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PubMed1980

A serological proof of adiaspiromycosis in wild rodents.

Using serological and histological methods, we examined 92 specimens of small, wild rodents (Apodemus sylvaticus, Clethrionomys glareolus, Micromys minutus, Microtus agrestis, M. arvalis, Mus musculus and Pitymys subterraneus) for the incidence of adiaspiromycosis. In addition, we examined 16 white, laboratory mice after their exposure to a natural biotope in which the incidence of adiaspiromycosis had been confirmed earlier. The results of serological tests were in correlation with those obtained with histological methods. While the immunodiffusion test showed a discrepancy of 6% only between the two methods, this was 19% for the complement fixation test. In animals with a negative histological finding, the immunodiffusion test confirmed antibodies in 3% the CF-test in 11%. An evident from results of serological methods, these might play an important role in the diagnosis of a spontaneous adiaspiromycosis even in wild rodents.

Animal Population Groups↗
PubMed1995

[Imported dengue fever in Switzerland--serological evidence for a hitherto unexpectedly high prevalence].

Dengue fever is probably the most important arthropod-borne viral infection worldwide. The World Health Organization estimates an incidence of 100 million cases per year. Dengue fever is of clinical importance mainly in tropical and subtropical zones, but the increasing number of travellers visiting these endemic areas means that physicians in temperate zones will meet this tropical infectious disease more frequently. To estimate the frequency of dengue fever in Switzerland, we retrospectively analyzed a cohort of patients in whom clinicians wished to rule out a case of malaria on the assumption that some of these patients may have been exposed to dengue virus while travelling in tropical and subtropical areas. Dengue was diagnosed by serology on contemporary stored serum samples with a commercially available assay that has been evaluated before. During the study period (1.1.93 to 1.7.94) a malaria diagnosis was requested by the physicians in our center in 87 cases and malaria was diagnosed in 10 (11.5%). In 38 of these 87 cases a stored serum sample was available for dengue serology. All of these patients had visited an area where not only malaria but dengue virus was endemic. In 7 of these 38 cases (18%) malaria was diagnosed. In 3 patients (8%) the dengue serology (IgM and IgG) was indicative of acute dengue fever. All 3 cases had clinical findings compatible with the disease. In 4 more patients (10%) anti-dengue IgG antibodies were found. All of these 4 patients had previous exposure to dengue virus but no acute clinical illness.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[The value of mycobacteria serology in the diagnosis of tubercular hepatitis].

The causes of granulomatous hepatitis are often difficult to determine and standard diagnosis methods for tuberculous hepatitis lack sensitivity, which led us to evaluate the contribution of mycobacteria serology. The case is reported of a woman in whom a diagnosis of extrapulmonary sarcoidosis had been made on two occasions (1985, 1987) in the presence of granulomatous hepatitis. Liver histology remained identical in 1991 but the existence of positive mycobacteria serology led to the start of antituberculous treatment. The satisfactory response in terms of clinical, laboratory and histological findings confirmed this diagnostic hypothesis. When search for the etiology of granulomatous hepatitis proves negative, positive mycobacteria serology is sufficient to justify specific antituberculous treatment.

Adult↗
PubMed1993

[Use of direct and serologic methods to detect Chlamydia trachomatis infections in cervix uteri of women].

Investigation included 254 women (18-75 years of age). In this number, 74 patients constituted a group with pathological changes in cervix uteri, while 180 women were seemingly healthy. The material was evaluated by a method of direct immunofluorescence (IF) with monoclonal antibody serum and a culture on McCoy cells. Antibodies in blood serum was detected by an immunoenzymatic test ELISA. Out of total number of 256 patients tested, elementary bodies of C. trachomatis were found in cylindrical cells of cervix uteri by the IF test in 54 (21.25%) of women. Analogical percentage of positive results was obtained by application of culture on McCoy cells. Positive serological results were found in 70 patients (27.55%). In group of 75 patients infected with C. trachomatis, 33 cases (44.59%) were confirmed by application of IF and cell culture, whereas positive serological results were found in 39 (52.70%) of investigated patients. In the group of seemingly healthy women in 11.60% elementary bodies of C. trachomatis were detected and in 17.22% of cases serological results were positive.

