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Altawalah H, Alfouzan W, Al-Fadalah T, Zalzala MA, Ezzikouri S. Viral etiology of severe lower respiratory tract infections in SARS-CoV-2 negative hospitalized patients during the COVID-19 pandemic in Kuwait. Heliyon 2024; 10:e29855. [PMID: 38681623 PMCID: PMC11046192 DOI: 10.1016/j.heliyon.2024.e29855] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 05/01/2024] Open
Abstract
Background The prevalence of respiratory infections is largely underexplored in Kuwait. The aim of our study is to determine the etiology of infections from patients who are SARS-CoV-2 negative hospitalized with severe lower respiratory tract infections (LRTIs) in Kuwait during the coronavirus disease 2019 (COVID-19) pandemic. Methods We conducted an observational cross-sectional study among severe LRTI patients between September 2021 and March 2022. Respiratory samples from 545 non-COVID-19 severe LRTIs patients were prospectively evaluated with FTD Respiratory 21 Plus® real-time PCR, targeting 20 different viruses and 1 atypical bacterial pathogen. Results Among all 545 hospitalized cases, 411 (75.4 %) tested positive for at least one respiratory pathogen. The most common were rhinovirus (HRV) (32.7 %), respiratory syncytial virus (RSV) (20.9 %), metapneumovirus (HMPV) (14.1 %), bocavirus (13.2 %), and influenza A (12.7 %). The proportion of pathogens detected was highest in the under-5 age group, while HKU1 (44.4 %) predominated in the elderly (>50 years). Conclusion Our study reveals a high prevalence of respiratory viruses in severe acute lower respiratory tract infections among non-COVID-19 hospitalized patients in Kuwait. HRV remains the main etiology affecting the country, particularly in infants. These results underscore the necessity of employing multiplex PCR for accurate diagnosis and describing the epidemiology of infections among severe lower respiratory tract infections. This will facilitate the use of specific antiviral therapy and help avoid excessive or inappropriate antibiotic therapy.
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Affiliation(s)
- Haya Altawalah
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, 24923, Kuwait
- Virology Unit, Yacoub Behbehani Center, Sabah Hospital, Ministry of Health, Kuwait, Kuwait
| | - Wadha Alfouzan
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, 24923, Kuwait
- Laboratory Medicine, Farwania Hospital, Ministry of Health, Farwania, Kuwait
| | - Talal Al-Fadalah
- Qualities and Accreditation Directorate, Ministry of Health, Kuwait, Kuwait
| | - Mariam Ali Zalzala
- Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, 24923, Kuwait
| | - Sayeh Ezzikouri
- Virology Unit, Viral Hepatitis Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
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Marin-Hinojosa C, Fatela-Cantillo D, Lopez-Campos JL. Measuring of Alpha-1 Antitrypsin Concentration by Nephelometry or Turbidimetry. Methods Mol Biol 2024; 2750:123-133. [PMID: 38108973 DOI: 10.1007/978-1-0716-3605-3_12] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Most clinical laboratories quantify alpha-1 antitrypsin using either nephelometry or turbidimetry techniques because they are commercially available, amenable to automation, and precise. Both methods are based on light scatter. The foundation of both techniques is based on incubation of the specimen with anti-AAT polyclonal antibody solution, a polymer matrix between endogenous AAT and the reagent antibodies forms, leading to production of light-scattering large particles. Although these two terms are sometimes used synonymously, technically speaking they are not.Nephelometry measures the amount of turbidity or cloudiness of a solution by directly quantifying the intensity of the light scattered by insoluble particles in the sample. Therefore, this technique measures the light that passes through the sample, with the detector being placed at an angle from the sample. Turbidimetry is the process of measuring the loss of intensity of the light transmitted linearly through a sample caused by the scattering effect of insoluble particles. The decrease in light transmission is measured compared to a reference, and the absorbed light is quantified.Beyond specific technical differences between both techniques, there are two major differences between the two procedures that may influence the results. First, the concentration of the sample and the resulting intensity of scattered light relative to the intensity of the light source is one major factor. Second, the size of the scattering particles is also a key differentiating factor. This chapter describes the technical requirements, the different protocols, and the clinical applicability of these two techniques in the diagnosis of alpha-1 antitrypsin deficiency.
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Affiliation(s)
- Carmen Marin-Hinojosa
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Daniel Fatela-Cantillo
- Unidad de Gestión Clínica de Laboratorios, Servicio de Bioquímica Clínica, Sección de Inmunoproteínas y Marcadores Tumorales, Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain
| | - Jose Luis Lopez-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
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Karunathilake C, Alles N, Dewasurendra R, Weerasinghe I, Chandrasiri N, Piyasiri SB, Samaranayake N, Silva H, Manamperi N, Karunaweera N. The use of recombinant K39, KMP11, and crude antigen-based indirect ELISA as a serological diagnostic tool and a measure of exposure for cutaneous leishmaniasis in Sri Lanka. Parasitol Res 2023; 123:77. [PMID: 38157062 DOI: 10.1007/s00436-023-08103-y] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
Cutaneous leishmaniasis (CL) in Sri Lanka is caused by Leishmania donovani, a parasite widely known to cause visceral leishmaniasis. Despite the fact that CL is not generally believed to elicit serological immune responses, recent studies show the presence of antibody responses against this atypical form of CL. This study assesses the potential of using recombinant K39 (rK39), KMP11, and crude parasite antigen-based indirect ELISAs as serological diagnostic tools and measures of exposure for CL in Sri Lanka. The study used serum samples from confirmed CL patients (n = 266) and apparently healthy individuals from endemic settings (n = 411). Serum samples from individuals residing in non-endemic areas were used as negative controls. In-house indirect ELISAs were optimized and validated for recombinant antigens. Previously validated crude parasite extract-based indirect ELISA was performed for comparison. The statistical analyses were performed using SPSS v26.0. The rK39 (sensitivity = 71.2%, specificity = 64%) and KMP11 (sensitivity = 79.2%, specificity = 71.4%) based indirect ELISA were shown to be less suitable for the diagnosis of CL, while crude parasite extract-based indirect ELISA (sensitivity = 82.4%, specificity = 85.7%) might be a better method of diagnosis. All 03 ELISAs seemed to be good methods as measures of exposure since correlations were observed between the seropositivity of all 03 ELISAs (rK39: p = 0.037, KMP11: p = 0.007, CrudeAg: p = 0.000) with provincial case incidences. The findings will be important in identifying the disease hotspots in order to design the control measures for CL induced by L. donovani in Sri Lanka.
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Affiliation(s)
- Charani Karunathilake
- Faculty of Medicine, Department of Parasitology, University of Colombo, Colombo, Sri Lanka
| | - Narmadha Alles
- Faculty of Medicine, Department of Parasitology, University of Colombo, Colombo, Sri Lanka
| | - Rajika Dewasurendra
- Faculty of Medicine, Department of Parasitology, University of Colombo, Colombo, Sri Lanka
| | - Isurika Weerasinghe
- Faculty of Medicine, Department of Parasitology, University of Colombo, Colombo, Sri Lanka
| | - Nipuni Chandrasiri
- Faculty of Medicine, Department of Parasitology, University of Colombo, Colombo, Sri Lanka
| | - Sachee Bhanu Piyasiri
- Faculty of Medicine, Department of Parasitology, University of Colombo, Colombo, Sri Lanka
| | - Nilakshi Samaranayake
- Faculty of Medicine, Department of Parasitology, University of Colombo, Colombo, Sri Lanka
| | - Hermali Silva
- Faculty of Medicine, Department of Parasitology, University of Colombo, Colombo, Sri Lanka
| | - Nuwani Manamperi
- Faculty of Medicine, Department of Parasitology, University of Kelaniya, Ragama, Sri Lanka
| | - Nadira Karunaweera
- Faculty of Medicine, Department of Parasitology, University of Colombo, Colombo, Sri Lanka.
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Gharekhani J, Rafaat Mohammed R, Heidari R, Hajipour N, Trotta M, Villanueva-Saz S. Assessment of Neospora caninum infection in bulls using serological and molecular techniques. Vet Parasitol Reg Stud Reports 2023; 46:100940. [PMID: 37935541 DOI: 10.1016/j.vprsr.2023.100940] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 10/07/2023] [Accepted: 10/11/2023] [Indexed: 11/09/2023]
Abstract
Neospora caninum is a significant cause of abortion and economic losses in cattle worldwide. The main aim of the present work was to detect the prevalence of N. caninum infection in bulls in Hamedan (Iran) using serology and molecular techniques. All blood samples (n = 792) were screened for detecting the antibodies to N. caninum using enzyme-linked immunosorbent assay (ELISA). Then seropositive animals were rechecked using the immunofluorescent antibody test (IFAT). Also, blood, epididymis, and spinal cord samples were collected from animals for molecular analysis using nested PCR. In serology, using ELISA, 3.91% of animals were seropositive for N. caninum. Additionally, true prevalence based on the sensitivity and specificity of the ELISA was calculated 1.25% (95% CI: 0.48-2.02%). Neospora-infection in animals, calculated as the number of bulls seropositive and/or one sample positive to nested PCR, was 3.40%; and 19 bulls tested positive by both serology and molecular diagnostic methods. The overlaps between ELISA and molecular results were observed in 74.19% of whole blood samples, 80.64% of the epididymis, and 87.09% of the spinal cord. Using ELISA, the seroprevalence of N. caninum was detected 1.8% in ≤2 and 5.45% in >2 years old group of animals (p = 0.009, PR = 3.1). In addition, the seropositivity in Holstein and native breed animals was calculated 6.57% and 2.93%, respectively (p = 0.019, PR = 2.3). Seven sequences with 94.9-99.3% similarity were detected in multiple alignments of positive PCR products. Our work was the first comprehensive evaluation of Neospora-infection/neosporosis in Iranian bulls. We detected a low prevalence of infection in animals compared to previous reports. The ELISA is a sensitive serological technique for detecting the highest number of positive bulls in the present investigation and, the nested PCR is a reliable technique to identify Neospora-DNA.
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Affiliation(s)
- Jamal Gharekhani
- Department of Laboratory Sciences, Central Veterinary Laboratory, Iranian Veterinary Organization, Hamedan, Iran.
| | - Rebin Rafaat Mohammed
- Department of Pathobiology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran; Director of the Central Clinical Laboratory of Sulaimani, Iraq
| | - Reza Heidari
- Medical Biotechnology Research Center, AJA University of Medical Sciences, Tehran, Iran; Research Center for Cancer Screening and Epidemiology, AJA University of Medical Sciences, Tehran, Iran
| | - Nasser Hajipour
- Department of Pathobiology, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
| | - Michele Trotta
- Clinical Immunology Laboratory, Veterinary Faculty, University of Zaragoza, Zaragoza, Spain
| | - Sergio Villanueva-Saz
- Clinical Immunology Laboratory, Veterinary Faculty, University of Zaragoza, Zaragoza, Spain; Department of Animal Pathology, Veterinary Faculty, University of Zaragoza, Zaragoza, Spain; Instituto Agroalimentario de Aragón-IA2 (Universidad de Zaragoza-CITA), Zaragoza, Spain
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Xun Z, Fu Y, Ye YC, Liu C, Ou QS. [Discussion on the guidelines for the prevention and treatment of chronic hepatitis B (version 2022)]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:1099-1100. [PMID: 38016779 DOI: 10.3760/cma.j.cn501113-20230410-00156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Affiliation(s)
- Z Xun
- Department of Laboratory Medicine, Fujian Key Laboratory of Laboratory Medicine, Gene Diagnosis Research Center, Fujian Clinical Research Center for Clinical Immunology Laboratory Test, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China Department of Laboratory Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
| | - Y Fu
- Department of Laboratory Medicine, Fujian Key Laboratory of Laboratory Medicine, Gene Diagnosis Research Center, Fujian Clinical Research Center for Clinical Immunology Laboratory Test, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China Department of Laboratory Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
| | - Y C Ye
- Department of Laboratory Medicine, Fujian Key Laboratory of Laboratory Medicine, Gene Diagnosis Research Center, Fujian Clinical Research Center for Clinical Immunology Laboratory Test, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China Department of Laboratory Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
| | - C Liu
- Department of Laboratory Medicine, Fujian Key Laboratory of Laboratory Medicine, Gene Diagnosis Research Center, Fujian Clinical Research Center for Clinical Immunology Laboratory Test, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China Department of Laboratory Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
| | - Q S Ou
- Department of Laboratory Medicine, Fujian Key Laboratory of Laboratory Medicine, Gene Diagnosis Research Center, Fujian Clinical Research Center for Clinical Immunology Laboratory Test, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China Department of Laboratory Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
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Dönmez RB, Demirel TN, Bilgin C, Tarhan N, Örkçü Ö, Ceylan Z, Guleken Z. Comparative and Predictive Analysis of Clinical and Metabolic Features of Anorexia Nervosa and Bulimia Nervosa. Addict Health 2023; 15:230-239. [PMID: 38322479 PMCID: PMC10843349 DOI: 10.34172/ahj.2023.1466] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/23/2023] [Indexed: 02/08/2024]
Abstract
Background Eating disorders have become increasingly prevalent over the years; the age at which they appear has decreased, and they can lead to serious illness or death. Therefore, the number of studies on the matter has increased. Eating disorders like anorexia nervosa (AN) and bulimia nervosa (BN) are affected by many factors including mental illnesses that can have serious physical and psychological consequences. Accordingly, the present study aimed to compare the clinical and metabolic features of patients with AN and BN and identify potential biomarkers for distinguishing between the two disorders. Methods Clinical data of 41 participants who sought treatment for eating disorders between 2012 and 2022, including 29 AN patients and 12 BN patients, were obtained from NPIstanbul Brain Hospital in Istanbul, Turkey. The study included the clinical variables of both outpatient and inpatient treatments. Principal component analysis (PCA) was utilized to gain insights into differentiating AN and BN patients based on clinical characteristics, while machine learning techniques were applied to identify eating disorders. Findings The study found that thyroid hormone levels in patients with AN and BN were influenced by non-thyroidal illness syndrome (NTIS), which could be attributed to various factors, including psychiatric disorders, substance abuse, and medication use. Lipid profile comparisons revealed higher triglyceride levels in the BN group (P<0.05), indicating increased triglyceride synthesis and storage as an energy source. Liver function tests showed lower levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in BN patients (P<0.05), while higher prolactin levels (P<0.05) suggested an altered hypothalamic-pituitary-gonadal axis. Imbalances in minerals such as calcium and magnesium (P<0.05) were observed in individuals with eating disorders. PCA effectively differentiated AN and BN patients based on clinical features, and the Naïve Bayes (NB) model showed promising results in identifying eating disorders. Conclusion The findings of the study provide important insights into AN and BN patients' clinical features and may help guide future research and treatment strategies for these conditions.
