The kinetics of the autologous red cell agglutination test for detecting circulating antibodies to HIV-1 were studied. Two monoclonal anti-red blood cell antibodies (1C3/86 and 10F7MN) were used to construct Fab-peptide conjugates for the test. Both antibodies recognize glycophorin alpha on the surface of erythrocytes by immunoprecipitation or immunoblotting techniques. The number of binding sites, association and dissociation constants of 1C3/86 Fab and 10F7MN Fab' fragments were determined (n = 4.80 X 10(5) sites/erythrocyte, Ka = 0.43 X 10(7) M-1, Kd = 23 X 10(-8) M for 1C3/86, n = 4.66 X 10(5) sites/erythrocyte, Ka = 1.05 X 10(7) M-1, Kd = 9.5 X 10(-8) M for 10F7MN. The binding studies were performed under the same conditions as the autologous red blood cell agglutination test. When 0.9 microgram of anti-glycophorin Fab was added to 10 microliters of blood 0.25 microgram of 1C3/86 Fab was bound whereas 0.29 microgram for 10F7MN Fab' was bound. Antibody binding reached a plateau after 2 min and once bound did not exchange with unbound Fab over the time scale of the test. The binding of the anti-peptide antibody (cross-linking antibody) was also complete within 2 min. Addition of approximately 0.1 microgram of anti-peptide antibody gave half a maximal agglutination score. This is equivalent to 10 micrograms/ml circulating antibody. Under the agglutination test conditions, Fab-peptide conjugate was bound to 14% of available glycophorin molecules. Half maximal agglutination occurred when approximately 1.1% of the bound Fab-peptide conjugates were cross-linked. A maximum agglutination score of four occurred in the presence of 1 microgram of anti-peptide antibody equivalent to 100 micrograms/ml circulating antibody whereas an agglutination score of 1+ was elicited by only 0.32 microgram anti-peptide antibody and involved the cross-linking of approximately 160 glycophorin molecules per red cell.

Antibodies↗

Sensitivity and specificity of latex agglutination tests used to identify Streptococcus agalactiae and Staphylococcus aureus isolated from bulk tank milk.

Comparisons were made among rapid latex agglutination tests and conventional biochemical tests used to identify Streptococcus agalactiae and Staphylococcus aureus. Ninety-eight streptococci and 149 staphylococci isolated from bulk tank milk were tested. Sensitivity and specificity for the latex agglutination test used for identification of Str agalactiae were 97.6 and 98.2%, respectively. Sensitivity and specificity for the latex agglutination test used for identification of S aureus were 90.2 and 67.5%, respectively. Of 25 staphylococci considered false-positive by the latex agglutination test, 14 (56%) were considered tube coagulase-positive. Fifteen staphylococci considered false-positive by latex agglutination test had biotypes representative of S hyicus of S xylosus.

Animals↗

Detection of rinderpest antigen by latex agglutination test.

A slightly modified latex agglutination test was applied for detection of rinderpest antigen. The antigen was added to sensitized latex particles in the presence of hyperimmune antiserum to facilitate agglutination. Out of 129 samples tested by latex agglutination (LA), solid phase aggregation of coated erythrocytes (SPACE), reverse phase passive haemagglutination (RPHA) and counter immunoelectrophoresis (CIE) test, 86.0, 86.8, 84.4 and 79.8 per cent, respectively, were found positive.

Antigens, Viral↗

Rapid diagnosis of Clostridium difficile-associated diarrhoea using a latex agglutination test.

A rapid latex agglutination test, Culturette Brand CDT from Marion Laboratories, was evaluated and compared to a tissue culture assay (TCA) and isolation of Clostridium difficile in 380 faecal specimens from 226 patients with clinically suspected Clostridium difficile-associated diarrhoea. The sensitivity and specificity of the latex test compared with the TCA were 83% and 80% respectively, and the positive and negative predictive values were 55% and 94% respectively. In patients with repeated sampling the sensitivity increased to 95%. The latex test may be useful as a screening test for negative specimens in laboratories where TCA is not available, but positive specimens have to be confirmed by TCA.

Cells, Cultured↗

Rapid and reliable identification of Staphylococcus aureus by a latex agglutination test.