Adult↗
PubMed1995

Sensitivity and specificity of various serologic tests for detection of Toxoplasma gondii infection in naturally infected sows.

The sensitivity and specificity of various serologic tests for antibodies to Toxoplasma gondii were compared in 1,000 naturally exposed sows, using isolation of viable T gondii as the definitive test. Serum samples obtained from heart blood of 1,000 sows from Iowa were examined for T gondii antibodies by use of the modified agglutination test (MAT), latex agglutination test (LAT), indirect hemagglutination test (IHAT), and ELISA. Toxoplasma gondii was isolated from 170 hearts of 1,000 sows by bioassays in mice and cats. The percentage of samples diagnosed as positive for each of the serologic tests was: MAT = 22.2% (titer > or = 1:20), IHAT = 6.4% (titer > or = 1:64), LAT = 10.4% (titer > or = 1:64), and ELISA = 24.1% (OD > 0.360). The sensitivity and specificity of these tests were calculated respectively to be: 82.9 and 90.29% for MAT, 29.4 and 98.3% for IHAT, 45.9 and 96.9% for LAT, and 72.9 and 85.9% for ELISA. The dye test was run at 1:20 dilution on only 893 sera because of bacterial contamination and presence of anticomplement substances. Dye test antibodies were found in 17.8% of the sera, and sensitivity and specificity were 54.4 and 90.8%, respectively. Thus, the MAT had the highest sensitivity among all serologic tests used.

Agglutination Tests↗
PubMedDate not supplied

Cirrhosis negatively affects the efficiency of serologic diagnosis of Helicobacter pylori infection.

In cirrhosis, Helicobacter pylori infection may be implicated, together with portal hypertension, bile reflux and alcohol abuse, in damage to gastric mucosa. Aim of this study was to define the influence of non-alcoholic liver disease on the incidence of Helicobacter pylori infection and on the diagnostic accuracy of specific serology. Enrolled in the study were 232 individuals, 105 also had cirrhosis. Infection by Helicobacter pylori, diagnosed by a positive concordance of quick urease test and histology, was detected in 97 (48 with cirrhosis) out of 184 patients. Severe gastritis was more frequent in patients with Helicobacter pylori infection than in patients without. Cirrhosis did not significantly affect the prevalence of Helicobacter pylori infection or the histological features of gastritis. Specific anti-Helicobacter pylori IgG and IgA assay (Bio-Rad GAP test) was used for serological diagnosis. Anti-Helicobacter pylori IgG showed a high sensitivity (85% in cirrhotics, 89% in non-cirrhotics) and low specificity being more evident in cirrhotics (38% vs 56% non-cirrhotics). Serum specific IgA showed low sensitivity (approximately 25% in both groups) and specificity of 79% in cirrhotics vs 84% in non-cirrhotics. In conclusion, non-alcoholic cirrhosis does not affect the incidence of Helicobacter pylori infection and the histological features of chronic gastritis but does decrease diagnostic efficiency of serological tests for Helicobacter pylori.

Antibodies, Bacterial↗
PubMed1996

Determination of the true prevalence of infection with the human T-cell lymphotropic viruses (HTLV-I/II) may require a combination of biomolecular and serological analyses.

