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Humisto A, Antikainen J, Holma T, Jarva H, Toivonen A, Loginov R, Mannonen L. Evaluation of the Novel CE-IVD-Marked Multiplex PCR QIAstat-Dx Meningitis/Encephalitis Panel. Microbiol Spectr 2023; 11:e0514422. [PMID: 37042772 PMCID: PMC10269741 DOI: 10.1128/spectrum.05144-22] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/23/2023] [Indexed: 04/13/2023] Open
Abstract
Central nervous system (CNS) infections such as meningitis and encephalitis are life-threatening conditions that demand hospital care and prompt identification of the causative agent. Since 2015, there has been only one CE-IVD-marked rapid multiplexed diagnostic assay in cassette format for bacterial and viral detection from cerebrospinal fluid (CSF): the BioFire FilmArray meningitis/encephalitis (ME) panel. In the beginning of 2022, Qiagen introduced the QIAstat-Dx meningitis/encephalitis panel. It is a CE-IVD-marked multiplex PCR cassette test intended for the identification of suspected infectious meningitis, encephalitis, or meningoencephalitis caused by bacterial, viral, or fungal pathogens. In this study, we evaluated patient and quality control samples using the QIAstat-Dx meningitis/encephalitis panel and compared the results to those of the BioFire FilmArray meningitis/encephalitis panel and reference methods (current routine analysis methods in our laboratory, PCR, or cultivation). The combined positive percent agreement between the two panel assays was 100%, and the negative percent agreement was 94%. We further compared specifically herpes simplex virus 1 (HSV-1), HSV-2, and varicella-zoster virus (VZV) dilution series using six commercial herpesvirus assays, including the two cassette tests. The results suggested that real-time PCR methods (with separate extraction) were the most sensitive methods. When comparing the cassette tests, the BioFire FilmArray meningitis/encephalitis panel produced more positive results than the QIAstat-Dx meningitis/encephalitis panel in the herpesvirus analyses. IMPORTANCE The diagnosis of infectious meningitis and encephalitis relies mostly on specific PCR and culturing methods, but commercial syndromic panel assays are bringing a change in diagnostics. With multiplexed analysis, the identification of the pathogen is potentially faster, and less sample material is needed. The novel QIAstat-Dx meningitis/encephalitis panel assay is intended for the rapid identification of pathogens from cerebrospinal fluid for suspected central nervous system (CNS) infection, which is a life-threatening condition and difficult to diagnose. We studied the performance of this panel assay using patient samples and dilution series of selected viruses. The evaluation data for this novel meningitis/encephalitis panel assay are useful for other clinical laboratories and organizations using or considering using this test.
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Affiliation(s)
- Anu Humisto
- Department of Clinical Microbiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Jenni Antikainen
- Department of Clinical Microbiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tanja Holma
- Department of Clinical Microbiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Hanna Jarva
- Department of Clinical Microbiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Anne Toivonen
- Department of Clinical Microbiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Raisa Loginov
- Department of Clinical Microbiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Laura Mannonen
- Department of Clinical Microbiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Holma T, Torvikoski J, Friberg N, Nevalainen A, Tarkka E, Antikainen J, Martelin JJ. Rapid molecular detection of pathogenic microorganisms and antimicrobial resistance markers in blood cultures: evaluation and utility of the next-generation FilmArray Blood Culture Identification 2 panel. Eur J Clin Microbiol Infect Dis 2021; 41:363-371. [PMID: 34350523 PMCID: PMC8831274 DOI: 10.1007/s10096-021-04314-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/09/2021] [Indexed: 11/30/2022]
Abstract
Rapid detection of pathogens causing bloodstream infections (BSI) directly from positive blood cultures is of highest importance in order to enable an adequate and timely antimicrobial therapy. In this study, the utility and performance of a recently launched next-generation fully automated test system, the Biofire FilmArray® Blood Culture Identification 2 (BCID2) panel, was evaluated using a set of 103 well-characterized microbial isolates including 29 antimicrobial resistance genes and 80 signal-positive and 23 signal-negative clinical blood culture samples. The results were compared to culture-based reference methods, MALDI-TOF, and/or 16S rDNA sequencing. Of the clinical blood culture samples, 68 were monomicrobial (85.0%) and 12 polymicrobial (15.0%). Six samples contained ESBL (blaCTX-M), two MRSA (mecA), and three MRSE (mecA) isolates. In overall, the FilmArray BCID2 panel detected well on-panel targets and resistance markers from mono- and polymicrobial samples. However, one Klebsiella aerogenes and one Bacteroides ovatus were undetected, and the assay falsely reported one Shigella flexneri as Escherichia coli. Hence, the sensitivity and specificity for detecting microbial species were 98.8% (95%CI, 95.8–99.9%) and 99.9% (95%CI, 99.8–99.9%), respectively. The sensitivity and specificity for detecting of resistance gene markers were 100%. The results were available within 70 min from signal-positive blood cultures with minimal hands-on time. In conclusion, the BCID2 test allows reliable and simplified detection of a vast variety of clinically relevant microbes causing BSI and the most common antimicrobial resistance markers present among these isolates.