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Affiliation(s)
| | | | - Cem Bilgin
- Faculty of Medicine, Üsküdar University, Istanbul, Turkey
| | - Nevzat Tarhan
- Department of Physiatry, Üsküdar University, NP Hospital, Istanbul, Turkey
| | - Özden Örkçü
- Vocational School of Food Technology, Üsküdar University, Istanbul, Turkey
| | - Zeynep Ceylan
- Department of Industrial Engineering, Faculty of Engineering, Samsun University, Samsun, Turkey
| | - Zozan Guleken
- Department of Physiology, Faculty of Medicine, Gaziantep Islam Science and Technology University, Gaziantep, Turkey
- Medical College of Rzeszów University, Rzeszów, Poland
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Anioke I, Duquenne L, Parmar R, Mankia K, Shuweihdi F, Emery P, Ponchel F. Lymphocyte subset phenotyping for the prediction of progression to inflammatory arthritis in anti-citrullinated-peptide antibody-positive at-risk individuals. Rheumatology (Oxford) 2023:kead466. [PMID: 37676828 DOI: 10.1093/rheumatology/kead466] [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: 03/10/2023] [Revised: 08/15/2023] [Accepted: 08/18/2023] [Indexed: 09/09/2023] Open
Abstract
OBJECTIVES Inflammatory arthritis (IA) is considered the last stage of a disease continuum, where features of systemic autoimmunity can appear years before clinical synovitis. Time to progression to IA varies considerably between at-risk individuals, therefore the identification of biomarkers predictive of progression is of major importance. We previously reported on the value of three CD4+T-cell subsets as biomarkers of progression. Here, we aim to establish the value of 18 lymphocyte subsets (LS) for predicting progression to IA. METHODS Participants were recruited based on a new musculoskeletal complaint and being positive for anti-citrullinated-peptide Antibody. Progression (over 10 years) was defined as the development of clinical synovitis. LS analysis was performed for lymphocyte lineages, naïve/memory subsets, inflammation-related cells (IRC), and regulatory cells (Treg/B-reg). Modelling used Logistic/Cox regressions. RESULTS Of 210 patients included, 93 (44%) progressed to IA, 41/93 (44%) within 12 months (rapid progressors). 5/18 LS were associated with progression (Treg/CD4-naïve/IRC (adjusted p < 0.0001), CD8 (p = 0.021), B-reg (p = 0.015)) and 3 trends (NK-cells/memory-B-cells/plasmablasts).Unsupervised hierarchical clustering using these 8 subsets segregated 3 clusters of patients, one cluster being enriched (63/109(58%)) and one poor (10/45(22%)) in progressors.Combining all clinical and LS variables, forward logistic regression predicted progression with accuracy=85.7% and AUC=0.911, selecting smoking/Rheumatoid-Factor/HLA-Shared-Epitope/Tender-Joint-Count-78 and Treg/CD4-naive/CD8/NK-cells/B-reg/plasmablasts.To predict rapid progression, a Cox regression was performed resulting in a model combining smoking/rheumatoid factor and IRC/CD4-naïve/Treg/NK-cells/CD8+T-cells (AUC=0.794). CONCLUSION Overall, progression was predicted by specific LS, suggesting potential triggers for events leading to the development of IA, while rapid progression was associated with a different set of subsets.
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Affiliation(s)
- Innocent Anioke
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- Department of Medical Laboratory Sciences, University of Nigeria, Nigeria
| | - Laurence Duquenne
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Rekha Parmar
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Kulveer Mankia
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Farag Shuweihdi
- Leeds Institute of Health Sciences. University of Leeds, School of Medicine
| | - Paul Emery
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Frederique Ponchel
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
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Park J, Bae JM. Trends of legionellosis reported in Jeju Province, Republic of Korea, 2015-2022. Osong Public Health Res Perspect 2023; 14:321-327. [PMID: 37652687 PMCID: PMC10493698 DOI: 10.24171/j.phrp.2023.0145] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/25/2023] [Accepted: 06/27/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND The number of reported cases of Legionnaires' disease (LD) in the Republic of Korea surged nationally in 2016; however, in 2022, this number was higher in Jeju Province than the previous national peak. A descriptive epidemiological study was conducted to analyze trends in the incidence of reported LD cases in Jeju Island from 2015 to 2022. METHODS The data for this study were obtained from case reports submitted to the Korea Disease Control and Prevention Agency through its Disease and Health Integrated Management System. The selection criteria were cases or suspected cases of LD reported among Jeju residents between 2015 and 2022. The 95% confidence interval of the crude incidence rate was calculated using the Poisson distribution. RESULTS Since 2020, the incidence rate of LD in Jeju has risen sharply, showing a statistically significant difference from the national incidence rate. A particular medical institution in Jeju reported a significant number of LD cases. Screening with the urine antigen test (UAT) also increased significantly. CONCLUSION Our findings indicate that the rapid increase in cases of LD in Jeju Province since 2020 was due to the characteristics of medical-care use among Jeju residents, which were focused on a specific medical institution. According to their clinical practice guidelines, this medical institution conducted UATs to screen patients suspected of pneumonia.
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Affiliation(s)
- Juyoung Park
- Department of Medicine, Graduate School, Jeju National University, Jeju, Republic of Korea
- Jeju Center for Infectious Disease Control and Prevention, Jeju, Republic of Korea
| | - Jong-Myon Bae
- Jeju Center for Infectious Disease Control and Prevention, Jeju, Republic of Korea
- Department of Preventive Medicine, Jeju National University College of Medicine, Jeju, Republic of Korea
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Benbetka C, Hachid A, Benallal KE, Khardine FA, Ayhan N, Bouredjoul N, Boulehbal WM, Bellila D, Khaldi A, Charrel R. Epidemiology, Isolation, and Genetic Characterization of Toscana Virus in Algerian Patients Displaying Neurological Infection, 2016-2018. IJID Reg 2023; 7:193-198. [PMID: 37123383 PMCID: PMC10131063 DOI: 10.1016/j.ijregi.2023.03.012] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 05/02/2023]
Abstract
Purpose The current study reports the results of the diagnosis of neuro-invasive Toscana virus (TOSV) infection in Algeria between 2016 and 2018 and describes the first isolation of TOSV strain from human samples in North Africa. Materiel and methods Cerebrospinal fluid (CSF) and sera samples were obtained from 720 hospitalized patients displaying neurological infection symptoms of unknown etiology, of which 604 were screened for TOSV. The diagnosis was performed by serological and/or RT-PCR tests. In addition, TOSV was isolated in vivo and in vitro from CSF and genetically characterized. Results 23 cases of TOSV neurological infections were detected. Cases were located in 11 Wilayas (administrative provinces), mainly in northern Algeria. In addition, we report the isolation of TOSV strain belonging to lineage A from human samples with its complete coding sequence. Conclusion Even though the number of infections is probably underestimated, TOSV is endemic in Algeria, with several cases of neuro-invasive diseases in humans recorded each year. Therefore, the diagnosis of TOSV should be included in the differential diagnosis of neurological diseases, especially aseptic meningitis, during the period of activity of the phlebotomine vector. Further studies are required to measure precisely the nationwide prevalence of TOSV in Algeria.
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Affiliation(s)
- Chahrazed Benbetka
- Laboratory of Arboviruses and Emerging Viruses, Institut Pasteur of Algeria, 16000, Algiers, Algeria
- Department of Immunology, Béni-Messous Teaching Hospital, University of Algiers, 16000, Algiers, Algeria
- Faculty of Pharmacy, University of Algiers 1, 16000, Algiers, Algeria
- Co-first authors.
| | - Aissam Hachid
- Laboratory of Arboviruses and Emerging Viruses, Institut Pasteur of Algeria, 16000, Algiers, Algeria
- Faculty of Pharmacy, University of Algiers 1, 16000, Algiers, Algeria
- Co-first authors.
| | - Kamal Eddine Benallal
- Laboratory of Parasitic Eco-epidemiology and Population Genetics, Institut Pasteur of Algeria, 16000, Algiers, Algeria
| | - Fayez Ahmed Khardine
- Laboratory of Arboviruses and Emerging Viruses, Institut Pasteur of Algeria, 16000, Algiers, Algeria
| | - Nazli Ayhan
- Unité des Virus Emergents, UVE: Aix Marseille Université, IRD 190, Inserm 1207, AP-HM Hôpitaux Universitaires de Marseille, 13005, Marseille, France
| | - Nesrine Bouredjoul
- Laboratory of Arboviruses and Emerging Viruses, Institut Pasteur of Algeria, 16000, Algiers, Algeria
| | | | - Djamila Bellila
- Faculty of Natural Sciences, University of Algiers 1, 16000, Algiers, Algeria
| | - Aldjia Khaldi
- Laboratory of Arboviruses and Emerging Viruses, Institut Pasteur of Algeria, 16000, Algiers, Algeria
- Faculty of Pharmacy, University of Algiers 1, 16000, Algiers, Algeria
| | - Rémi Charrel
- Unité des Virus Emergents, UVE: Aix Marseille Université, IRD 190, Inserm 1207, AP-HM Hôpitaux Universitaires de Marseille, 13005, Marseille, France
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Stone JA, van der Gugten JG. Quantitative tandem mass spectrometry in the clinical laboratory: Regulation and opportunity for validation of laboratory developed tests. J Mass Spectrom Adv Clin Lab 2023; 28:82-90. [PMID: 36937811 PMCID: PMC10017411 DOI: 10.1016/j.jmsacl.2023.03.001] [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: 12/14/2022] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/07/2023] Open
Abstract
Tandem mass spectrometry is an important analytical tool for clinical laboratories, but tests developed and validated in-house (laboratory developed tests, or LDTs) require special consideration. In late 2022, the forecast for United States (U.S.) federal regulation of LDTs changed unexpectedly when the VALID Act was not passed by the U.S. Congress. This Act would have modified the Food and Drug Administration's (FDA's) role to increase regulatory oversight for LDT providers. In this revised context, we review optimization of quantitative mass spectrometry LDT validation and suggest avenues other than an additional FDA mandate to achieve uniform best practice. Common challenges, logistical barriers, and recommendations for easing the burden of best-quality quantitative mass spectrometry LDT method validation are discussed.
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Key Words
- AACC, American Association for Clinical Chemistry
- AMP, Association for Molecular Pathology
- CAP, College of Amercian Pathologists
- CLIA’88, Clinical Laboratory Improvement Amendments of 1988
- CLSI, Clinical Laboratory Standards Institute
- CMS, Centers for Medicare & Medicaid Services
- CoA, Certificate of Analysis
- FDA, Federal Drug Administration
- FFDCA, Federal Food, Drug and Cosmetics Act
- GC–MS, Gas Chromatography-Mass Spectrometry
- HELP, U.S. Senate Committee on Health, Education, Labor & Pensions
- IA, Immunoassay(s)
- IVD, In-vitro Device
- LC-MSMS, Liquid Chromatography-Tandem Mass Spectrometry
- LDT, Laboratory Developed Test
- Laboratory diagnosis
- Liquid chromatography-tandem mass spectrometry
- MDA, Medical Device Amendments
- MLS, Medical Laboratory Scientist(s)
- MSACL, Mass Spectrometry & Advances in the Clinical Laboratory
- Method validation
- QntLCMS-LDT, Quantitative LC-MSMS LDT
- SOP, Standard Operating Procedure
- VALID, Verifying Accurate Leading-edge IVCT Development Act of 2021
- VITAL, Verified Innovative Testing in American Laboratories Act of 2021
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Affiliation(s)
- Judith A. Stone
- Department of Clinical Laboratories, University of California San Francisco Health, San Francisco, CA, United States
| | - J. Grace van der Gugten
- Office of the Chief Medical Examiner, Government of Alberta, Edmonton, AB, Canada
- Corresponding author.