A latex slide agglutination test detecting clumping factor and protein A simultaneously is recommended for rapid and reliable routine identification of Staphylococcus aureus. Strains (836) of staphylococci isolated from clinical specimens were examined, all S. aureus strains identified by conventional methods were correctly differentiated by the latex test, and no false-positive results occurred with other staphylococci. The reagent is easy to prepare since plasma is the coating material.

Bacteriological Techniques↗

Evaluation of latex agglutination test for alpha-fetoprotein in diagnosing rupture of fetal membranes.

To assess the utility of a latex agglutination test for alpha-fetoprotein in vaginal fluid for diagnosing rupture of the fetal membranes, we tested 91 pregnant women, including 32 with an established rupture, 19 with no evidence of rupture and 40 with a suspected rupture. Results were compared with those of the pH indicator and the fern tests. The latex agglutination test had better sensitivity, specificity, or both, than the pH indicator and the fern tests. We conclude that the latex agglutination test is more accurate than either the pH indicator or the fern test for diagnosing premature rupture of fetal membranes.

Adult↗

An evaluation of the staphylococcal co-agglutination test for the detection of group A rotavirus in human faeces.

The group A rotavirus staphylococcal co-agglutination test was evaluated and its sensitivity and specificity compared with an in-house enzyme-linked immunosorbent assay (ELISA) and a commercial latex agglutination test (Rotalex). In addition, the storage stability of the staphylococcal reagents was ascertained. Examination of 136 clarified suspensions of diarrhoeal faeces by the staphylococcal co-agglutination test revealed a high proportion of false positives (26%) and uninterpretable results (34%) due to non-specific agglutination. Non-specific agglutination could be removed effectively by prior absorption of the clarified faecal specimens with unsensitized staphylococci. The staphylococcal co-agglutination test was less sensitive and specific than the in-house enzyme-linked immunosorbent assay but was comparable to the Rotalex slide latex agglutination test. The staphylococcal reagents have a shelf life of at least 29 weeks.

Agglutination Tests↗

The use of staphylococcal protein A in the mixed agglutination test.

A mixed agglutination (MA) test employing staphylococcal protein A (SpA) instead of an antiglobulin reagent has been developed for the detection of IgG antibodies bound to cell-surface antigens. In the SpA MA test, a single indicator system may be used for the detection of IgG antibodies from several mammalian species. The sensitivity of this test compares favorably with that of the conventional MA test in the detection of most mammalian IgG. The main advantage of the conventional SpA MA test is its usefulness in the study of antigens on cells because of adherence of antibody-coated indicator erythrocytes.

Animals↗

Study of the plate agglutination test with rose bengal antigen for the diagnosis of human brucellosis.

This study presents the results of a number of serological tests, in particular the plate agglutination test using acid antigen stained with rose bengal, in the examination of 440 human sera for brucellosis. In addition, the sera were examined for the presence of specific antibodies of various classes (IgM and IgG). These investigations showed the rose bengal plate agglutination test to be highly specific and sensitive as a rapid method for the diagnosis of human brucellosis.

Agglutination Tests↗

False-positive reactions in the latex agglutination test for Cryptococcus neoformans antigen.

The latex agglutination test for Cryptococcus neoformans antigen is a simple and rapid procedure for the diagnosis of cryptococcal meningitis. Although the test is sensitive, care must be taken to prevent contamination of the sample, which may result in false-positive reactions. It was discovered in our laboratory that immersion of a platinum wire inoculating loop into a sample of cerebrospinal fluid 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 cerebrospinal fluid 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.

Antigens, Fungal↗

Comparison of the latex agglutination test with the hemagglutination inhibition test, enzyme-linked immunosorbent assay, and neutralization test for detection of antibodies to rubella virus.

The ability of a rapid, latex agglutination test to diagnose rubella infection and to measure immune status was evaluated by comparison with the hemagglutination-inhibition (HAI) test, enzyme-linked immunosorbent assay (ELISA), and the neutralization (NT) test. The latex agglutination test accurately detected serological conversions in 74 pairs of sera representing 21 natural infections and 53 immunizations. The antibody levels of 276 sera from the general population were determined by latex agglutination, HAI, and ELISA. The correlation coefficients between the titers obtained by HAI and latex agglutination and by ELISA and latex agglutination were statistically significant. Results on 12 sera did not agree when measured by the three tests. These sera were included among the 196 specimens tested by NT. The correlation coefficient between NT and latex agglutination titers was statistically significant. There was one serum positive by latex agglutination but negative by NT, and five sera were negative by latex agglutination but had titers of 4 to 8 in the NT. The relative sensitivity of detecting antibody was greater by latex agglutination than by HAI. An additional 49 sera containing residual nonspecific hemagglutinin inhibitors were evaluated by latex agglutination and NT. The untreated sera showed no false positive reactions, and 36 of 39 NT positive sera were positive in the latex agglutination test.