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Affiliation(s)
- Tanja Holma
- HUS Diagnostic Center, HUSLAB, Department of Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - Jukka Torvikoski
- HUS Diagnostic Center, HUSLAB, Department of Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Nathalie Friberg
- HUS Diagnostic Center, HUSLAB, Department of Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Annika Nevalainen
- HUS Diagnostic Center, HUSLAB, Department of Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Eveliina Tarkka
- HUS Diagnostic Center, HUSLAB, Department of Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jenni Antikainen
- HUS Diagnostic Center, HUSLAB, Department of Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jari J Martelin
- HUS Diagnostic Center, HUSLAB, Department of Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Kouri T, Holma T, Kirjavainen V, Lempiäinen A, Alagrund K, Tohmola N, Pihlajamaa T, Kouri VP, Lehtonen M, Friman S, Pätäri-Sampo A. UriSed 3 PRO automated microscope in screening bacteriuria at region-wide laboratory organization. Clin Chim Acta 2021; 516:149-156. [PMID: 33549597 DOI: 10.1016/j.cca.2021.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 12/15/2020] [Accepted: 01/27/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS We assessed the possibility to rule out negative urine cultures by counting with UriSed 3 PRO (77 Elektronika, Hungary) at Helsinki and Uusimaa Hospital District. MATERIALS AND METHODS Bacteria counting of the UriSed 3 PRO automated microscope was verified with reference phase contrast microscopy against growth in culture. After acceptance into routine, results of bacteria and leukocyte counting from 56 426 specimens with eight UriSed 3 PRO instruments were compared against results from parallel samples cultured on chromogenic agar. Laboratory data including preanalytical details were accessed through the regional database of the Helsinki and Uusimaa Hospital District. RESULTS A combined sensitivity of 87-92% and a negative predictive value of 90-96% with a specificity of 54-50% was reached, depending on criteria. Preanalytical data (incubation time in bladder) combined with the way of urine collection would improve these figures if reliable. CONCLUSIONS Complex patient populations, regional logistics and data interfases, and economics related to increased costs of additional particle counts against costs of screening cultures of all samples, did not support adaptation of a screening process of urine cultures. This conclusion was made locally, and may not be valid elsewhere.
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Affiliation(s)
- Timo Kouri
- Department of Clinical Chemistry, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland; Department of Clinical Chemistry, University of Helsinki, Finland.
| | - Tanja Holma
- Department of Clinical Microbiology, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland; Department of Clinical Microbiology, University of Helsinki, Finland
| | - Vesa Kirjavainen
- Department of Clinical Microbiology, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland; Department of Clinical Microbiology, University of Helsinki, Finland
| | - Anna Lempiäinen
- Department of Clinical Chemistry, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland; Department of Clinical Chemistry, University of Helsinki, Finland
| | - Katariina Alagrund
- Department of Clinical Chemistry, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland; Department of Clinical Chemistry, University of Helsinki, Finland
| | - Niina Tohmola
- Department of Clinical Chemistry, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland; Department of Clinical Chemistry, University of Helsinki, Finland
| | - Tero Pihlajamaa
- Department of Clinical Chemistry, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland; Department of Clinical Chemistry, University of Helsinki, Finland
| | - Vesa-Petteri Kouri
- Department of Clinical Chemistry, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland; Department of Clinical Chemistry, University of Helsinki, Finland
| | - Maaret Lehtonen
- Department of Clinical Chemistry, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland; Department of Clinical Chemistry, University of Helsinki, Finland
| | - Sirpa Friman
- Department of Clinical Chemistry, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland; Department of Clinical Chemistry, University of Helsinki, Finland
| | - Anu Pätäri-Sampo
- Department of Clinical Microbiology, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland; Department of Clinical Microbiology, University of Helsinki, Finland