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Hong KH, Kim GJ, Roh KH, Lee H, Park OK, Kim TS, Kim JS, Lee J, Seong MW, Kim SY, Park JS, Park Y, Huh HJ, Ryoo N, Kim HS, Sung H, Yoo CK. Guidelines for the Laboratory Diagnosis of Monkeypox in Korea. Ann Lab Med 2023; 43:137-144. [PMID: 36281507 PMCID: PMC9618902 DOI: 10.3343/alm.2023.43.2.137] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/26/2022] [Revised: 07/18/2022] [Accepted: 09/11/2022] [Indexed: 11/06/2022] Open
Abstract
While the coronavirus disease 2019 pandemic is ongoing, monkeypox has been rapidly spreading in non-endemic countries since May 2022. Accurate and rapid laboratory tests are essential for identifying and controlling monkeypox. Korean Society for Laboratory Medicine and the Korea Disease Prevention and Control Agency have proposed guidelines for diagnosing monkeypox in clinical laboratories in Korea. These guidelines cover the type of tests, selection of specimens, collection of specimens, diagnostic methods, interpretation of test results, and biosafety. Molecular tests are recommended as confirmatory tests. Skin lesion specimens are recommended for testing in the symptomatic stage, and the collection of both blood and oropharyngeal swabs is recommended in the presymptomatic or prodromal stage.
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Affiliation(s)
- Ki Ho Hong
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Gab Jung Kim
- Bureau of Infectious Disease Diagnosis Control, Korea Disease Control and Prevention Agency, Osong, Korea
| | - Kyoung Ho Roh
- Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Hyukmin Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ok Kyu Park
- Bureau of Infectious Disease Diagnosis Control, Korea Disease Control and Prevention Agency, Osong, Korea
| | - Taek Soo Kim
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jae-Seok Kim
- Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Jaehyeon Lee
- Department of Laboratory Medicine, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
| | - Moon-Woo Seong
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - So Yeon Kim
- Department of Laboratory Medicine, National Medical Center, Seoul, Korea
| | - Jae-Sun Park
- Bureau of Infectious Disease Diagnosis Control, Korea Disease Control and Prevention Agency, Osong, Korea
| | - Younhee Park
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hee Jae Huh
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Namhee Ryoo
- Department of Laboratory Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Hyun Soo Kim
- Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Heungsup Sung
- Department of Laboratory Medicine, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea
| | - Cheon Kwon Yoo
- Bureau of Infectious Disease Diagnosis Control, Korea Disease Control and Prevention Agency, Osong, Korea
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Kim N, Shin S. Laboratory Diagnosis of Monkeypox in South Korea: Continuing the Collaboration With the Public Sector. Ann Lab Med 2023; 43:135-136. [PMID: 36281506 PMCID: PMC9618908 DOI: 10.3343/alm.2023.43.2.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Namhee Kim
- Department of Laboratory Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea,Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sue Shin
- Department of Laboratory Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea,Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea,Corresponding author: Sue Shin, M.D., Ph.D. Department of Laboratory Medicine, SMG-SNU Boramae Medical Center, 20 Boramae-ro 5-gil, Dongjak-gu, Seoul 07061, Korea Tel: +82-2-870-2602, Fax: +82-2-870-2630, E-mail:
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Wang H, Pian H, Fan L, Li J, Yang J, Zheng Z. Multiple-probe-assisted DNA capture and amplification for high-throughput African swine fever virus detection. Appl Microbiol Biotechnol 2023; 107:797-805. [PMID: 36576568 DOI: 10.1007/s00253-022-12334-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 12/29/2022]
Abstract
African swine fever (ASF) is one of the most devastating infectious diseases affecting domestic pigs and wild boar. The grave socio-economic impact of African swine fever infection at a global level makes large-scale rapid and robust diagnosis a critical step towards effective control. Here, we describe multiple-probe-assisted DNA capture and amplification technology (MADCAT) - a novel, sensitive, simple, and high-throughput method for detecting ASFV directly from whole blood or other complex matrices. Through a unique DNA capture approach which specifically captures the target DNA onto 96-well plate for subsequent amplification, MADCAT abandons the complicated extraction protocol and achieves ultrafast and high-throughput detection. The sample-to-result time for 96 samples is about 90 min, as compared with the 3-4 h time of the conventional real-time qPCR method. The limit of detection (LOD) of MADCAT is 0.5 copies/μL blood and is 5 times more sensitive than an extraction-based qPCR assay when testing serially diluted whole blood samples. The assay is 100% specific against other common swine pathogens. In the clinical diagnosis of 96 field samples, all 22 positive samples were correctly identified with lower Ct values than extraction-based qPCR, confirming its high diagnostic sensitivity (100%). Owing to its high-throughput, specific high sensitivity, and direct detection features, MADCAT shows great potential for use in large-scale ASFV surveillance and monitoring for effective disease control. KEY POINTS: • No nucleic acid extraction, 100% capture efficiency, and high-throughput • Ultra-high sensitivity of 0.5 DNA copies/μL or 6 DNA copies/reaction • The sample-to-answer time for 96 samples is about 90 min.
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Xing F, Lo SW, Liu M, Deng C, Ye H, Sun L, Yang J, Lo SKF, Lau SKP, Woo PCY. Emergence of Tropheryma whipplei detection in respiratory samples by next-generation sequencing: Pathogen or innocent bystander? J Infect 2023; 86:154-225. [PMID: 36509359 DOI: 10.1016/j.jinf.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
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Bauça JM, Ajzner É, Cadamuro J, Hillarp A, Kristoffersen AH, Meijer P. An international study on activated partial thromboplastin time prolongation. Part 1: Analytical results. Clin Chim Acta 2022; 535:167-173. [PMID: 36041550 DOI: 10.1016/j.cca.2022.08.024] [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: 05/31/2022] [Revised: 07/28/2022] [Accepted: 08/23/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Unexpected prolongation of first-line coagulation tests, including activated partial thromboplastin time (APTT), should trigger further work-up by performing mixing tests to elucidate the underlying cause, direct further specific testing and clarify their possible clinical impact. The aim of our study was to assess whether methodological diversity has any impact on the APTT mixing test results and their interpretation. MATERIAL AND METHODS Two lyophilized plasma samples (case 1: heparin contamination [0.5 IU/mL]; case 2: factor VIII deficiency [0.13 IU/mL]) and their respective fictional clinical cases were sent to European laboratories for APTT measurement and performance of mixing tests. Participants were surveyed about the methodology (reagents, analytical platform, reference ranges), APTT results, mixing test conditions, their classification (normal, equivocal, prolonged) and categorization of the sample (factor deficiency, presence of inhibitor, anticoagulant, unknown). RESULTS A total of 269 responses were included. For case 1, all participants reported a prolonged APTT, and 91% obtained no correction in the mixing test, without differences among reagents or analytical platforms. Only 15% of them selected the presence of an anticoagulant as the single cause for the prolongation. For case 2, 99% of participants reported a prolonged APTT, while some heterogeneity in the mixing test results was found. Eighty-six percent of participants selected factor deficiency as the cause for APTT prolongation. CONCLUSIONS Most European laboratories obtained valid results for APTT and the subsequent mixing tests, despite using different methodologies. However, their classification could be improved. Therefore, more training and periodic evaluations are recommended to harmonize protocols and ensure proper result classification and categorization.
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Affiliation(s)
- Josep Miquel Bauça
- Department of Laboratory Medicine, Hospital Universitari Son Espases, Palma, Spain.
| | - Éva Ajzner
- Central Laboratory, András Jósa University Hospital, Nyíregyháza, Hungary
| | - Janne Cadamuro
- Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Andreas Hillarp
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Ann Helen Kristoffersen
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway; Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Piet Meijer
- ECAT Foundation (External Quality Control for Assays and Tests), Voorschoten, Netherlands
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Bauça JM, Ajzner É, Cadamuro J, Hillarp A, Kristoffersen AH, Meijer P. An international study on activated partial thromboplastin time prolongation. Part 2: Interpretative commenting. Clin Chim Acta 2022; 535:174-179. [PMID: 36055391 DOI: 10.1016/j.cca.2022.08.026] [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: 05/31/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Providing evidence-based interpretative comments (IC) is an integral task of clinical laboratory professionals. It may be of special relevance for coagulation testing, where pathological first-line tests could trigger more specialized tests. Our aim was to evaluate the quality of ICs provided to the physician in two samples with activated partial thromboplastin time (APTT) prolongation. MATERIAL AND METHODS Two lyophilized plasma samples and their respective fictional clinical cases (case 1: heparin contamination and case 2: factor VIII deficiency) were sent to European laboratories for APTT and APTT mixing test measurement, and elaboration of ICs based on their results. The quality of ICs was evaluated in terms of analytical classification, laboratory interpretation, advice to physician, clarity, length and whether the clinical question was answered. RESULTS A total of 214 laboratories were included. Classification of the analytical result was stated in 57 % of comments. Laboratory interpretation was found in 91 % of comments for case 1 and 83.3 % for case 2, among which 9.3 % and 6.5 % were considered wrong, respectively. Advice for the requesting physician was provided in 65.8 % of comments for case 1 and 61.2 % for case 2, among which 36 % and 4.7 % were considered wrong, respectively. More than 70 % of comments for both cases were evaluated as clear and of an adequate length. CONCLUSION A significant number of laboratories provide clear interpretations and helpful advice for the management of altered coagulation results. Nevertheless, the finding of several confusing and misleading comments highlights the need for recommendations on elaboration of interpretative comments.
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Affiliation(s)
- Josep Miquel Bauça
- Department of Laboratory Medicine, Hospital Universitari Son Espases, Palma, Spain.
| | - Éva Ajzner
- Central Laboratory, András Jósa University Hospital, Nyíregyháza, Hungary
| | - Janne Cadamuro
- Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Andreas Hillarp
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
| | - Ann Helen Kristoffersen
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway; Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Piet Meijer
- ECAT Foundation (External Quality Control for Assays and Tests), Voorschoten, Netherlands
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Liu N, Sun Q. Quantitation of Pyrimidine in Urine by Ultra-Performance Liquid Chromatography-Tandem Mass Spectrometry. Methods Mol Biol 2022; 2546:431-7. [PMID: 36127610 DOI: 10.1007/978-1-0716-2565-1_38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Inborn errors of pyrimidine metabolism result from deficiencies in pyrimidine de novo synthesis, degradation, and salvage pathways. Enzymatic deficiencies in pyrimidine catabolism lead to mitochondrial neurogastrointestinal encephalopathy (MNGIE), pyrimidinuria, dihydropyrimidinuria, ureidopropionic aciduria, and other disorders. While MNGIE presents with gastrointestinal dysmotility, cachexia and leukoencephalopathy, pyrimidinuria, and dihydropyrimidinuria may show symptoms of epilepsy, autism, mental retardation, and dysmorphic features. The application of HPLC-MS/MS facilitates rapid screening of pyrimidine metabolites. Here we describe a sensitive and reliable LC-MS/MS method for quantitative determination of uracil, thymine, thymidine, dihydrouracil, and dihydrothymine in urine that are diagnostic biomarkers of MNGIE, pyrimidinuria, and dihydropyrimidinuria.
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Liu N, Sun Q. Laboratory Diagnosis of Cerebral Creatine Deficiency Syndromes by Determining Creatine and Guanidinoacetate in Plasma and Urine. Methods Mol Biol 2022; 2546:129-140. [PMID: 36127584 DOI: 10.1007/978-1-0716-2565-1_12] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Cerebral creatine deficiency syndromes are caused by the dysfunctional creatine biosynthesis or transport and comprise three hereditary neurodevelopmental defects including arginine-glycine amidinotransferase (AGAT), guanidinoacetate methyltransferase (GAMT), and creatine transporter deficiencies. All conditions are characterized by seizures, intellectual disability, and behavioral abnormalities. Laboratory diagnosis of these disorders relies on the determination of creatine and guanidinoacetate concentrations in both plasma and urine. Here we describe a rapid quantitative UPLC/MS/MS method for the simultaneous determination of these analytes using a normal-phase HILIC column after analyte derivatization. The approach is suitable for neonatal screening follow-ups and monitoring of the treatment for creatine deficiency syndromes.
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Affiliation(s)
- Ning Liu
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
- Baylor Genetics, Houston, TX, USA
| | - Qin Sun
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.
- Baylor Genetics, Houston, TX, USA.
