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Chapter 7 : Immunoassays for Diagnosis of Infectious Diseases*

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Immunoassays for Diagnosis of Infectious Diseases*, Page 1 of 2

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Abstract:

By definition, immunoassays are biochemical assays that detect the presence of an analyte, either antibody or antigen, using labeled antibodies as the analytical reagent. Immunoassays can be adapted for detection of analytes across laboratory disciplines and are often more cost-effective than other diagnostic methods. In the clinical microbiology laboratory, immunoassays often serve as confirmatory tests, and therefore the results are typically not intended to be used as the sole basis on which a diagnosis is made. However, for certain infectious diseases, including Lyme disease, cryptococcal meningitis, and syphilis, antibody and antigen detection by immunoassays is the primary means by which the infection is established. Due to their ease of use, rapid turnaround time, and generally high specificity, immunoassays are increasingly becoming available for point-of-care testing. This chapter summarizes the common immunologic testing methods currently used in clinical microbiology laboratories and their application for the diagnosis of infectious diseases. The discussion emphasizes general assay design, with important caveats relevant to test development and interpretation. While some examples relating to clinical testing are included, for an in-depth, pathogen-focused discussion, the reader is directed to the designated chapters in this .

Citation: Theel E, Carpenter A, Binnicker M. 2015. Immunoassays for Diagnosis of Infectious Diseases*, p 91-105. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch7
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FIGURE 1

Precipitin curve showing the zone of equivalence, prozone phenomenon, and postzone phenomenon. doi:1128/9781555817381.ch7.f1

Citation: Theel E, Carpenter A, Binnicker M. 2015. Immunoassays for Diagnosis of Infectious Diseases*, p 91-105. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch7
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FIGURE 2

Image of an immunodiffusion reaction. doi:1128/9781555817381.ch7.f2

Citation: Theel E, Carpenter A, Binnicker M. 2015. Immunoassays for Diagnosis of Infectious Diseases*, p 91-105. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch7
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FIGURE 3

Diagram of a direct and an indirect immunofluorescence assay (IFA). doi:1128/9781555817381.ch7.f3

Citation: Theel E, Carpenter A, Binnicker M. 2015. Immunoassays for Diagnosis of Infectious Diseases*, p 91-105. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch7
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Image of FIGURE 4
FIGURE 4

Diagram of a competitive EIA. doi:1128/9781555817381.ch7.f4

Citation: Theel E, Carpenter A, Binnicker M. 2015. Immunoassays for Diagnosis of Infectious Diseases*, p 91-105. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch7
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Image of FIGURE 5
FIGURE 5

Diagram of a noncompetitive EIA. doi:1128/9781555817381.ch7.f5

Citation: Theel E, Carpenter A, Binnicker M. 2015. Immunoassays for Diagnosis of Infectious Diseases*, p 91-105. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch7
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Image of FIGURE 6
FIGURE 6

Diagram of an IgM capture EIA. doi:1128/9781555817381.ch7.f6

Citation: Theel E, Carpenter A, Binnicker M. 2015. Immunoassays for Diagnosis of Infectious Diseases*, p 91-105. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch7
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FIGURE 7

Diagram of the Western blot procedure. doi:1128/9781555817381.ch7.f7

Citation: Theel E, Carpenter A, Binnicker M. 2015. Immunoassays for Diagnosis of Infectious Diseases*, p 91-105. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch7
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Image of FIGURE 8
FIGURE 8

Diagram of a lateral-flow immunoassay (LFA). doi:1128/9781555817381.ch7.f8

Citation: Theel E, Carpenter A, Binnicker M. 2015. Immunoassays for Diagnosis of Infectious Diseases*, p 91-105. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch7
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Tables

Generic image for table
TABLE 1

Approximate sensitivities of various immunoassays

Citation: Theel E, Carpenter A, Binnicker M. 2015. Immunoassays for Diagnosis of Infectious Diseases*, p 91-105. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch7
Generic image for table
TABLE 2

Assay performance characteristics

Citation: Theel E, Carpenter A, Binnicker M. 2015. Immunoassays for Diagnosis of Infectious Diseases*, p 91-105. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch7

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