Infection with the human T-cell lymphotropic virus types I and II (HTLV-I/II) usually is determined by tests that detect antibodies to the viral structural proteins. However, recent studies revealed that patients with mycosis fungoides have proviral DNA sequences related to the HTLV transactivating-transforming gene tax, without having antibodies to the virus. These results raised the possibility that the prevalence of HTLV infection in the general population of the United States also may be underestimated. To reassess the prevalence of HTLV-I/II infection effectively, a population at increased risk for infection (i.e., a cohort of injection drug users [IDUs]) was studied. Paired sera and peripheral blood mononuclear cells (PBMCs) from 81 IDUs were subjected to testing by Western blot analysis for antibodies to the viral structural proteins gag and env and by polymerase chain reaction (PCR) Southern analysis to detect gag, pol and tax proviral DNA sequences. Western blot assays showed 1 of 81 IDUs to be positive for HTLV-I, 14 to be positive for antibodies to HTLV-II, and 3 to be HTLV-serotype indeterminate. When whole-cell lysates of PBMCs from these individuals were subjected to PCR and Southern analysis. 39 of 81 were found to have HTLV-related sequences. A total of nine IDUs were found to be infected with HTLV-I, a figure nearly 10 times higher than that estimated by serology alone. Bio-molecular analysis showed HTLV-II-specific proviral sequences in 21 IDUs. Three individuals were seropositive for HTLV-II but lacked PCR evidence of gag, pol and tax sequences. Thus, the overall prevalence of HTLV infection among this cohort was 59% (43 of 81) (i.e., more than twice the frequency predicted by serology, 18 of 81 or 22%). These results indicate that it may be necessary to incorporate biomolecular as well as serological methodologies to identify all persons infected with these retroviruses.

Blotting, Southern↗
PubMedDate not supplied

Immediate endoscopy or initial Helicobacter pylori serological testing for suspected peptic ulcer disease: estimating cost-effectiveness using decision analysis.

OBJECTIVE: To compare the clinical and economic effects of a strategy using immediate endoscopy to a non-invasive strategy utilizing a serologic test for Helicobacter pylori infection for individuals with symptoms suggestive of peptic ulcer disease. DESIGN: Cost-effectiveness analysis evaluating the clinical and economic effects of alternative management strategies of hypothetical patients with suspected peptic ulcer disease in a computer simulation model. INTERVENTION: Two strategies for hypothetical patients with suspected ulcer disease were evaluated: 1) Immediate endoscopy and biopsy for H. pylori, using antisecretory treatment in all patients with documented ulcers and adding antibiotic eradication therapy for those patients with ulcers whose biopsies were positive for H. pylori. 2) Empiric treatment with antisecretory therapy and serologic testing for H. pylori for all patients, using antibiotic eradication therapy only in patients testing positive for H. pylori. MEASUREMENTS: Cost per ulcer cured over a one-year study period. RESULTS: The more cost-effective strategy was the test-and-treat strategy (Strategy 2) with $4481 cost per ulcer cured. The immediate endoscopy strategy resulted in $8045 cost per ulcer cured. The cost-effectiveness advantage of the non-invasive strategy diminished as the cost of endoscopy fell or as the probability of recurrent symptoms rose in patients initially managed without endoscopy. CONCLUSION: Endoscopy, though costly, precisely guided diagnosis and treatment and, thus, potentially reduced the number of patients inappropriately treated. However, cost-effectiveness analysis supports the continued practice of initial non-invasive management of patients with symptoms suggestive of peptic ulcer disease, achieving the benefits of H. pylori eradication through the use of serologic testing to guide antibiotic use.

Computer Simulation↗
PubMed1997

[Toxoplasmosis diagnosis in pregnancy: computer assisted follow-up interpretation of serologic tests].

Primary infection with Toxoplasma gondii during pregnancy can result in fetal infection with serious sequelae for the unborn if not treated properly. Early diagnosis enables drug therapy and significantly reduces the risk of fetal disease. A systematic serological screening procedure was established in Austria in 1975 to detect primary toxoplasma infection as early as possible during pregnancy. Since the screening program is based solely on observation and interpretation of serological data, the question arises whether a knowledge-based system for automatic interpretation can achieve a sufficient interpretative accuracy for introduction to routine work. For this reason the system Toxopert-I was developed. The system is aimed at facilitating routine laboratory work, as well as assuring quality by setting standards for therapy. The required knowledge base was designed as a knowledge graph, each state representing a certain interpretation. One or more available serological test results cause the knowledge graph to change its current state. If all available test results are processed, the final state reached corresponds to the respective current interpretation for the patient. A retrospective analysis of 1000 pregnant women yielded a total diagnostic sensitivity and specificity of over 99% in comparison with the clinician's diagnosis which was used as the Gold Standard.

Animals↗
PubMed1998

[Assessment of 4 commercial immunoenzymatic assays for the serologic diagnosis of Helicobacter pylori infection].