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Melnikov VG, Berger A, Sing A. Detection of diphtheria toxin production by toxigenic corynebacteria using an optimized Elek test. Infection 2022; 50:1591-1595. [PMID: 36053480 PMCID: PMC9438344 DOI: 10.1007/s15010-022-01903-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/04/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Diphtheria, still present in many countries of the world, is caused by toxigenic strains of species of the Corynebacterium diphtheriae complex, mainly Corynebacterium diphtheriae and the emerging zoonotic pathogen C. ulcerans. The immunoprecipitation test according to Elek is the gold standard for detection of the major virulence factor diphtheria toxin (DT) in toxigenic corynebacteria. Due to its sophisticated methodological requirements, the classical Elek test is performed mainly by specialized reference laboratories. It was revealed that the current modification of the Elek test does not detect the toxin in weakly toxigenic isolates. Therefore, a more robust method for detecting free DT is urgently needed, especially for toxigenic C. ulcerans strains which are known to produce often much lower amounts of DT than C. diphtheriae. METHODS Thirty-one tox-positive C. ulcerans isolates with a negative standard Elek test result previously determined as NTTB (non-toxigenic tox bearing) were re-analyzed in this study using a modified immunoprecipitation method optimized regarding different parameters including type and concentration of antitoxin, medium volume, inoculum distance from the antitoxin disk and position of controls. RESULTS All 31 C. ulcerans strains tested positive in the optimized Elek test. CONCLUSION Only with a reliable and easy-to-handle method for detecting the toxigenicity of C. ulcerans, it is possible to assess the etiological role of this emerging zoonotic bacterium in human pathology.
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Affiliation(s)
- Vyacheslav G. Melnikov
- National Conciliary Laboratory on Diphtheria, Veterinärstraße 2, 85764 Oberschleißheim, Germany
| | - Anja Berger
- National Conciliary Laboratory on Diphtheria, Veterinärstraße 2, 85764 Oberschleißheim, Germany
- Department of Public Health Microbiology, Bavarian Health and Food Safety Authority (LGL), Veterinärstraße 2, 85764 Oberschleißheim, Germany
| | - Andreas Sing
- National Conciliary Laboratory on Diphtheria, Veterinärstraße 2, 85764 Oberschleißheim, Germany
- Department of Public Health Microbiology, Bavarian Health and Food Safety Authority (LGL), Veterinärstraße 2, 85764 Oberschleißheim, Germany
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Macêdo JVL, Frias IAM, Oliveira MDL, Zanghelini F, Andrade CAS. A systematic review and meta-analysis on the accuracy of rapid immunochromatographic tests for dengue diagnosis. Eur J Clin Microbiol Infect Dis 2022; 41:1191-201. [PMID: 35988010 DOI: 10.1007/s10096-022-04485-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/12/2022] [Indexed: 11/03/2022]
Abstract
Rapid immunochromatographic tests are frequently used to diagnose dengue due to their easy use, low cost, and fast response. A high level of accuracy is essential for rapid diagnostic tests to support their large-scale use. Thus, this systematic review aims to evaluate the accuracy of rapid dengue diagnostic tests. The investigation was run through the following databases: LILACS, Medline (Pubmed), CRD, The Cochrane Library, Trip Medical Database, and Google Scholar. To solve difficulties, two independent reviewers performed document screening and selection. ELISA assay was adopted as a reference test because of several methodologic advantages. Seventeen articles were included accordingly, reckoning 6837 participating individuals. The receiver operating characteristic (ROC) and Forest Plot were conducted to evaluate the sensitivity and specificity for each analyzed parameter (anti-dengue IgM, IgG, and NS1 antigen). The risk of bias and quality of evidence were assessed as moderate using QUADAS-2 and Grading of Recommendations Assessment, Development, and Evaluation (GRADE), respectively. The sensitivity of IgM concerning the studied tests ranged from 13.8 to 90%, while that of NS1 ranged from 14.7 to 100% (95% CI). The antibodies with NS1 presented increased sensitivity; pooled data show that the association of the three analytes bestows the best result, with a combined sensitivity of 90% (CI 95%: 87-92%) and a pooled specificity of 89% (CI 95%: 87-92%). Thus, the present review provides relevant knowledge for decision-making between available rapid diagnostic tests.
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Abstract
Standard 2-tier testing (STTT), incorporating a screening enzyme immunoassay (EIA) or an immunofluorescence assay (IFA) that reflexes to IgM and IgG immunoblots, has been the primary diagnostic test for Lyme disease since 1995. In 2019, the Food and Drug Administration approved a modified 2-tier test strategy using 2 EIAs: offering a faster, less expensive, and more sensitive assay compared with STTT. New technologies examine early immune responses to Borrelia burgdorferi have the potential to diagnose Lyme disease in the first weeks of infection when existing serologic testing is not recommended due to low sensitivity.
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Affiliation(s)
- Takaaki Kobayashi
- Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Hospitals & Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA.
| | - Paul G Auwaerter
- Sherrilyn and Ken Fisher Center for Environmental Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Hong KH, Kim GJ, Roh KH, Sung H, Lee J, Kim SY, Kim TS, Park JS, Huh HJ, Park Y, Kim JS, Kim HS, Seong MW, Ryoo NH, Song SH, Lee H, Kwon GC, Yoo CK. Update of Guidelines for Laboratory Diagnosis of COVID-19 in Korea. Ann Lab Med 2022; 42:391-397. [PMID: 35177559 PMCID: PMC8859556 DOI: 10.3343/alm.2022.42.4.391] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [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: 01/20/2022] [Revised: 01/25/2022] [Accepted: 02/07/2022] [Indexed: 11/19/2022] Open
Abstract
Korean Society for Laboratory Medicine and the Korea Disease Prevention and Control Agency have announced guidelines for diagnosing coronavirus disease (COVID-19) in clinical laboratories in Korea. With the ongoing pandemic, we propose an update of the previous guidelines based on new scientific data. This update includes recommendations for tests that were not included in the previous guidelines, including the rapid molecular test, antigen test, antibody test, and self-collected specimens, and a revision of the previous recommendations. This update will aid clinical laboratories in performing laboratory tests for diagnosing COVID-19.
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Affiliation(s)
- Ki Ho Hong
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Gab Jung Kim
- Bureau of Infectious Disease Diagnosis Control, the Korea Disease Control and Prevention Agency, Osong, Korea
| | - Kyoung Ho Roh
- Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Heungsup Sung
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jaehyeon Lee
- Department of Laboratory Medicine, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
| | - So Yeon Kim
- Department of Laboratory Medicine, National Medical Center, Seoul, Korea
| | - Taek Soo Kim
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jae-Sun Park
- Bureau of Infectious Disease Diagnosis Control, the Korea Disease Control and Prevention Agency, Osong, Korea
| | - Hee Jae Huh
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Younhee Park
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jae-Seok Kim
- Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Hyun Soo Kim
- Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Moon-Woo Seong
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Nam Hee Ryoo
- Department of Laboratory Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Sang Hoon Song
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hyukmin Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Gye Cheol Kwon
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Cheon Kwon Yoo
- Bureau of Infectious Disease Diagnosis Control, the Korea Disease Control and Prevention Agency, Osong, Korea
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De Conto F, Buttrini M, Dell'Anna ML, Maccari C, Montanari G, Arcangeletti MC, Martinelli M, Chezzi C, Calderaro A. Detection of occult hepatitis B virus infection among subjects with isolated hepatitis B core antibodies: Results from a 3-year survey in an Italian tertiary-care hospital. Clin Res Hepatol Gastroenterol 2022; 46:101892. [PMID: 35202845 DOI: 10.1016/j.clinre.2022.101892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/09/2022] [Accepted: 02/13/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Hepatitis B virus (HBV) infection causes hepatitis, liver cirrhosis, hepatocellular carcinoma, and death. This study examines the subjects with isolated anti-HBV core antigen antibody (anti-HBcAg), a pattern characterized by the persistent HBV carriage in the absence of HBV surface antigen (HBsAg) and anti-HBsAg antibody. METHODS Based on medical orders, from 2017 to 2019, serological and molecular assays were performed on serum/plasma samples of 33,048 subjects (71.4% Italians, 28.6% foreigners), who referred to the Virology Unit of the University-Hospital of Parma (Northern Italy) for the laboratory diagnosis of HBV infection. RESULTS The seroprevalence was 4.6% for HBsAg and 11% for anti-HBcAg. The occurrence of the isolated anti-HBcAg status was 3.1%, with higher frequency in males than in females (66.3% vs. 33.7%, P < 0.0001), in Italians than in foreigners (54.8% vs. 45.2%, P < 0.001), and in outpatients than in inpatients (57.4% vs. 42.6%, P < 0.0001). Foreigners with isolated anti-HBcAg came mostly from Africa (67.9%) and Eastern Europe (26.2%). Among subjects with isolated anti-HBcAg, 14.8% had occult HBV infection, 26.3% hepatitis C virus co-infection, 2% human immunodeficiency virus co-infection, and 3.3% both of these latter co-infections. CONCLUSIONS The anti-HBcAg assay accurately evaluates the HBV exposure; subjects with isolated anti-HBcAg antibody should be further analysed for HBV DNA. The HBV infection prevalence in Italy is increasing, due to growing migratory flows from endemic areas.
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Dubljanin E, Dzamic A, Vujcic I, Mijatovic S, Crvenkov T, Grujicic SS, Calovski IC. Correlation of clinical characteristics, by calculation of SCIO index, with the laboratory diagnosis of onychomycosis. Braz J Microbiol 2022; 53:221-9. [PMID: 35000126 DOI: 10.1007/s42770-021-00676-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 12/24/2021] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Onychomycosis is a chronic fungal infection with increasing incidence and the global prevalence is estimated to be 5.5%. The aim of our study was to perceive objectively severity of onychomycosis by calculating Scoring Clinical Index for Onychomycosis and to correlate this index with accurate laboratory diagnosis in our patients. MATERIALS AND METHODS The study population comprised of 417 patients with laboratory confirmed onychomycosis. For each patient, we recorded basic demographic information, site of infection, the most affected nail with onychomycosis, clinical presentation, and type of onychomycosis. The evaluation of the disease severity was based on Scoring Clinical Index for Onychomycosis which was calculated for every patient separately. Mycological identification was done by microscopy and fungal culture. RESULTS The majority of patients had distal and lateral subungual onychomycosis (95.44%) that was localized on big toe (62.59%), with female to male ratio 1.24:1. Male patients had significantly more nails affected with onychomycosis compared with female patients (p = 0.011), while female had significantly more often onychomycosis on fingernails 2-5 (p < 0.05), and they reported significantly more often pain (p < 0.05) and esthetic problems (p < 0.05). Mean Scoring Clinical Index for Onychomycosis was 16.76. Dermatophytes were most frequently isolated (91.85%). In patients with onychomycosis caused by dermatophytes, Scoring Clinical Index for Onychomycosis had significantly higher values (p = 0.032). CONCLUSION Comprehensive understanding of disease characteristics will allow introduction of individualized treatment plan for each patient, based on proper fungal identification and standardized method of evaluating disease severity, which could help the patient achieve a complete cure.
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Anderson KE, Desnick RJ, Stewart MF, Ventura P, Bonkovsky HL. Acute Hepatic Porphyrias: "Purple Flags"-Clinical Features That Should Prompt Specific Diagnostic Testing. Am J Med Sci 2022; 363:1-10. [PMID: 34606756 DOI: 10.1016/j.amjms.2021.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 06/15/2021] [Accepted: 09/28/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Porphyrias are a group of rare diseases leading to dysregulation in heme biosynthesis and the accumulation of heme precursors, including porphyrinogens, which in their oxidized states [porphyrins] are reddish or purple. Acute hepatic porphyrias (AHP) comprise four diseases that cause acute debilitating neurovisceral attacks. Despite diagnostic advances, AHP is often undiagnosed or misdiagnosed due to a lack of disease awareness, low clinical suspicion, variable presentation, and nonspecific symptoms that mimic more common diseases. Delays in diagnosis and treatment increase the risk of serious acute and chronic complications. METHODS In order to assess whether symptoms alone or in combination might be utilized as important indicators or "purple flags" that, when present, should alert clinicians to suspect AHP and pursue specific diagnostic testing, we conducted a comprehensive review of the literature on AHP, including cohort studies and case reports over two epochs, from 1980 to 2006 and from 2012 to 2018. RESULTS We found that severe abdominal pain, with or without acute central nervous system manifestations and peripheral neuropathy, continues to be the most frequent symptom. Hyponatremia, change in urine color, and certain chronic symptoms were also identified as features that should raise suspicion of AHP. To improve diagnosis of AHP, clinicians need to take a broad perspective, including demographic data and medical history, into consideration. CONCLUSIONS The clinical features of AHP continue to be severe pain, especially pain in the abdomen. Other features that should raise suspicion are autonomic, peripheral, or central neuropathies, hyponatremia, and red-purple urine color.
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Affiliation(s)
- Karl E Anderson
- Division of Gastroenterology & Hepatology, Department of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Robert J Desnick
- Department of Genetics and Genomic Medicine, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - M Felicity Stewart
- Salford Royal NHS Foundation Trust, Salford, UK; Division of Medical Education, University of Manchester, Manchester, UK
| | - Paolo Ventura
- Internal Medicine Unit, Policlinico Hospital, Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Herbert L Bonkovsky
- Section on Gastroenterology & Hepatology, Department of Medicine, Wake Forest University School of Medicine/North Carolina Baptist Hospital, Nutrition Research Center, Winston-Salem, NC, USA..