Antibodies, Viral↗

The sensitivity and specificity of an agglutination test for antibodies to streptococcal extracellular antigens: a quantitative analysis and comparison of the Streptozyme test with the anti-streptolysin O and anti-deoxyribonuclease B tests.

As a part of studies of streptococcal infections of the upper respiratory tract, sera from 142 individuals (mean age 11.9 years) with signs and symptoms on tonsillitis or pharyngitis and their family contacts were studied to quantitatively evaluate the sensitivity and specificity of the Streptozyme test. We also compared this agglutination test for streptococcal extracellular antibodies with the antistreptolysin O and antideoxyribonuclease B tests. Using different lots of Streptozyme reagent we found evidence suggesting variation in the strength of the reagent from lot to lot. Evaluation of the group specificity of the Streptozyme test suggests that it may not be specific for antibodies to extracellular products of group A streptococci, since a response to this test was seen in individuals with only non-group A strains isolated from their upper respiratory tracts. In patients with group A streptococci isolated from the upper respiratory tract, the quantitative sensitivity of the antibody response as measured by the Streptozyme test is comparable to, but no greater than, the ASO or anti-DNase B tests. Our analysis of upper limits of normal for the Streptozyme test in the study population indicates that previous recommendations for values for elevated titers are too low, especially for predominantly pediatric populations, so that previous reports of patients demonstrating an antibody response to Streptozyme-measured antibodies may include a significant number of patients with "normal" levels. This study indicates the need for both further documentation of standardization of the reagents used in this agglutination test and additional quantitative studies of the response measured by Streptozyme.

Adolescent↗

Modification of the slide agglutination test for the detection of sperm-agglutinins.

We have modified the slide agglutination test (SAT) in order to make it available for the routine detection and titration of sperm agglutinins. Serum and seminal plasma samples of 156 subfertile patients were tested by the modified slide agglutination test (MSAT) in two trials. Fifteen per cent of serum and 7.5% of siminal plasma samples gave positive results and MSAT showed excellent reproducibility: a highly significant statistical correlation between the positive titres in the two determinations was observed. One hundred and ten samples were tested simultaneously by the MSAT and the tray agglutination test (TAT). The two tests showed a similar sensitivity with a significant statistical correlation between the positive titres. Using the MSAT the reading of results was easier and more precise. Therefore we propose the MSAT for the routine detection and titration of sperm-agglutinins.

Humans↗

Serological diagnosis of Indian visceral leishmaniasis: direct agglutination test versus rK39 strip test.

We evaluated the direct agglutination test (DAT), using freeze-dried (FD) and aqueous (AQ) antigen, and the rK39 immunochromatographic strip test in the diagnosis of Indian visceral leishmaniasis (VL). Sera from 508 subjects (150 parasitologically confirmed patients with VL, 100 and 153 healthy controls drawn from non-endemic and endemic regions, respectively, and 105 patients with other diseases presenting with fever and/or splenomegaly) were tested. The sensitivity of the tests were as follows: DAT (FD), 96% (95% CI 91-98); DAT (AQ), 97% (95% CI 93-99); rK39 strip test, 99% (95% CI 95-100). The specificity of DAT (FD), DAT (AQ) and rK39 strip tests were 85% (95% CI 81-88), 87% (95% CI 83-91) and 89% (95% CI 86-92), respectively. A significant correlation (high degree of agreement) was observed between all tests (kappa>0.80). We conclude that the sensitivity of FD antigen is comparable to that of AQ antigen. Similarly, the rK39 strip test is as sensitive as the DAT, but the strip test's greater convenience of use makes it a better tool for diagnosis of VL in peripheral areas of endemic regions.

Agglutination Tests↗

Simple, speedy, sensitive, and specific serodiagnosis of pertussis by using a particle agglutination test.