BACKGROUND: The aim of this study was to evaluate four commercial tests for the serologic diagnosis of infection by Helicobacter pylori based on the detection of IgG class antibodies versus this microorganism. METHODS: Four commercial kits were analyzed based on the ELISA method in serum samples of 48 patients admitted for digestive endoscopy. The data of the serologic tests were compared with those provided by the culture, the histologic observation and the urease test of gastric biopsy specimens. The calculation of seroprevalence of anti-H. pylori antibodies in serum of 60 asymptomatic subjects was carried out. RESULTS: The seroprevalence of infection by H. pylori in an asymptomatic population of between 18 to 78 years of age was 58.33%. A sensitivity of 94.3% and a specificity of 88.9% were observed with the Pyloriset EIA-G test. The positive predictive value (PPV) was 92.2% and the negative predictive value (NPV) 91.5%. With the Chemifarma commercial kit the sensitivity was 78.8% and the specificity 100% with a PPV of 100% and NPV of 76.7%. Plate showed a sensitivity of 85.3% and a specificity of 87.5% with a PPV of 90% and a NPV of 80.76%. Milenia had a sensitivity of 80% and a specificity of 66.7% and a PPV of 77% and a NPV of 70.7%. CONCLUSIONS: The usefulness of the serologic tests for the diagnosis of Helicobacter pylori infection is herein confirmed with the test evaluated showing a high sensitivity and specificity as well as high predictive values.

Adolescent↗
PubMedDate not supplied

Microbiological and serological diagnostic tests for Helicobacter pylori: an overview.

Different invasive and non-invasive diagnostic tests are available for the diagnosis of H. pylori in the individual patient. In practice, endoscopic tests are best for a primary diagnosis of H. pylori infection because endoscopy allows assessment of treatment indications. The new rapid urease tests may help the clinician in treatment decision-making. Culture is currently not recommended for routine evaluation, but it is becoming increasingly important in certain populations with higher prevalence of drug resistance, since it allows to test for susceptibility to antibiotics. Serological testing has been recommended for initial pre-endoscopy or pre-treatment screening in dyspeptic patients. However, several current "in-office" tests appear insufficiently accurate or would need further validation before being recommended for use in clinical management strategies at a primary care level. The urea breath tests are best suited to confirm eradication early after treatment while laboratory serology tests are of limited use since 6 months are required before a result can be obtained. The serological office tests cannot be used for post-treatment assessment of H. pylori status.

Bacteriological Techniques↗
PubMed2000

Herpes serology for dermatologists.

Serologic tests for antibodies to herpes simplex virus (HSV) have traditionally played a limited role in the treatment of patients with genital herpes. The epidemiological gold standard has been the Western blot analysis, which is only available in a few research centers and is expensive. The gold standard of diagnosis for HSV infection has been viral culture. Diagnosis by viral culture has severely underestimated the number of individuals infected. The majority of patients who are seropositive for herpes simplex virus type 2 (HSV-2) by Western blot analysis are unaware of their symptoms (unrecognized infection) or have subclinical infection. These patients are unlikely to present for culture. Enzyme-linked immunosorbent assay (ELISA) for the serologic diagnosis of herpes has been available for many years but suffers from poor sensitivity and specificity. Reliable, convenient serologic tests for antibodies that distinguish between prior infection with HSV-1 and HSV-2 have recently become commercially available.

Antibodies, Viral↗
PubMed1999

Serologic hepatitis B immunity in vaccinated health care workers.