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Peker BO, Şener AG, Kaptan Aydoğmuş F. Antinuclear antibodies (ANAs) detected by indirect immunofluorescence (IIF) method in acute COVID-19 infection; future roadmap for laboratory diagnosis. J Immunol Methods 2021; 499:113174. [PMID: 34737165 PMCID: PMC8556075 DOI: 10.1016/j.jim.2021.113174] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 09/10/2021] [Revised: 10/06/2021] [Accepted: 10/20/2021] [Indexed: 01/04/2023]
Abstract
INTRODUCTION As in other viral infections, anti-nuclear antibodies (ANAs) are observed in SARS-CoV-2 infection. We investigated the presence of autoantibodies in acute COVID-19 and the association with early laboratory findings. MATERIALS AND METHODS We examined 50 sera (>18 years, 25 Female) from patients with acute COVID-19. ANAs (HEp-20-10 liver biochip), anti-neutrophil cytoplasmic antibody (ANCA, Europlus Granulocyte Mosaic 32) and anti-double stranded DNA were investigated with product of Euroimmune AG (Luebeck, Germany) by indirect immunofluorescence (IIF) method. Also, antibody against cyclic citrullinated peptide (anti-CCP) was examined by a chemiluminisens assay (Euroimmun AG, Luebeck, Germany). Samples from 50 blood bank donors collected before the COVID-19 pandemic were used as controls. RESULTS The IIF-ANA test was positive in 18% (N = 9/50) of the patients. The median time of sample collection was 7 days (range: 1-28 days) after diagnosis. ANA was positive in only one (2%) control sample. Five (55.5%) patients were ANA positive with a strong titer (3+). There was no relationship between antibody titration and time of sample collection (p = 0,55). Anti-CCP was detected in a nucleolar (3+) positive patient (2%). ANA was detected in 14.28% (N = 1/7, rods-rings (±), p = 0,78) of patients in the intensive care unit(ICU). Patients treated in the clinic have more and higher titers of ANA, mostly in nucleolar patterns, than ICU patients. CONCLUSIONS The variety of antibodies detected in acute COVID-19 and the uncertainty of how long they persist can lead to confusion, especially in the diagnosis of systemic autoimmune rheumatic diseases for IIF-ANA testing in immunology laboratories. Improvements in cell lines and methods will facilitate the diagnostic process.
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Affiliation(s)
- Bilal Olcay Peker
- Department of Medical Microbiology, İzmir Katip Çelebi University Atatürk Training And Research Hospital, İzmir, Turkey,Corresponding author at: Department of Medical Microbiology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, Basın Sitesi, Karabağlar 35360, İzmir, Turkey
| | - Aslı Gamze Şener
- Department of Medical Microbiology, İzmir Katip Çelebi University Atatürk Training And Research Hospital, İzmir, Turkey
| | - Figen Kaptan Aydoğmuş
- Department of Infectious Diseases, İzmir Katip Çelebi University Atatürk Training And Research Hospital, İzmir, Turkey
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Long JR, Mitchell K, Edwards J, Wroblewski D, Luke E, Dickinson M, Kidney A, Dumas N, DelRosso P, Dorsinville M, Antwi M, Weiss D, Nazarian E, Limberger RJ, Musser KA, Halse TA. Laboratory diagnosis of bacterial meningitis by direct detection, serotyping and Next Generation Sequencing: How 10 years of testing in New York State has evolved to improve laboratory diagnosis and public health. Mol Cell Probes 2021; 61:101786. [PMID: 34863914 DOI: 10.1016/j.mcp.2021.101786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/09/2021] [Accepted: 11/27/2021] [Indexed: 11/23/2022]
Abstract
Since 2005, the Wadsworth Center (WC) has provided molecular testing on cerebrospinal fluid (CSF) and whole blood specimens in close collaboration with epidemiologists in New York State and New York City. In this study, we analyzed 10 years of data to demonstrate the significant value of utilizing molecular methods to assess patient specimens for etiologic agents of bacterial meningitis. A comprehensive molecular testing algorithm to detect and serotype/serogroup bacterial agents known to cause bacterial meningitis (Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae and Streptococcus agalactiae) has evolved, and retrospective specimen testing has been essential for each improvement. Over a ten-year span from 2010 to 2019 the WC received 831 specimens from 634 patients with suspected bacterial meningitis. Real-time PCR was positive for at least one of the agents in 223 (27%) specimens from 183 patients (29%). Of the 223 positives, 146 (66%) were further characterized by real-time PCR into serogroup/serotype. Additionally, examination of 131 paired specimens of CSF and whole blood from the same patients found better detection in CSF, but whole blood is a useful alternative for diagnosis when CSF is not available. For specimens initially PCR-negative, 16S rDNA Sanger sequencing was requested by the submitter for 146 cases resulting in the identification of bacterial agents in an additional 24 (16%) specimens. In a retrospective study, Next Generation Sequencing (NGS) was evaluated for the detection of pathogens in 53 previously tested PCR-negative CSF specimens and identified bacteria in 14 (26%) specimens. This molecular testing algorithm has provided clinicians a diagnosis when culture is negative with the potential to guide therapy. It has also aided public health in determining when antibiotic prophylaxis was needed, augmented surveillance data to yield a fuller picture of community prevalence, and highlighted gaps in the spectrum of agents that cause bacterial meningitis.
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Pillay TS, Muyldermans S. Application of Single-Domain Antibodies ("Nanobodies") to Laboratory Diagnosis. Ann Lab Med 2021; 41:549-558. [PMID: 34108282 PMCID: PMC8203438 DOI: 10.3343/alm.2021.41.6.549] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/28/2021] [Accepted: 05/24/2021] [Indexed: 12/15/2022] Open
Abstract
Antibodies have proven to be central in the development of diagnostic methods over decades, moving from polyclonal antibodies to the milestone development of monoclonal antibodies. Although monoclonal antibodies play a valuable role in diagnosis, their production is technically demanding and can be expensive. The large size of monoclonal antibodies (150 kDa) makes their re-engineering using recombinant methods a challenge. Single-domain antibodies, such as “nanobodies,” are a relatively new class of diagnostic probes that originated serendipitously during the assay of camel serum. The immune system of the camelid family (camels, llamas, and alpacas) has evolved uniquely to produce heavy-chain antibodies that contain a single monomeric variable antibody domain in a smaller functional unit of 12–15 kDa. Interestingly, the same biological phenomenon is observed in sharks. Since a single-domain antibody molecule is smaller than a conventional mammalian antibody, recombinant engineering and protein expression in vitro using bacterial production systems are much simpler. The entire gene encoding such an antibody can be cloned and expressed in vitro. Single-domain antibodies are very stable and heat-resistant, and hence do not require cold storage, especially when incorporated into a diagnostic kit. Their simple genetic structure allows easy re-engineering of the protein to introduce new antigen-binding characteristics or attach labels. Here, we review the applications of single-domain antibodies in laboratory diagnosis and discuss the future potential in this area.
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Affiliation(s)
- Tahir S Pillay
- Department of Chemical Pathology and NHLS- Tshwane Academic Division, University of Pretoria, Pretoria, South Africa.,Division of Chemical Pathology, University of Cape Town, Cape Town, South Africa.,Department of Chemical Pathology, University of Pretoria, Prinshof Campus, Pretoria, South Africa
| | - Serge Muyldermans
- Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium.,Liaoning Key Laboratory of Molecular Recognition and Imaging, School of Bioengineering, Dalian University of Technology, Dalian, China
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Somily AM, Khan MA, Morshed M. The Laboratory Diagnosis of Clostridioides difficile Infection: An update of current laboratory practice. J Infect Dev Ctries 2021; 15:1364-1375. [PMID: 34780357 DOI: 10.3855/jidc.13217] [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: 06/07/2020] [Accepted: 06/27/2021] [Indexed: 10/31/2022] Open
Abstract
Clostridioides difficile can cause colitis and is associated with hospital acquired infections. The C. difficile infection (CDI) is due to production of toxins A and B which bind to epithelial cell surface receptors and triggers signaling pathways, leading to loss of epithelial barrier function, apoptosis, and inflammation, culminating in diarrheal disease. In early days, laboratory diagnosis of CDI was based on cell culture, identification of toxins, and their cytopathic effects. These assays were replaced by enzyme immunoassays for the detection of C. difficile toxins and the GDH house-keeping gene for improved specificity. Later, molecular assays with higher sensitivity were introduced which are becoming easier to incorporate into the test algorithm. The diagnosis of CDI and significance of laboratory results can be challenging with asymptomatic colonization of C. difficile in some patients. Test result interpretation is even more challenging due to multiple guidelines, emerging resistant C. difficile ribotypes, as well as differences in disease prevalence. An accurate test result for diagnosis of CDI depends on selecting patients with high pre-test probability, collecting an acceptable stool specimen, and a thorough understanding of current test methods.
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Affiliation(s)
- Ali Mohammed Somily
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University, King Saud University Medical City, Riyadh, Saudi Arabia.
| | - Mohammad Aatif Khan
- Microbiology Laboratory, Prince Mohammad Bin Abdul Aziz Hospital, Riyadh, Saudi Arabia
| | - Muhammad Morshed
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada; British Columbia Centre for Disease Control Public Health Laboratory, Vancouver, Canada
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Walker DH, Myers CTE, Blanton LS, Bloch KC, Fowler VG, Gaines DN, Paddock CD, Yaglom HD. Rickettsiosis subcommittee report to the tick-borne disease working group. Ticks Tick Borne Dis 2021; 13:101855. [PMID: 34739931 DOI: 10.1016/j.ttbdis.2021.101855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 05/07/2021] [Revised: 09/01/2021] [Accepted: 10/07/2021] [Indexed: 10/20/2022]
Abstract
Tick-borne rickettsial infections are serious, common, and difficult to diagnose. Among the most important factors leading to failure to diagnose and treat tick-borne rickettsioses effectively is a lack of consideration of the potential diagnosis by primary caregivers and emergency department physicians in patients presenting with undifferentiated acute febrile illness during tick season. This situation exists because of insufficient primary and continuing medical education of medical students, primary care and emergency medicine residents, and practicing physicians regarding tick-borne rickettsioses specific to the region where they practice. Delayed initiation of treatment with an appropriate antibiotic is associated with adverse outcomes including increased rates of hospitalization, admission to an intensive care unit, and mortality. The earliest symptoms are nonspecific, consisting of fever, headache, myalgias, and nausea and/or vomiting. Laboratory abnormalities are typically absent at this time when the therapeutic response to an appropriate antibiotic would be optimal. There is a mistaken idea among a substantial portion of physicians that the best antibiotic available, doxycycline, should not be administered to children 8 years of age or younger or during pregnancy. For all of the above reasons, there is unnecessary morbidity and mortality caused by tick-borne rickettsioses. This report proposes measures to address these critical issues regarding tick-borne rickettsioses.
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Affiliation(s)
- David H Walker
- The University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX 77555, United States.
| | - Cdr Todd E Myers
- US Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, United States
| | - Lucas S Blanton
- The University of Texas Medical Branch at Galveston, 301 University Blvd., Galveston, TX 77555, United States
| | - Karen C Bloch
- Vanderbilt University Medical Center, 2200 Medical Center North, Nashville, TN 37232, United States
| | - Vance G Fowler
- Duke University, 315 Trent Drive, Room 185 Hanes Building, Division of Infectious Diseases, Duke University Medical Center, Durham, NC 27710, United States
| | - David N Gaines
- Virginia Department of Health, Office of Epidemiology, 109 Governor Street, Richmond, VA 23219, United States
| | - Christopher D Paddock
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, United States
| | - Hayley D Yaglom
- Translational Genomics Research Institute (TGen North), 3051 West Shamrell Boulevard, Suite 106, Flagstaff, AZ 86005, United States
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Dixon DM, Branda JA, Clark SH, Dumler JS, Horowitz HW, Perdue SS, Pritt BS, Sexton DJ, Storch GA, Walker DH. Ehrlichiosis and anaplasmosis subcommittee report to the Tick-borne Disease Working Group. Ticks Tick Borne Dis 2021; 12:101823. [PMID: 34517150 DOI: 10.1016/j.ttbdis.2021.101823] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 05/03/2021] [Revised: 08/18/2021] [Accepted: 08/29/2021] [Indexed: 10/20/2022]
Abstract
Ehrlichioses and anaplasmosis have undergone dramatic increases in incidence, and the geographic ranges of their occurrence and vectors have also expanded. There is marked underreporting of these diseases owing to deficient physician awareness and knowledge of the illnesses as well as limited access to appropriate diagnostic tests. Human monocytic ehrlichiosis and anaplasmosis are life threatening diseases with estimated case fatality rates of 2.7 and 0.3%, respectively. However, knowledge of their full range of signs and symptoms is incomplete, and the incidence of subclinical infections is unknown. Currently available laboratory diagnostic methods are poorly utilized, and with the exception of nucleic acid amplification tests are not useful for diagnosis during the acute stage of illness when timely treatment is needed. The Ehrlichiosis and Anaplasmosis Subcommittee of the Tick-Borne Disease Working Group recommended active clinical surveillance to determine the true incidence, full clinical spectrum, and risk factors for severe illness, as well as standardized surveillance of ticks for these pathogens, and enhanced education of primary medical caregivers and the public regarding these diseases. The subcommittee identified the needs to develop sensitive, specific acute stage diagnostic tests for local clinical laboratories and point-of-care testing, to develop approaches for utilizing electronic medical records, data mining, and artificial intelligence for assisting early diagnosis and treatment, and to develop adjunctive therapies for severe disease.