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Kouri T, Alagrund K, Lehtonen M, Tohmola N, Pihlajamaa T, Kouri VP, Friman S, Holma T, Kirjavainen V, Pätäri-Sampo A, Lempiäinen A. Verification of UriSed 3 PRO automated urine microscope in regional laboratory environment. Clin Chim Acta 2021; 515:96-103. [PMID: 33460593 DOI: 10.1016/j.cca.2021.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/08/2021] [Accepted: 01/09/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS Ten UriSed 3 PRO automated microscopes (77 Elektronika, Hungary) were verified for nine HUSLAB laboratories with 160 000 annual urine samples. MATERIALS AND METHODS Particle counting of the primary UriSed 3 PRO instrument (77 Elektronika, Hungary) was verified against reference visual microscopy with 463 urine specimens, and against urine culture on chromogenic agar plates with parallel 396 specimens. Nine secondary instruments were compared pairwise with the primary instrument. RESULTS Relative imprecisions compared to Poisson distribution, R(CV), were estimated to be 1.0 for white blood cell (WBC) and 1.5 for red blood cell (RBC) counts, respectively. Spearman's correlations against visual microscopy were rS = 0.94 for WBC, rS = 0.87 for RBC, and rS = 0.82 for squamous epithelial cell (SEC) counts. Agreement with visual microscopy (Cohen's weighted kappa) was 0.94 for WBC, 0.89 for RBC, 0.88 for SEC, 0.59 for combined casts, and 0.49 for non-squamous epithelial cells (NEC). Bacteria were detected with a sensitivity of 90% and specificity of 39 against culture at 107 CFB/L (104 CFU/mL). Created flagging limits allowed automated reporting for 70-75% of patient results. CONCLUSIONS UriSed 3 PRO instruments were adopted into routine use after acceptance of the verification.
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Affiliation(s)
- Timo Kouri
- Department of Clinical Chemistry, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland; Department of Clinical Chemistry, University of Helsinki, Finland.
| | - Katariina Alagrund
- Department of Clinical Chemistry, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland
| | - Maaret Lehtonen
- Department of Clinical Chemistry, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland
| | - Niina Tohmola
- Department of Clinical Chemistry, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland
| | - Tero Pihlajamaa
- Department of Clinical Chemistry, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland
| | - Vesa-Petteri Kouri
- Department of Clinical Chemistry, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland
| | - Sirpa Friman
- Department of Clinical Chemistry, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland
| | - Tanja Holma
- Department of Clinical Microbiology, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland
| | - Vesa Kirjavainen
- Department of Clinical Microbiology, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland
| | - Anu Pätäri-Sampo
- Department of Clinical Microbiology, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland
| | - Anna Lempiäinen
- Department of Clinical Chemistry, HUSLAB, Helsinki University Hospital, HUS Diagnostic Center, FIN-00029 HUS, Helsinki, Finland
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Holma T, Antikainen J, Haiko J. Evaluation of three molecular carbapenemase tests: Eazyplex SuperBug complete B, Novodiag CarbaR+, and Amplidiag CarbaR+MCR. J Microbiol Methods 2020; 180:106105. [PMID: 33217483 DOI: 10.1016/j.mimet.2020.106105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Carbapenemase-producing Gram-negative bacilli, i.e., Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter, are of increased concern for the public health around the world. There is urgent need for rapid and accurate tests in order to provide correct treatment and to prevent bacterial spread in healthcare settings. METHODS The aim of this study was to evaluate three commercial multiplex carbapenemase tests with CE-IVD marking: Eazyplex SuperBug complete B (AmplexDiagnostics), Novodiag CarbaR+ (Mobidiag), and Amplidiag CarbaR+MCR (Mobidiag). All these tests recognize KPC, NDM, OXA-48/181 group, VIM, OXA-23 group, and OXA-24/40 group, and Novodiag CarbaR+ and Amplidiag CarbaR+MCR additionally recognize IMP, OXA-51 group (with promoter located within ISAbaI), OXA-58 group, and MCR, and Amplidiag CarbaR+MCR further recognizes GES (carbapenemase-type only). RESULTS The sensitivities and specificities of these tests with bacterial isolates were 100%. The sensitivity directly from clinical samples was 100%, but the specificity was lower, which is simply explained by the higher sensitivity of the molecular methods compared with culture method. CONCLUSIONS Overall, these CE-IVD marked tests provide a good alternative in the detection of carbapenemase-producing organisms.
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Affiliation(s)
- Tanja Holma
- Helsinki University and Helsinki University Hospital, HUSLAB, Department of Clinical Microbiology, Helsinki, Finland
| | - Jenni Antikainen
- Helsinki University and Helsinki University Hospital, HUSLAB, Department of Clinical Microbiology, Helsinki, Finland
| | - Johanna Haiko
- Helsinki University and Helsinki University Hospital, HUSLAB, Department of Clinical Microbiology, Helsinki, Finland.
