Serological tests using Sporothrix species antigens for the accurate diagnosis of sporotrichosis: a meta-analysis.

Some species of the fungus Sporothrix cause a chronic granulomatous infection in humans and animals called sporotrichosis. In the last decades, some research into serological tests has been carried out by different groups for the rapid detection of this infection. We performed a systematic review of the literature with meta-analysis to evaluate studies using Sporothrix spp. antigens and to evaluate their accuracy for sporotrichosis diagnostic. We searched Scopus, MEDLINE, Web of Science, GALE, Technology Research Database, DOA, Elsevier, SciELO, and Google Scholar Databases. The united results of sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio with their corresponding 95% confidence intervals (CI) were assessed. A total of 15 assays from 8 studies using 7 different serological methods and 8 different antigens were analyzed. The studies were performed in the USA, Brazil, and Venezuela from 1973 until 2015 and presented good quality. A high heterogeneity for sensitivity [I2 = 90.7%; 87% CI = (84-89), P < 0.001] and specificity [I2 = 89.2%; 93% CI = (92-95), P < 0.001] was observed. The performance of diagnostic tests was 0.93. Enzyme-linked immunosorbent assay was the main tool used, and the ConA-binding fraction antigen of the strain 1099-18 appears as a promising diagnostic biomarker candidate.