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Affiliation(s)
| | - John A Branda
- Massachusetts General Hospital and Harvard Medical School, 55 Fruit St., Boston, MA 02114, United States.
| | - Stephen H Clark
- University of Connecticut School of Medicine, 200 Academic Way, Farmington, CT 06032, United States
| | - J Stephen Dumler
- Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Joint Pathology Center, 4301 Jones Bridge Road, Building B, Room 3152, Bethesda, MD 20814, United States.
| | - Harold W Horowitz
- Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, United States.
| | | | - Bobbi S Pritt
- Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, United States.
| | - Daniel J Sexton
- Duke University Medical Center, Durham, NC 27710, United States.
| | - Gregory A Storch
- Washington University School of Medicine, 425 South Euclid Avenue, St. Louis, MO 63110, United States.
| | - David H Walker
- The University of Texas Medical Branch at Galveston, 301 University Boulevard, Galveston, TX 77555-0609, United States.
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Chen Z, Xu W, Ma W, Shi X, Li S, Hao M, Fang Y, Zhang L. Clinical laboratory evaluation of COVID-19. Clin Chim Acta 2021; 519:172-182. [PMID: 33939954 PMCID: PMC8086377 DOI: 10.1016/j.cca.2021.04.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/20/2021] [Accepted: 04/28/2021] [Indexed: 01/08/2023]
Abstract
COVID-19, caused by SARS-CoV-2, is a highly infectious disease, and clinical laboratory detection has played important roles in its diagnosis and in evaluating progression of the disease. Nucleic acid amplification testing or gene sequencing can serve as pathogenic evidence of COVID-19 diagnosing for clinically suspected cases, and dynamic monitoring of specific antibodies (IgM, IgA, and IgG) is an effective complement for false-negative detection of SARS-CoV-2 nucleic acid. Antigen tests to identify SARS-CoV-2 are recommended in the first week of infection, which is associated with high viral loads. Additionally, many clinical laboratory indicators are abnormal as the disease evolves. For example, from moderate to severe and critical cases, leukocytes, neutrophils, and the neutrophil-lymphocyte ratio increase; conversely, lymphocytes decrease progressively but are over activated. LDH, AST, ALT, CK, high-sensitivity troponin I, and urea also increase progressively, and increased D-dimer is an indicator of severe disease and an independent risk factor for death. Severe infection leads to aggravation of inflammation. Inflammatory biomarkers and cytokines, such as CRP, SAA, ferritin, IL-6, and TNF-α, increase gradually. High-risk COVID-19 patients with severe disease, such as the elderly and those with underlying diseases (cardiovascular disease, diabetes, chronic respiratory disease, hypertension, obesity, and cancer), should be monitored dynamically, which will be helpful as an early warning of serious diseases.
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Affiliation(s)
- Zhufeng Chen
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Laboratory Medicine, Jinan, PR China
| | - Wanju Xu
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Laboratory Medicine, Jinan, PR China
| | - Wanshan Ma
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Laboratory Medicine, Jinan, PR China
| | - Xiaohong Shi
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Laboratory Medicine, Jinan, PR China
| | - Shuomin Li
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Laboratory Medicine, Jinan, PR China
| | - Mingju Hao
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Laboratory Medicine, Jinan, PR China
| | - Yuanxun Fang
- Rural Vitalization Research Institute of Qilu, Shandong Agriculture and Engineering University, Jinan, PR China
| | - Li Zhang
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Laboratory Medicine, Jinan, PR China,Corresponding author at: Department of Clinical Laboratory Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Laboratory Medicine, 16766 Jingshi Road, Jinan, Shandong Province, PR China
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Abstract
We developed a carbapenemase test based on the ability of imipenem to inhibit noncarbapenemase β-lactamases. The test uses bacterial isolates with a fluorescent β-lactamase substrate, producing objective results with 100% sensitivity and specificity in 10 minutes. The assay is inexpensive and consists of only 1 mixing step.
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Munne K, Bhanothu V, Bhor V, Patel V, Mahale SD, Pande S. Detection of SARS-CoV-2 infection by RT-PCR test: factors influencing interpretation of results. Virusdisease 2021; 32:187-189. [PMID: 33969149 PMCID: PMC8089129 DOI: 10.1007/s13337-021-00692-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 10/07/2020] [Accepted: 04/23/2021] [Indexed: 11/30/2022] Open
Abstract
In this current pandemic of coronavirus disease 2019 (COVID-19), prompt interventions in terms of early detection and clinical management along with isolation of positive cases is of utmost importance. This helps to limit not only the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections but also the morbidity and mortality associated with it. Different strategies for screening of COVID-19 in containment zones and non-containment areas include testing of symptomatic patients and their contacts in fever clinics, hospital-based testing, testing on demand and population-based screening. The choice of tests like reverse-transcription polymerase chain reaction (RT-PCR), rapid antigen testing (RAT) or antibody test depends upon these strategies and also the turnaround time. Currently, RT-PCR is considered the gold standard for COVID-19 detection. This commentary provides the insights and experiences on COVID-19 diagnosis by RT-PCR. The utility of this test is limited by several false positive, false negative and inconclusive results at early stages of infection, scarcity of reagents and lack of well-equipped labs including trained staff. Moreover, appropriate sample collection and transport, standard laboratory protocols, stringent quality control norms, good quality RNA extraction kits, PCR kits with suitable primers can help in improving accuracy of the test results. A careful assessment of clinical, radiological and molecular findings is required for identifying potential cases of COVID-19.
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Affiliation(s)
- Kiran Munne
- Department of Clinical Research, ICMR-National Institute for Research in Reproductive Health, Jehangir Merwanji Street, Parel, Mumbai, 400012 India
| | - Venkanna Bhanothu
- Genetic Research Centre, ICMR-National Institute for Research in Reproductive Health, Jehangir Merwanji Street, Parel, Mumbai, 400012 India
| | - Vikrant Bhor
- Molecular Immunology and Microbiology, ICMR-National Institute for Research in Reproductive Health, Jehangir Merwanji Street, Parel, Mumbai, 400012 India
| | - Vainav Patel
- Department of Biochemistry, ICMR-National Institute for Research in Reproductive Health, Jehangir Merwanji Street, Parel, Mumbai, 400012 India
| | - Smita D. Mahale
- ICMR-National Institute for Research in Reproductive Health, Jehangir Merwanji Street, Parel, Mumbai, 400012 India
| | - Shailesh Pande
- Genetic Research Centre, ICMR-National Institute for Research in Reproductive Health, Jehangir Merwanji Street, Parel, Mumbai, 400012 India
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Elkadi OA, Hassan R, Elanany M, Byrne HJ, Ramadan MA. Identification of Aspergillus species in human blood plasma by infrared spectroscopy and machine learning. Spectrochim Acta A Mol Biomol Spectrosc 2021; 248:119259. [PMID: 33307345 DOI: 10.1016/j.saa.2020.119259] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 08/06/2020] [Revised: 11/14/2020] [Accepted: 11/24/2020] [Indexed: 06/12/2023]
Abstract
Invasive Aspergillosis is a challenging infection that requires convenient, efficient, and cost-effective diagnostics. This study addresses the potential of infrared spectroscopy to satisfy this clinical need with the aid of machine learning. Two models, based on Partial Least Squares-Discriminant Analysis (PLS-DA), have been trained by a set of infrared spectral data of 9 Aspergillus-spiked and 7 Aspergillus-free plasma samples, and a set of 200 spectral data simulated by oversampling these 16 samples. Two further models have also been trained by the same sets but with auto-scaling performed prior to PLS-DA. These models were assessed using 45 mock samples, simulating the challenging samples of patients at risk of Invasive Aspergillosis, including the presence of drugs (9 tested) and other common pathogens (5 tested) as potential confounders. The simple model shows good prediction performance, yielding a total accuracy of 84.4%, while oversampling and autoscaling improved this accuracy to 93.3%. The results of this study have shown that infrared spectroscopy can identify Aspergillus species in blood plasma even in presence of potential confounders commonly present in blood of patients at risk of Invasive Aspergillosis.
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Affiliation(s)
- Omar Anwar Elkadi
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, Egypt; Dar Elsalam Cancer Center, Cairo, Egypt.
| | - Reem Hassan
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Mervat Elanany
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Hugh J Byrne
- FOCAS Research Institute, Technological University Dublin, City Campus, Dublin, Ireland.
| | - Mohammed A Ramadan
- Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, Egypt.
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Wilson MJ, Sparkes D, Myers C, Smielewska AA, Husain MM, Smith C, Rolfe KJ, Zhang H, Jalal H. Streamlining SARS-CoV-2 confirmatory testing to reduce false positive results. J Clin Virol 2021; 136:104762. [PMID: 33607351 PMCID: PMC7877812 DOI: 10.1016/j.jcv.2021.104762] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/09/2021] [Indexed: 10/26/2022]
Abstract
BACKGROUND Confirmatory testing of SARS-CoV-2 results is essential to reduce false positives, but comes at a cost of significant extra workload for laboratories and increased turnaround time. A balance must be sought. We analysed our confirmatory testing pathway to produce a more refined approach in preparation for rising case numbers. METHODS Over a 10-week low prevalence period we performed confirmatory testing on all newly positive results. Turnaround time was measured and results were analysed to identify a threshold that could be applied as a cut-off for future confirmatory testing and reduce overall workload for the laboratory. RESULTS Between 22/06/20 and 31/08/20 confirmatory testing was performed on 108 newly positive samples, identifying 32 false positive results (30 %). Turnaround time doubled, increasing by an extra 17 h. There was a highly statistically significant difference between initial Relative Light Unit (RLU) of results that confirmed compared to those that did not, 1176 vs 721 (P < 0.00001). RLU = 1000 was identified as a suitable threshold for confirmatory testing in our laboratory: with RLU ≥ 1000, 55/56 (98 %) confirmed as positive, whereas with RLU < 1000 only 12/38 (32 %) confirmed. CONCLUSIONS False positive SARS-CoV-2 tests can be identified by confirmatory testing, yet this may significantly delay results. Establishing a threshold for confirmatory testing streamlines this process to focus only on samples where it is most required. We advise all laboratories to follow a similar process to identify thresholds that trigger confirmatory testing for their own assays, increasing accuracy while maintaining efficiency for when case numbers are high.
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Affiliation(s)
- Michael J Wilson
- Department of Virology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Clinical Microbiology & Public Health Laboratory, Public Health England, Cambridge, UK.
| | - Dominic Sparkes
- Clinical Microbiology & Public Health Laboratory, Public Health England, Cambridge, UK; Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge, UK
| | - Chloe Myers
- Clinical Microbiology & Public Health Laboratory, Public Health England, Cambridge, UK
| | - Anna A Smielewska
- Clinical Microbiology & Public Health Laboratory, Public Health England, Cambridge, UK; Department of Pathology, University of Cambridge, Cambridge, UK
| | - Mir Mubariz Husain
- Department of Virology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Christopher Smith
- Clinical Microbiology & Public Health Laboratory, Public Health England, Cambridge, UK
| | - Kathryn J Rolfe
- Clinical Microbiology & Public Health Laboratory, Public Health England, Cambridge, UK
| | - Hongyi Zhang
- Clinical Microbiology & Public Health Laboratory, Public Health England, Cambridge, UK
| | - Hamid Jalal
- Clinical Microbiology & Public Health Laboratory, Public Health England, Cambridge, UK.
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Abstract
The purpose of this article is to review the many facets of central nervous system tuberculosis (CNS-TB). The entities described are tuberculous meningitis (TBM) and its complications, spinal cord disorders, tuberculomas and co-infection with the human immune-deficiency virus (HIV). The latter has become a common problem worldwide becoming a more fulminant disease. The accuracy of the conventional and the modern molecular techniques for the diagnosis of TBM have a high specificity but a low to moderate sensitivity. Computerised tomographic scans and magnetic resonance imaging have many characteristic features which have vastly improved the diagnostic accuracy of CNS-TB. The recommended therapeutic regimens are an extrapolation of the regimen used for pulmonary TB, hence the optimal composition, dosage and duration of the therapy are not yet established. Multidrug resistant TB is emerging as a global threat and the delay in recognition of drug resistance combined with the lack of data on appropriate drug regimen adds to its high mortality.
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Affiliation(s)
- Sarosh M Katrak
- Prof. Emeritus, Grant Medical College & Sir JJ Group of Hospitals, Emeritus Director, Jaslok Hospital & Research Centre, Mumbai, India.