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Jokela P, Jääskeläinen AE, Jarva H, Holma T, Ahava MJ, Mannonen L, Lappalainen M, Kurkela S, Loginov R. SARS-CoV-2 sample-to-answer nucleic acid testing in a tertiary care emergency department: evaluation and utility. J Clin Virol 2020; 131:104614. [PMID: 32889495 PMCID: PMC7451096 DOI: 10.1016/j.jcv.2020.104614] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/24/2020] [Accepted: 08/26/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Rapid sample-to-answer tests for detection of SARS-CoV-2 are emerging and data on their relative performance is urgently needed. OBJECTIVES We evaluated the analytical performance of two rapid nucleic acid tests, Cepheid Xpert® Xpress SARS-CoV-2 and Mobidiag Novodiag® Covid-19, in comparison to a combination reference of three large-scale PCR tests. Moreover, utility of the Novodiag® test in tertiary care emergency departments was assessed. RESULTS In the preliminary evaluation, analysis of 90 respiratory samples resulted in 100% specificity and sensitivity for Xpert®, whereas analysis of 107 samples resulted in 93.4% sensitivity and 100% specificity for Novodiag®. Rapid SARS-CoV-2 testing with Novodiag® was made available for four tertiary care emergency departments in Helsinki, Finland between 18 and 31 May, coinciding with a rapidly declining epidemic phase. Altogether 361 respiratory specimens, together with relevant clinical data, were analyzed with Novodiag® and reference tests: 355/361 of the specimens were negative with both methods, and 1/361 was positive in Novodiag® and negative by the reference method. Of the 5 remaining specimens, two were negative with Novodiag®, but positive with the reference method with late Ct values. On average, a test result using Novodiag® was available nearly 8 hours earlier than that obtained with the large-scale PCR tests. CONCLUSIONS While the performance of novel sample-to-answer PCR tests need to be carefully evaluated, they may provide timely and reliable results in detection of SARS-CoV-2 and thus facilitate patient management including effective cohorting.
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Affiliation(s)
- Pia Jokela
- HUS Diagnostic Center, HUSLAB, Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Finland
| | - Anu E Jääskeläinen
- HUS Diagnostic Center, HUSLAB, Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Finland.
| | - Hanna Jarva
- HUS Diagnostic Center, HUSLAB, Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Finland; Translational Immunology Research Program and Department of Bacteriology and Immunology, University of Helsinki, Helsinki, Finland
| | - Tanja Holma
- HUS Diagnostic Center, HUSLAB, Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Finland
| | - Maarit J Ahava
- HUS Diagnostic Center, HUSLAB, Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Finland
| | - Laura Mannonen
- HUS Diagnostic Center, HUSLAB, Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Finland
| | - Maija Lappalainen
- HUS Diagnostic Center, HUSLAB, Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Finland
| | - Satu Kurkela
- HUS Diagnostic Center, HUSLAB, Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Finland
| | - Raisa Loginov
- HUS Diagnostic Center, HUSLAB, Clinical Microbiology, University of Helsinki and Helsinki University Hospital, Finland
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Salin JT, Salkinoja-Salonen M, Salin PJ, Nelo K, Holma T, Ohtonen P, Syrjälä H. Building-related symptoms are linked to the in vitro toxicity of indoor dust and airborne microbial propagules in schools: A cross-sectional study. Environ Res 2017; 154:234-239. [PMID: 28107741 DOI: 10.1016/j.envres.2017.01.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/10/2017] [Accepted: 01/12/2017] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Indoor microbial toxicity is suspected to cause some building-related symptoms, but supporting epidemiological data are lacking. OBJECTIVE We examined whether the in vitro toxicity of indoor samples from school buildings was associated with work-related health symptoms (building-related symptoms, BRS). METHODS Administrators of the Helsinki City Real Estate Department selected 15 schools for the study, and a questionnaire on symptoms connected to work was sent to the teachers in the selected schools for voluntary completion. The cellular toxicity of classroom samples was determined by testing substances extracted from wiped indoor dust and by testing microbial biomass that was cultured on fallout plates. Boar sperm cells were used as indicator cells, and motility loss was the indicator for toxic effects. The effects were expressed as the half maximal effective concentration (EC50) at which >50% of the exposed boar sperm cells were immobile compared to vehicle control. RESULTS Completed symptom questionnaires were received from 232 teachers [median age, 43 years; 190 (82.3%) women] with a median time of 6 years working at their school. Samples from their classrooms were available and were assessed for cellular toxicity. The Poisson regression model showed that the impact of extracts of surface-wiped school classroom dust on teacher work-related BRS was 2.8-fold (95% CI: 1.6-4.9) higher in classrooms with a toxic threshold EC50 of 6µgml-1 versus classrooms with insignificant EC50 values (EC50 >50µgml-1); P<0.001. The number of symptoms that were alleviated during vacation was higher in school classrooms with high sperm toxicity compared to less toxic sites; the RR was 1.9 (95% CI: 1.1-3.3, P=0.03) for wiped dust extracts. CONCLUSIONS Teachers working in classrooms where the samples showed high sperm toxicity had more BRS. The boar sperm cell motility inhibition assay appears promising as a tool for demonstrating the presence of indoor substances associated with BRS.
