Diagnostic accuracy of ELISA in sporotrichosis: A systematic review and meta-analysis.

Abstract

<h4>Background</h4>Sporotrichosis is a subcutaneous mycosis caused by the traumatic inoculation of dimorphic fungi from the genus Sporothrix. Traditional diagnostic methods, including direct microscopy and fungal culture, are time-consuming, require specialized expertise, and may yield false-negative results.<h4>Aims</h4>This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of the enzyme-linked immunosorbent assay (ELISA) technique in detecting sporotrichosis in humans and animals.<h4>Methods</h4>A comprehensive literature search was conducted across PubMed, LILACS, EMBASE, Scopus, Web of Science, ScienceDirect, CAPES Periodicals, and the Cochrane Library using both free-text terms and MeSH descriptors. The methodological quality of the studies included was assessed using the QUADAS-2 tool. Pooled sensitivity and specificity were estimated using a random-effects model. Secondary outcomes included the positive and negative likelihood ratios and the diagnostic odds ratio (DOR).<h4>Results</h4>Twelve studies met the inclusion criteria, comprising 1612 samples (1350 human and 262 feline). ELISA demonstrated a pooled sensitivity of 91% (95% CI: 85-94) and specificity of 90% (95% CI: 86-93), with a DOR of 94.2 (95% CI: 46.9-189.1). Subgroup analysis revealed higher diagnostic performance in feline samples, particularly when crude antigen extracts and combined fungal forms were used.<h4>Conclusions</h4>ELISA exhibits high diagnostic accuracy for sporotrichosis in both human and veterinary contexts. Its performance, especially in feline hosts, supports its potential role as a reliable diagnostic alternative to conventional methods.