BACKGROUND: Hepatitis B vaccination is recommended for health care workers but has a nonresponse rate of 5% to 32% and an unknown duration of immunity. There is no standardized postvaccination protocol to confirm, monitor, and maintain immunity. OBJECTIVE: To assess the hepatitis B serologic immune status in health care workers who were previously vaccinated. METHODS: A convenience survey and an objective laboratory study, which included testing for hepatitis B surface antigen, core antibody, and qualitative and quantitative surface antibody (anti-HBs), were performed. The data collected included vaccination date, number of doses of vaccine, whether and when titers had previously been checked, titer results, sex of patient, job description, and age at the time of our study and at vaccination. RESULTS: Group A (n = 109, 71%) had detectable anti-HBs titers, and group B (n = 45, 29%) had no detectable anti-HBs titers. Group A was vaccinated 4.80 +/- 0.30 (mean +/- SEM) years prior to our testing, received 2.91 +/- 0.04 (mean +/- SEM) vaccinations, and had a mean +/- SEM titer of 112.91 +/- 5.18 mIU/mL. There was no statistical significance in time since vaccination, number of doses of vaccine, sex, job description, age at the time of our serologic testing, or age at the time of vaccination between groups A and B. Six of 6 subjects given booster doses of vaccine in group B developed anti-HBs. Only 62 subjects (40%) in the entire study population had anti-HBs status previously determined, with 48 (77%) reporting immunity to hepatitis B virus. CONCLUSIONS: Twenty-nine percent of the health care workers who were vaccinated against hepatitis B showed no serologic evidence of hepatitis B immunity. It is unclear whether these subjects are nonresponders, lost immunity, or retained anamnestic potential. Booster vaccination response in 6 of 6 subjects suggests immunity. We recommend (1) postvaccination testing within 1 to 2 months to document immunity, (2) periodic anti-HBs monitoring, and (3) booster vaccination to maintain protective titer levels.

Adult↗
PubMed1991

Comparison of maternal and newborn serologic tests for syphilis.

OBJECTIVE: To compare the cord blood, newborn serum, and maternal serum for the diagnosis of congenital syphilis. DESIGN: Retrospective chart review. SETTING: Kings County Hospital Center, Brooklyn, NY. PATIENTS: Three hundred forty-eight mother-newborn pairs with positive syphilis serology. MEASUREMENTS AND RESULTS: One hundred fifteen newborns (33%) had rapid plasma reagin tests of cord blood that were nonreactive. Their mothers had positive serologic findings. There were 10% false-positive cord blood samples (cord blood rapid plasma reagin tests reactive, newborn serum rapid plasma reagin tests nonreactive) and 5% false-negative cord blood samples (cord rapid plasma reagin tests nonreactive, newborn serum rapid plasma reagin tests reactive). Thirty-three newborns had congenital syphilis. Seven newborns had cord titers fourfold higher than their mothers'; only four of these newborns had congenital syphilis. Maternal serology is superior to cord blood analysis for identifying newborns at risk of congenital syphilis.

False Negative Reactions↗
PubMed1998

Nasopharyngeal swab and PCR for the screening of nasopharyngeal carcinoma in the endemic area: a good supplement to the serologic screening.

BACKGROUND: Nasopharyngeal carcinoma (NPC) is a common head and neck cancer in Taiwan. Early detection is the best way to improve survival for this disease. A prospective study was designed to assess the feasibility of a new screening method for NPC by use of polymerase chain reaction (PCR) based on the close association of NPC and Epstein-Barr virus (EBV). METHODS: One hundred thirty-three different tissues from nasopharynx, nose, and sinus were investigated by use of PCR to check for the presence of EBV genome. Subsequently, from April 1996 to March 1997, 55 patients were enrolled in a prospective screening study. All patients underwent nasopharyngeal swabs before biopsy. Polymerase chain reaction detection of EBV genome was conducted on swab samples. Anti-EBV viral capsid antigen (VCA) in IgA and IgG class were checked at the same visit. RESULTS: The EBV genome was present in 91.4% (85/93) of NPC tissues and in 25.0% (10/40) of non-NPC tissues (p < .001, chi2 test). Of the 55 swabs, 49 (89.1%) specimens obtained enough cells for PCR examination. Thirty of these 49 patients were pathologically proved NPC. The presence of EBV were 86.7% (26/30) in NPC group and 42.1% (8/19) in non-NPC group. The sensitivity and specificity were 86.7% and 57.9%, respectively, which were similar to those of serologic method (87.5% and 43.5%) when the cut-off point was set at anti-VCA IgG > or = 160 and IgA > or = 10. Combining both methods elevates the specificity to 84.2%. CONCLUSIONS: The sensitivity of this PCR screening method is similar to that of the serologic method. Combining both methods can greatly increase the specificity, indicating this new method is a good supplement to the serologic screening of this endemic disease.