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Affiliation(s)
- J T Salin
- Department of Infection Control, Oulu University Hospital, Finland
| | - M Salkinoja-Salonen
- Department of Food and Environmental Sciences, FI 00014 University of Helsinki, Finland; Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - P J Salin
- Oulu University Hospital, Inspector Sec Oy Laboratories, Oulu, Finland; Department of Food and Environmental Sciences, FI 00014 University of Helsinki, Finland
| | - K Nelo
- Oulu University Hospital, Inspector Sec Oy Laboratories, Oulu, Finland
| | - T Holma
- Department of Otorhinolaryngology and Head and Neck Surgery, Oulu University Hospital, Finland; PEDEGO Research Unit, University of Oulu, Finland; Medical Research Center Oulu, Finland
| | - P Ohtonen
- Division of Operative Care and Medical Research Center, Finland
| | - H Syrjälä
- Department of Infection Control, Oulu University Hospital, Finland.
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Abstract
A new test was developed to assess speech recognition in noise. The test was designed to be run in a personal computer supplied with a sound card. One thousand disyllabic test words and noise were stored in digitized form on the hard disk of the computer. The measure given by this test is speech recognition threshold in noise (SRTN) corresponding to 50% recognition. The present series of 180 cases with various hearing impairments and 39 controls were examined with speech-in-noise test and conventional audiometry. In keeping with earlier studies, the SRTN turned out to be significantly elevated in cases with sensorineural hearing impairment; this elevation was related to the grade of hearing impairment. On the other hand, no essential difference was seen between the SRTN values of subjects with mixed hearing impairment and persons with normal hearing.
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Affiliation(s)
- T Holma
- Department of Otolaryngology, Oulu University Hospital, Finland
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Löppönen H, Holma T, Sorri M, Jyrkinen L, Karhula V, Koivula A, Ilkko E, Laitinen J, Koivukangas J, Oikarinen J, Alamäki O. Computed tomography data based rapid prototyping model of the temporal bone before cochlear implant surgery. Acta Otolaryngol Suppl 1997; 529:47-9. [PMID: 9288265 DOI: 10.3109/00016489709124077] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Rapid prototyping (RP) technique allows automatic fabrication of 3D model parts. This method was applied to make a temporal bone model before cochlear implant surgery. A helical CT scan is used to acquire high resolution data from the middle and the inner ear of the patient. From the scanning data bone structures and soft tissues can be separated because their different grayscale pixel values. By using a guided image processing tool the desired parts of the anatomy can be extracted and 3D data created. The segmented data are processed to the form suitable for creating a high accuracy RP model. The RP model is made in the stereolithography (SLA) process by means of a computer guided HeCd laser beam inducing polymerisation of acrylic solution as it passes layer by layer over the surface of the polymer solution. In this prototype model the anatomy of the temporal bone can be clearly visualised, including, e.g., mastoid cells, tympanic cavity, bony canal of facial nerve, and round and oval windows. The inner ear spaces including vestibule, semicircular canals and cochlear turn are also shaped. The transparent acrylic material allows bonelike mechanical handling. The RP model can be dissected and used in individual surgical planning and simulation prior to cochlear implantation.
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Affiliation(s)
- H Löppönen
- Department of Otolaryngology, University of Oulu, Finland.
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Lukkari P, Jumppanen J, Holma T, Sirén H, Jinno K, Elo H, Riekkola ML. Effect of the buffer solution on the elution order and separation of bis(amidinohydrazones) by micellar electrokinetic capillary chromatography. J Chromatogr A 1992. [DOI: 10.1016/0021-9673(92)87138-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
When planning for health services, questions of production and distribution as well as cost and quality are key issues for health planners and decision makers. The lack of available objective data often makes this work difficult. This paper presents recent efforts in Finland to improve the collection of information needed for planning in the field of physiotherapy.
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