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de Paula HHS, Martins AF, das Chagas RR, Moreira J, de Aguiar RS, da Cruz Lamas C, Cardozo SV. Chikungunya fever: How accurate is the clinical-epidemiological diagnosis compared to the gold standard of molecular and serological laboratory diagnosis? J Clin Virol 2020; 133:104679. [PMID: 33197755 DOI: 10.1016/j.jcv.2020.104679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 10/20/2020] [Accepted: 10/24/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the accuracy of the current World Health Organization' (WHO) Chikungunya fever (CHIKF) clinical-epidemiological case definition against the gold standard of laboratory diagnosis. METHODS This was a prospective study of patients seeking medical care at an Emergency Department in the metropolitan area of Rio de Janeiro, Brazil, from January to June 2018. Clinical features were recorded. Screening for CHIKF was performed using the RT-qPCR and ELISA-IgM antibody assay. Clinical features of CHIKF RT-qPCR/IgM positive cases were compared with those with other febrile illnesses. RESULTS 27,900 ED visits were recorded, of which 172 (0.61 %) patients were screened for arboviral illness. The prevalence of laboratory-confirmed CHIKF (Lab-CHIKF) was 110/172 [64 %]. Chikungunya virus RNA was detected in 92/172 (53.5 %) patients, while in 18/80 (10.5 %), only IgM was positive. Compared to CHIKV-negative subjects, patients with CHIKF presented much earlier after the onset of symptoms (2 [1-4] vs. 3.5 [2.5-5], p = 0.007), and more frequently reported arthritis (61.8 % vs. 33.9 %, p < 0.0001), arthralgia (96.4 % vs. 79 %, p < 0.0001), and conjunctivitis (35.5 % vs. 16.1 %, p = 0.007). After adjustments for other clinical predictors, arthritis/arthralgia [aOR: 6 (95 % CI 1.8-19.7)] and the presence of conjunctivitis [aOR: 2.85 (95 % CI 1.30-6.24] were positively associated with lab-CHIKF. The sensitivity, specificity, positive predictive value, and negative predictive value of the WHO CHIKF clinical case definition was 96.3 %, 20.9 %, 68.3 % and 76.4 %, respectively, and accuracy was 0.69 [AUC: 0.69 (95 % CI 0.61-0.75)]. CONCLUSION The WHO case definition needs to be improved for better accuracy, especially in areas in epidemics in areas with co-circulation of arboviruses.
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Mihu AG, Balta C, Marti DT, Paduraru AA, Lupu MA, Olariu TR. Seroprevalence of Toxoplasma gondii infection among women of childbearing age in an endemic region of Romania, 2016-2018. ACTA ACUST UNITED AC 2020; 27:59. [PMID: 33198884 PMCID: PMC7669453 DOI: 10.1051/parasite/2020057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 07/28/2020] [Accepted: 10/24/2020] [Indexed: 01/24/2023]
Abstract
Toxoplasmosis is an important worldwide zoonosis caused by the protozoan parasite Toxoplasma gondii. This parasitic infection is often asymptomatic in immunocompetent people. However, if the infection occurs in pregnant women, it can have serious consequences for the foetus. In this study, we evaluated the seroprevalence of T. gondii in women of childbearing age in Arad County, Western Romania. Serum samples from 2626 women were analysed using a Siemens ADVIA Centaur XP Immunoassay System. Toxoplasma gondii IgG antibodies were demonstrated in 1081 women (41%) and prevalence tended to increase with age, from 32% in women aged 15–19 years to 62% in women aged 40–45 years. There was a higher prevalence in rural areas (46%) than in urban areas (36%). This study provides new data on T. gondii seroprevalence in women of childbearing age from Western Romania.
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Affiliation(s)
- Alin Gabriel Mihu
- Discipline of Parasitology, Victor Babes University of Medicine and Pharmacy, Piata Eftimie Murgu, No. 1, 300041 Timisoara, Romania - Bioclinica, Dreptatii Street, No. 23, Bl. 707, 310300 Arad, Romania - Vasile Goldis Western University, Liviu Rebreanu Street, No. 86, 310048 Arad, Romania
| | - Cornel Balta
- Vasile Goldis Western University, Liviu Rebreanu Street, No. 86, 310048 Arad, Romania
| | - Daniela Teodora Marti
- Vasile Goldis Western University, Liviu Rebreanu Street, No. 86, 310048 Arad, Romania
| | - Ana Alexandra Paduraru
- Discipline of Parasitology, Victor Babes University of Medicine and Pharmacy, Piata Eftimie Murgu, No. 1, 300041 Timisoara, Romania - Clinical Laboratory, Municipal Clinical Emergency Hospital, Strada Gheorghe Dima Nr. 5, 300254 Timisoara, Romania - Center for Diagnosis and Study of Parasitic Diseases, Victor Babes University of Medicine and Pharmacy, Piata Eftimie Murgu, No. 1, 300041 Timisoara, Romania
| | - Maria Alina Lupu
- Discipline of Parasitology, Victor Babes University of Medicine and Pharmacy, Piata Eftimie Murgu, No. 1, 300041 Timisoara, Romania - Clinical Laboratory, Institute of Cardiovascular Diseases, Strada Gheorghe Adam Numarul 13A, 300310 Timisoara, Romania - Center for Diagnosis and Study of Parasitic Diseases, Victor Babes University of Medicine and Pharmacy, Piata Eftimie Murgu, No. 1, 300041 Timisoara, Romania
| | - Tudor Rares Olariu
- Discipline of Parasitology, Victor Babes University of Medicine and Pharmacy, Piata Eftimie Murgu, No. 1, 300041 Timisoara, Romania - Clinical Laboratory, Municipal Clinical Emergency Hospital, Strada Gheorghe Dima Nr. 5, 300254 Timisoara, Romania - Center for Diagnosis and Study of Parasitic Diseases, Victor Babes University of Medicine and Pharmacy, Piata Eftimie Murgu, No. 1, 300041 Timisoara, Romania
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Li C, Zhao C, Bao J, Tang B, Wang Y, Gu B. Laboratory diagnosis of coronavirus disease-2019 (COVID-19). Clin Chim Acta 2020; 510:35-46. [PMID: 32621814 PMCID: PMC7329657 DOI: 10.1016/j.cca.2020.06.045] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/28/2020] [Accepted: 06/29/2020] [Indexed: 02/06/2023]
Abstract
The outbreak of Coronavirus Disease-2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has threatened health worldwide. As of the end of 2020, there were nearly 10 million confirmed cases and nearly 5 million deaths associated with COVID-19. Rapid and early laboratory diagnosis of COVID-19 is the main focus of treatment and control. Molecular tests are the basis for confirmation of COVID-19, but serological tests for SARS-CoV-2 are widely available and play an increasingly important role in understanding the epidemiology of the virus and in identifying populations at higher risk for infection. Point-of-care tests have the advantage of rapid, accurate, portable, low cost and non-specific device requirements, which provide great help for disease diagnosis and detection. This review will discuss the performance of different laboratory diagnostic tests and platforms, as well as suitable clinical samples for testing, and related biosafety protection. This review shall guide for the diagnosis of COVID-19 caused by SARS-CoV-2.
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Affiliation(s)
- Chenxi Li
- Medical Technology School of Xuzhou Medical University, Xuzhou Key Laboratory of Laboratory Diagnostics, Xuzhou 221004, China
| | - Chengxue Zhao
- Medical Technology School of Xuzhou Medical University, Xuzhou Key Laboratory of Laboratory Diagnostics, Xuzhou 221004, China
| | - Jingfeng Bao
- Medical Technology School of Xuzhou Medical University, Xuzhou Key Laboratory of Laboratory Diagnostics, Xuzhou 221004, China
| | - Bo Tang
- Nanjing Vazyme Medical Technology Co. Ltd., Nanjing 210046, China
| | - Yunfeng Wang
- Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, USA.
| | - Bing Gu
- Medical Technology School of Xuzhou Medical University, Xuzhou Key Laboratory of Laboratory Diagnostics, Xuzhou 221004, China; Department of Laboratory Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, China.
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Abstract
The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which began in Wuhan, Hubei Province, China, has rapidly spread to produce a global pandemic. It is now clear that person-to-person transmission of SARS-CoV-2 has been occurring and that the virus has been dramatically growing in recent months. Early, rapid and accurate diagnosis is of great significance for curtailing the spread of SARS-CoV-2. There are currently several diagnostic techniques (e.g. viral culture and nucleic acid amplification test) being used to detect the virus. However, the sensitivity and specificity of these methods are quite different, with the sample source and detection limit varying greatly. This study reviewed all types and characteristics of the currently available laboratory diagnostic assays for detecting SARS-CoV-2 infection and summarized the selection strategies of testing and sampling sites at different disease stages to improve the diagnostic accuracy of Coronavirus Disease 2019 (COVID-19).
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Affiliation(s)
- Yuzhong Xu
- Department of Clinical Laboratory, Shenzhen Baoan Hospital, The Second Affiliated Hospital of Shenzhen University, Shenzhen, China; Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Department of Pathogen Biology, Shenzhen University School of Medicine, Shenzhen, China
| | - Minggang Cheng
- Department of Clinical Laboratory, Shenzhen Baoan Hospital, The Second Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Xinchun Chen
- Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Department of Pathogen Biology, Shenzhen University School of Medicine, Shenzhen, China
| | - Jialou Zhu
- Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Department of Pathogen Biology, Shenzhen University School of Medicine, Shenzhen, China; Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education and Guangdong Province, College of Optoelectronic Engineering, Shenzhen University, Shenzhen, China.
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Petros S, Weidhase L. [Laboratory testing in intensive care medicine]. Med Klin Intensivmed Notfmed 2020; 115:539-544. [PMID: 32880671 DOI: 10.1007/s00063-020-00730-y] [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: 07/19/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022]
Abstract
Despite the tremendous technological developments in medicine, careful history-taking and clinical examination remain the cornerstones of diagnostics. Numerous laboratory tests are ordered in intensive care and emergency medicine. The rate of overutilization of these tests during initial patient admission is almost 50%. Patient history may be frequently insufficient for conducting targeted laboratory testing, and concern about not overlooking a pathology also contributes to laboratory test overutilization. On the other hand, laboratory test profiles are frequently defined a priori to simplify the management process. However, these profiles are commonly based on symptoms rather than on a suspected diagnosis. Several laboratory variables are outside the normal range in critically ill patients. However, normal ranges are defined on the basis of data from healthy subjects, and these do not allow for a clear distinction between stress adaptation and clinically relevant changes that require correction. Pathophysiological changes due to the acute injury in critically ill patients and the reaction of the organism to the injury or even to the treatment itself can lead to changes in laboratory values. Untargeted laboratory tests contribute to iatrogenic anemia and increased costs. The results of such tests are either hardly noticed or, in the worst case, lead to further unnecessary diagnostic steps and unjustified therapeutic measures. Point-of-care laboratory tests, including blood gas analysis, blood count, serum electrolytes, and lactate, to assess the patient's homeostatic state and laboratory data for the relevant critical care scores are uniformly required. Beyond that, every laboratory test should be chosen wisely based on a concrete clinical question.
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Affiliation(s)
- S Petros
- Interdisziplinäre Internistische Intensivmedizin, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland. .,Medizinische Klinik 1, Bereich Hämostaseologie, Universitätsklinikum Leipzig, Leipzig, Deutschland.
| | - L Weidhase
- Interdisziplinäre Internistische Intensivmedizin, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland
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Abstract
In mid-December 2019, a novel atypical pneumonia broke out in Wuhan, Hubei Province, China and was caused by a newly identified coronavirus, initially termed 2019 Novel Coronavirus and subsequently severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of 19 May 2020, a total of 4,731,458 individuals were reported as infected with SARS-CoV-2 among 213 countries, areas or territories with recorded cases, and the overall case-fatality rate was 6.6% (316,169 deaths among 4,731,458 recorded cases), according to the World Health Organization. Studies have shown that SARS-CoV-2 is notably similar to (severe acute respiratory syndrome coronavirus) SARS-CoV that emerged in 2002–2003 and Middle East respiratory syndrome coronavirus (MERS-CoV) that spread during 2012, and these viruses all contributed to global pandemics. The ability of SARS-CoV-2 to rapidly spread a pneumonia-like disease from Hubei Province, China, throughout the world has provoked widespread concern. The main symptoms of coronavirus disease 2019 (COVID-19) include fever, cough, myalgia, fatigue and lower respiratory signs. At present, nucleic acid tests are widely recommended as the optimal method for detecting SARS-CoV-2. However, obstacles remain, including the global shortage of testing kits and the presentation of false negatives. Experts suggest that almost everyone in China is susceptible to SARS-CoV-2 infection, and to date, there are no effective treatments. In light of the references published, this review demonstrates the biological features, spread, diagnosis and treatment of SARS-CoV-2 as a whole and aims to analyse the similarities and differences among SARS-CoV-2, SARS-CoV and MERS-CoV to provide new ideas and suggestions for prevention, diagnosis and clinical treatment.
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Affiliation(s)
- Tingting Hu
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Ying Liu
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Mingyi Zhao
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Quan Zhuang
- Transplantation Center, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Linyong Xu
- Department of Biomedical Informatics, School of Life Sciences, Central South University, Changsha, China
| | - Qingnan He
- Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, China
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Abstract
A subgroup of COVID-19 patients develop very severe disease with requirement for ICU treatment, ventilation, and ECMO therapy. Laboratory tests indicate that the immune and clotting system show marked alterations with hyper-activation, hyper-inflammation, cytokine storm development. Furthermore, organ-specific biomarkers demonstrate the involvement of cardiac muscle, kidney, and liver dysfunction in many patients. In this article the use of laboratory biomarkers is discussed with regard to their use for diagnosis, disease progression, and risk assessment.