We developed a particle agglutination test (KPA) with poly(gamma-methyl L-glutamate) as the solid particle for measurement of pertussis toxin (PT) antibody. In this study, KPA was assessed as a means of serodiagnosing pertussis, and the results were compared with those of indirect enzyme-linked immunosorbent assay (indirect ELISA) and the microagglutination test. First, four serum samples were collected from each of 21 healthy children: before and 4 weeks after receiving three primary doses of acellular pertussis vaccines and before and 4 weeks after receiving a booster dose. In all 21 vaccinees, a significant rise in PT antibody titers was observed by KPA after each vaccination, and among all 84 serum samples collected, an excellent correlation was demonstrated between the values obtained by indirect ELISA and those obtained by KPA (r = 0.92). Second, paired serum samples were collected at intervals of approximately 2 weeks from 51 patients with culture-confirmed pertussis. A significant increase in titer (fourfold or more) was observed in 39 (76%) patients by KPA, 34 (67%) patients by indirect ELISA, and 23 (45%) patients by the microagglutination test. In acute- and convalescent-phase sera collected from 20 nonpertussis patients, there were no changes in titers by KPA. The KPA procedure was as simple as that of the microagglutination test, and the reaction time was only 2 h (or overnight). In this study, KPA was demonstrated to be a simple, speedy, sensitive, and specific serodiagnostic method for pertussis.

Agglutination Tests↗

2-mercaptoethanol Brucella agglutination test: usefulness for predicting recovery from brucellosis.

Ninety-two patients with brucellosis were studied for 18 months, and 15 to 29 sera from each patient were tested by the standard tube brucella agglutination test and by the 2-mercaptoethanol (2ME) brucella agglutination test. The standard tube test remained positive (greaterr than or equal to 160) for 1.5 years in 44 of the 92 patients (48%), despite adequate antibiotic treatment. The 2ME titers remained positive (greater than or equal to 160) in only 8 of 92 patients (9%) after 1 year, and in only 4 of 92 patients (4%) after 1.5 years. Positive 2ME titers 1 year after initiation of treatment were present in 3 of 10 patients (30%) with drug allergies that interfered with antibiotic treatment, in contrast to only 5 of 82 patients (6%) without any allergies (P = 0.039). None of 84 patients with negative 2ME titers after 12 months of treatment had significant signs or symptoms of brucellosis, and none developed chronic brucellosis. In contrast, four of eight patients with positive 2ME titers after 12 months of treatment still had signs and symptoms of brucellosis and required further treatment. The 2ME test is superior to the standard tube test in determining the adequacy of antibiotic therapy, and a negative 2ME test is strong evidence against a diagnosis of chronic brucellosis.

Agglutination Tests↗

Evaluation of the latex agglutination test for detection of Clostridium difficile.

We compared two Clostridium difficile latex agglutination tests, Meritec from Meridian Diagnostic (Cincinnati, Ohio) and CDT from Becton-Dickinson (Cockeysville, Md), on 289 specimens submitted for tissue culture cytotoxicity using MRC-5 cells. When compared with CDT, the Meritec latex agglutination test had a sensitivity of 90% (26/29), a specificity of 97% (251/260), and a correlation of 96%. Meritec was compared with tissue culture cytotoxicity on 357 specimens. Meritec had a sensitivity of 77% (30/39), a specificity of 93% (298/318), and a correlation of 92%. Clinical review of 10 Meritec +/- tissue culture cytotoxicity minus patients revealed one likely, two probable, and seven doubtful cases of C difficile disease. In contrast, review of 10 Meritec +/- tissue culture cytotoxicity plus patients showed seven likely and three probable cases of C difficile disease. The Meritec is comparable with the CDT latex agglutination test, but is not nearly as sensitive as either tissue culture assay or culture for detection of C difficile disease. A positive latex agglutination test should be confirmed by a tissue culture cytotoxicity assay.

Clostridioides difficile↗

Improved rapid slide agglutination test for presumptive diagnosis of canine brucellosis.

A modified rapid slide agglutination test for the presumptive identification of Brucella canis infection in dogs has been developed. The method required mixing 0.1 ml of canine serum with 0.1 ml of 0.2 M 2-mercaptoethanol solution. Equal volumes (0.05 ml) of the treated serum and the B. canis plate antigen were mixed. Agglutination results were read within 2 min. Clinical studies showed 100% agreement between this method and the conventional 2-mercaptoethanol tube agglutination test. Excellent correlation was shown between cultural isolation and the modified rapid slide agglutination test, using sera from experimentally infected dogs.

Agglutination Tests↗