Immunomagnetic leukocyte differential in whole blood on an electronic microdevice

Leukocytes are the frontline defense mechanism of the immune system. Their composition dynamically changes as a response to a foreign body, infection, inflammation, or other malignant behavior occurring within the body. Monitoring the composition of leukocytes, namely leukocyte differential, is a crucial assay periodically performed to diagnose an infection or to assess a person's vulnerability for a health anomaly. Currently, leukocyte differential analysis is performed using hematology analyzers or flow cytometers, both of which are bulky instruments that require trained and certified personnel for operation. In this work, we demonstrate a new technique to obtain leukocyte differentials in a highly portable and integrated microfluidic chip by magnetically analyzing the CD33 expression of leukocytes. When benchmarked against conventional laboratory instruments, our technology demonstrated <5% difference on average for all subtypes. Our results show that hematology testing could be performed beyond the centralized laboratories at a low cost and ultimately provide point-of-care and at-home testing opportunities.

Problems encountered in conventional HIV 1/2 Algorithms: lack of necessity for immunoblot assays to confirm repeated ELISA reactive results

BACKGROUND

The use of conventional (serologically based) HIV 1/2 diagnostic algorithms has become controversial in recent years.

OBJECTIVES

Sera from patients who underwent verification tests were evaluated because repeated ELISA-reactive results demonstrated a HIV1+HIV2 positive band pattern.

METHODS

The line immunoassay (LIA) test was used for repeated HIV enzyme immunoassays (EIA)-reactive sera in patients at three centers. The Bio-Rad Geenius™ HIV 1/2 and the HIV-1 RNA tests were used. HIV-1 and RNA HIV-2 were investigated using PCR.

RESULTS

LIA was used to evaluate 3,224 out of 10,591 samples with repeated ELISA reactivity (30%). We found that 32 (1%) of the sera, along with HIV1 bands and HIV2 gp36 bands, were positive. Only 28 of the 32 verified serum samples with gp36 bands were repeated, and no gp36 band positivity was detected using the Bio-Rad Geenius™ HIV-1/2 confirmatory assay in these serum samples. The HIV-2 proviral DNAs were also negative. Therefore, we excluded the possibility of HIV1+2 co-infection. All samples from the 32 patients were positive for HIV-1 RNA.

CONCLUSION

Our findings highlight the need to exclude confirmatory tests like the LIA test from the current diagnostic HIV algorithm and replace it with rapid HIV-1 and HIV-2 confirmatory immunochromotographic tests.

Recurrent port infection due to chryseobacterium indologenes

Infections due to Chryseobacterium indologenes (C. indologenes) are rare and generally associated with immunosupression and indwelling catheters. We report a recurrent port infection caused by C. indologenes. In the first bacteremia episode we did not remove the port and only applied antibiotherapy. However, the patient presented with bacteremia with the same bacteria and successfully treated with antibiotherapy and removal of the port.