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Affiliation(s)
- Chrysanthi Skevaki
- Institute of Laboratory Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Philipps Universität Marburg, German Center for Lung Research (DZL) Marburg, Baldinger Straße, 35043 Marburg, Germany
| | - Paraskevi C Fragkou
- 4th Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Chongsheng Cheng
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Min Xie
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Harald Renz
- Institute of Laboratory Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Philipps Universität Marburg, German Center for Lung Research (DZL) Marburg, Baldinger Straße, 35043 Marburg, Germany.
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Li H, Chen L, Zhang XX. [Research progress on laboratory diagnosis of drug-induced liver injury]. Zhonghua Gan Zang Bing Za Zhi 2020; 28:536-9. [PMID: 32660188 DOI: 10.3760/cma.j.cn501113-20190313-00084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Drug-induced liver injury (DILI) is one of the common adverse drug reactions in the clinic and is also the main reason for the withdrawal of new drugs from the market. Although the overall incidence rate of DILI is not high; however, it can cause severe adverse outcome and even death, and has become the core cause of acute liver failure in Europe and the United States. In addition, DILI diagnosis is a puzzling problem for clinicians. Drug re-stimulation can be used as the "gold standard" in the diagnosis of DILI, but it may re-induce liver failure, so it cannot be recommended for clinical use. Currently, laboratory diagnostic methods including serum biomarker, genetic testing, scoring scale, and so on are available for DILI.
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Sung H, Roh KH, Hong KH, Seong MW, Ryoo N, Kim HS, Lee J, Kim SY, Ryu SW, Kim MN, Han MG, Lee SW, Lee H, Yoo CK. COVID-19 Molecular Testing in Korea: Practical Essentials and Answers From Experts Based on Experiences of Emergency Use Authorization Assays. Ann Lab Med 2020; 40:439-447. [PMID: 32539299 PMCID: PMC7295959 DOI: 10.3343/alm.2020.40.6.439] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 04/28/2020] [Accepted: 05/29/2020] [Indexed: 01/24/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Early detection of COVID-19 and immediate isolation of infected patients from the naive population are important to prevent further pandemic spread of the infection. Real-time reverse transcription (RT)-PCR to detect SARS-CoV-2 RNA is currently the most reliable diagnostic method for confirming COVID-19 worldwide. Guidelines for clinical laboratories on the COVID-19 diagnosis have been recently published by Korean Society for Laboratory Medicine and the Korea Centers for Disease Control and Prevention. However, these formal guidelines do not address common practical laboratory issues related to COVID-19 real-time RT-PCR testing and their solutions. Therefore, this guideline is intended as a practical and technical supplement to the “Guidelines for Laboratory Diagnosis of COVID-19 in Korea”.
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Affiliation(s)
- Heungsup Sung
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Kyoung Ho Roh
- Department of Laboratory Medicine, National Health Insurance Service, Ilsan Hospital, Goyang, Korea
| | - Ki Ho Hong
- Department of Laboratory Medicine, Seoul Medical Center, Seoul, Korea
| | - Moon-Woo Seong
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Namhee Ryoo
- Department of Laboratory Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Hyun Soo Kim
- Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Jaehyeon Lee
- Department of Laboratory Medicine, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
| | - So Yeon Kim
- Department of Laboratory Medicine, National Medical Center, Seoul, Korea
| | - Sook Won Ryu
- Department of Laboratory Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Mi-Na Kim
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Myung Guk Han
- Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Sang Won Lee
- Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Hyukmin Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Cheon Kwon Yoo
- Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Osong, Korea
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Centoamore NHF, Chierato MER, Silveira VBV, Asano KM, Iamamoto K, Fahl WO, Scheffer KC, Achkar SM, Mesquita LP, Maiorka PC, Mori E. Comparison of five different laboratory techniques for the rabies diagnosis in clinically suspected cattle in Brazil. J Virol Methods 2020; 283:113918. [PMID: 32554044 DOI: 10.1016/j.jviromet.2020.113918] [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: 03/31/2020] [Revised: 06/01/2020] [Accepted: 06/11/2020] [Indexed: 01/18/2023]
Abstract
The direct-fluorescent antibody test (dFAT) is considered the "gold standard" assay to diagnose rabies. However, it is crucial to develop molecular techniques, such as RT-PCR and RT-qPCR, since many laboratories lack the needed supplies for performing complementary methods (viral isolation, for example). For this purpose, diagnostic techniques must be specific and sensitive to guarantee accuracy. This present investigation aimed to detect rabies virus (RABV) in 126 clinically suspected cattle in Brazil using different diagnostic tests [dFAT, mouse inoculation test (MIT), immunohistochemistry (IHC), RT-PCR and RT-qPCR] and to compare those results obtained under routine laboratory conditions. The results of the present investigation demonstrate that the molecular techniques are more sensitive and may detect low viral load, even though the non-homogeneous viral distribution caused a false-negative result in dFAT. We also observed a usual alteration in antigens distribution among regions of the central nervous system (CNS). By both dFAT and IHC assays, the most reliable CNS structures were thalamus and midbrain. Although this investigation demonstrated diagnostic sensitivity and specificity close to 100 % in all laboratory techniques employed, a dFAT auxiliary test is required for bovine specimens, such as molecular techniques, when there are poor sampling conditions (low viral load combined with unavailability of brainstem structures).
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Affiliation(s)
- N H F Centoamore
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - M E R Chierato
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - V B V Silveira
- Instituto Pasteur de Sao Paulo, Avenida Paulista 393, Sao Paulo, SP 01311‑000, Brazil
| | - K M Asano
- Instituto Pasteur de Sao Paulo, Avenida Paulista 393, Sao Paulo, SP 01311‑000, Brazil
| | - K Iamamoto
- Instituto Pasteur de Sao Paulo, Avenida Paulista 393, Sao Paulo, SP 01311‑000, Brazil
| | - W O Fahl
- Instituto Pasteur de Sao Paulo, Avenida Paulista 393, Sao Paulo, SP 01311‑000, Brazil
| | - K C Scheffer
- Instituto Pasteur de Sao Paulo, Avenida Paulista 393, Sao Paulo, SP 01311‑000, Brazil
| | - S M Achkar
- Instituto Pasteur de Sao Paulo, Avenida Paulista 393, Sao Paulo, SP 01311‑000, Brazil
| | - L P Mesquita
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - P C Maiorka
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - E Mori
- Department of Pathology, School of Veterinary Medicine and Animal Science, University of Sao Paulo, Sao Paulo, SP, Brazil; Instituto Pasteur de Sao Paulo, Avenida Paulista 393, Sao Paulo, SP 01311‑000, Brazil.
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Dunn JJ, Baldanti F, Puchhammer E, Panning M, Perez O, Harvala H. Measles is Back - Considerations for laboratory diagnosis. J Clin Virol 2020; 128:104430. [PMID: 32454430 DOI: 10.1016/j.jcv.2020.104430] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 02/24/2020] [Revised: 05/04/2020] [Accepted: 05/09/2020] [Indexed: 10/24/2022]
Abstract
Measles is a highly contagious viral illness that continues to cause significant mortality among young children worldwide despite the availability of a safe and effective vaccine. During the first half of 2019, over 182 countries reported more than 300,000 measles cases; greater than double the number from the same period in 2018. Timely recognition and laboratory confirmation of infected individuals as well as appropriate infection prevention measures are crucial to avert further transmission. This review highlights the importance of early recognition of the signs and symptoms of measles and provides details on the laboratory methods commonly employed to confirm cases, investigate outbreaks and characterize the virus. It's critical that clinicians, laboratorians and public health administrations work together to rapidly identify, confirm and contain the spread of measles globally.
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Affiliation(s)
- J J Dunn
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, USA; Department of Pathology, Texas Children's Hospital, Houston, TX, USA.
| | - F Baldanti
- Molecular Virology Unit, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy
| | - E Puchhammer
- Center for Virology, Medical University Vienna, Austria
| | - M Panning
- Department of Medicine, Institute for Virology, University of Freiburg, Germany
| | - O Perez
- Department of Pathology, University of Illinois at Chicago College of Medicine, USA
| | - H Harvala
- Department of Infection, University College of London, London, UK; National Microbiology Services, NHS Blood and Transplant, London, UK
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Hong KH, Lee SW, Kim TS, Huh HJ, Lee J, Kim SY, Park JS, Kim GJ, Sung H, Roh KH, Kim JS, Kim HS, Lee ST, Seong MW, Ryoo N, Lee H, Kwon KC, Yoo CK. Guidelines for Laboratory Diagnosis of Coronavirus Disease 2019 (COVID-19) in Korea. Ann Lab Med 2020; 40:351-360. [PMID: 32237288 PMCID: PMC7169629 DOI: 10.3343/alm.2020.40.5.351] [Citation(s) in RCA: 230] [Impact Index Per Article: 57.5] [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: 03/16/2020] [Revised: 03/17/2020] [Accepted: 03/25/2020] [Indexed: 12/20/2022] Open
Abstract
The outbreak of coronavirus disease 2019 (COVID-19), which began in December 2019, is still ongoing in Korea, with >9,000 confirmed cases as of March 25, 2020. COVID-19 is a severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection, and real-time reverse transcription-PCR is currently the most reliable diagnostic method for COVID-19 around the world. Korean Society for Laboratory Medicine and the Korea Centers for Disease Prevention and Control propose guidelines for diagnosing COVID-19 in clinical laboratories in Korea. These guidelines are based on other related domestic and international guidelines, as well as expert opinions and include the selection of test subjects, selection of specimens, diagnostic methods, interpretation of test results, and biosafety.
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Affiliation(s)
- Ki Ho Hong
- Department of Laboratory Medicine, Seoul Medical Center, Seoul, Korea
| | - Sang Won Lee
- Center for Laboratory Control of Infectious Diseases, Centers for Disease Control and Prevention, Osong, Korea
| | - Taek Soo Kim
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hee Jae Huh
- Deopartment of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jaehyeon Lee
- Department of Laboratory Medicine, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
| | - So Yeon Kim
- Department of Laboratory Medicine, National Medical Center, Seoul, Korea
| | - Jae Sun Park
- Center for Laboratory Control of Infectious Diseases, Centers for Disease Control and Prevention, Osong, Korea
| | - Gab Jeong Kim
- Center for Laboratory Control of Infectious Diseases, Centers for Disease Control and Prevention, Osong, Korea
| | - Heungsup Sung
- Department of Laboratory Medicine, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea
| | - Kyoung Ho Roh
- Department of Laboratory Medicine, National Health Insurance Service, Ilsan Hospital, Goyang, Korea
| | - Jae Seok Kim
- Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Hyun Soo Kim
- Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Seung Tae Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Moon Woo Seong
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Korea
| | - Namhee Ryoo
- Department of Laboratory Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Hyukmin Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kye Chul Kwon
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Cheon Kwon Yoo
- Center for Laboratory Control of Infectious Diseases, Centers for Disease Control and Prevention, Osong, Korea
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Boskabadi H, Heidari E, Zakerihamidi M. Etiology, clinical findings and laboratory parameters in neonates with acute bacterial meningitis. Iran J Microbiol 2020; 12:89-97. [PMID: 32494342 PMCID: PMC7244827] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Neonatal meningitis is one of the most important and serious neonatal infections with a high mortality and morbidity rate. The present study aimed to investigate the causes, clinical signs, laboratory parameters and mortality rates in newborns with bacterial meningitis. MATERIALS AND METHODS This cross-sectional study was performed on 468 neonates aged 2-28 days admitted to NICU in Ghaem Hospital Mashhad, Iran by available sampling method during 2009-2018. Meningitis was confirmed according to positive results of CSF culture and clinical feature. By using researcher-made questionnaire, neonate's individual data including cardiopulmonary resuscitation, the Apgar score of the first and fifth minutes, gestational age, birth weight, clinical symptoms and laboratory data such as ESR, WBC and positive culture of CSF were studied. RESULTS Among 468 newborn suspected to infection, lumbar Puncture (LP) was performed for 233 cases (50%). Of 233 neonates, 148 neonates (63.5%) had negative results for CSF culture and 85 cases (36.5%) had positive CSF culture. 94% of cases with meningitis were born premature. Blood culture had positive results in 80% of infants with late-onset meningitis and negative in 20%. The most common clinical findings were respiratory symptoms (94%). Klebsiella pneumoniae and Entrobacter aerugenes were the most common microorganisms of meningitis. Gestational disorders were observed in 55.3% of newborns with meningitis. C-Reactive Protein (CRP) of neonates with meningitis was twice higher than normal cases, and leukocytes and proteins in the CSF in neonates with meningitis were higher than healthy ones. Finally, 36% of neonates with meningitis died in our study. For analyzing the relationships between variables, independent t-test was used after controlling the normality, and Chi-square was used for analyzing the relationship of variables with nominal scale. CONCLUSION The most common pathogens of meningitis were Klebsiella pneumoniae and Enterobacter aerogenes. Respiratory symptoms were the most common clinical signs, and laboratory symptoms included increased CRP, increased leukocytes and proteins in CSF.
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Affiliation(s)
- Hassan Boskabadi
- Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elahe Heidari
- Department of Pediatrics, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Zakerihamidi
- Department of Midwifery, Faculty of Medical Sciences, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran
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