Antibodies, Viral↗
PubMedDate not supplied

HSV-2 specific serology should be offered routinely to antenatal patients.

The most devastating consequence of genital herpes is neonatal herpes. It is clear that the majority of newborns acquire their infection by contact with infected genital secretions during delivery from an asymptomatic mother who acquired a first episode of genital herpes near the time of labour. Since the majority of cases of first episode genital herpes during pregnancy are unrecognised, the prevention of neonatal transmission will depend upon the identification of the HSV serologically discordant couple and the institution of appropriate interventions by mid pregnancy. Therefore, the précis of this discussion paper is that universal HSV serological testing should be performed at the first prenatal visit. As a corollary, type specific HSV serology will need to be commercially available and relatively inexpensive. In any country, pregnant women and their partners represent a broad, cross section of sexually active adults. The vast majority present themselves to the health care system for care during their pregnancies which is a period of time in which the focus of care is primarily preventive and during which women are generally motivated and compliant. This is truly the 'golden opportunity' to identify patients already infected as well as those at risk for acquiring genital herpes. Information regarding genital herpes and methods of preventing transmission to susceptible partners and newborn infants can easily be added to educational programmes which have already become an institution within prenatal care.

Adult↗
PubMedDate not supplied

Fetal infection from rubeovirus or cytomegalovirus: correlation among maternal serological profiles, invasive diagnostic procedures, and long-term follow-up.

Different variables influence the possibility that maternal viral infection may be transmitted to the fetus, although not all fetal infections result in fetal "illness" with consequent fetopathy. As concerns the fetus, prenatal diagnosis includes invasive techniques necessary for fetal tissue sampling. These techniques carry some risks. The fetal infectious risk, as determined by maternal clinico-serological profile and according to sonographic investigation, always should be weighed against the risks and benefits of invasive diagnostic procedures. The present study re-elaborates the criteria necessary for defining fetal risk as related to the maternal serological profile. In the 26 mothers with rubeola infection, the incidence of fetal mortality was 7.7%. Fetal prognosis worsens with the precocity of eruption. In these cases the esantema is the most reliable prognostic element as an indication to perform the invasive procedure. In the 15 patients with cytomegalovirus infection, no fetal or postnatal losses occurred. Morbidity occurred in 13.3% of cases, and the two ill fetuses were classified in the same risk group. In this group of patients, the maternal serological profile is a significant predictor of fetal morbidity.

Amniotic Fluid↗
PubMed2001

Co-infection by serologically-silent hepatitis B virus may contribute to poor interferon response in patients with chronic hepatitis C by down-regulation of type-I interferon receptor gene expression in the liver.

Intrahepatic mRNA levels of type-I interferon (IFN) receptor genes have been shown to correlate with the clinical efficacy of IFN therapy in patients with chronic hepatitis C. Recently, co-infection by serologically-silent hepatitis B virus (HBV) has been assumed to be associated with the poor IFN response in patients with chronic hepatitis C. The aim of this study was to investigate the relationship between the co-infection of serologically-silent HBV and type-I IFN receptor gene expression in the liver of patients with chronic hepatitis C. The intrahepatic mRNA levels of IFNAR2, one of the two subunits of the type-I IFN receptor, were quantified and compared with both the prevalence of HBV DNA and the hepatitis C virus (HCV) genotype in 45 patients with chronic hepatitis C, who were negative for hepatitis B surface antigen. Co-infection, as evaluated by a nested polymerase chain reaction, was present in 22 patients (48.9%), with dominance of the HCV genotype 1b (65.2%) over genotype 2a (31.8%). Co-infection was associated with lower IFNAR2 mRNA levels, higher levels of serum HCV RNA, and a poor IFN response, regardless of the HCV genotype. The findings suggest the possibility that co-infection by serologically-silent HBV is one of the factors that can lead to an unfavorable IFN response in chronic hepatitis C by down-regulation of IFN receptor gene expression in the liver.

Adult↗