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Pulmonary fat embolism in a preterm infant receiving Intralipid intravenously is described. Serum obtained at the time of clinical deterioration agglutinated Intralipid. This coincided with the onset of septicaemia and with a raised serum C reactive protein concentration. Subsequent clinical improvement was associated with reduction in the C reactive protein concentration and nonagglutination of Intralipid.
An example of the ;albumin' auto-agglutinating phenomenon is reported. This was found in the serum of a man dying from carcinoma of the stomach with liver secondaries. It is suggested that the serum factor is of a protein (probably globulin) nature, and may have been produced by the diseased liver.
The platelets of a patient with reticulum-cell sarcoma were found to exhibit agglutination and cytopathic changes when her blood was treated with EDTA but not with other anticoagulants. Investigation showed that the phenomenon was caused by a serum factor that was probably an antibody.
Streptococcal grouping sera, diluted and absorbed to remove cross-reactions, were bound to staphylococci and used to group trypsinised beta-haemolytic streptococci by coagglutination. The results compared well with those obtained using the Phadebact streptococcal grouping kit. The same sera bound to staphylococci without prior dilution and absorption could be used to group enzyme extracts of haemolytic streptococci by slide agglutination, the results again comparing favourably with those of the Phadebact kit.
IgM rheumatoid factors have been measured in 92 patients by both laser nephelometry and the traditional hospital procedure of a latex slide test followed by differential agglutination titre (DAT). Of the results 86% were in accordance by both methods, but seronegative patients with a high nephelometry score all showed, after reference to their clinical state and previous investigations, that the nephelometry result more accurately represented their clinical state than the DAT, which was shown to be in error in five out of the six cases. Six seropositive patients with low nephelometry scores were also studied; three were in complete remission on gold or penicillamine therapy. Nephelometry is both technically simpler and more reliable than the traditional DAT method, and our results suggest that it has some advantages over the DAT in routine use.
An immunoglobulin-M immunosorbent agglutination assay (ISAGA) was introduced to detect toxoplasma specific IgM. This assay incorporates mu chain capture and use of entire toxoplasma trophozoites as an antigen source. The performance of the ISAGA was compared with that of a double sandwich enzyme linked immunosorbent assay (DS-ELISA) currently used in the Public Health Laboratory Service Toxoplasma Reference Laboratories. The ISAGA was found to be more sensitive than DS-ELISA but there was no demonstrable difference in the specificity or reproducibility between the two assays. The ISAGA is suitable for the diagnosis of acute toxoplasmosis in immunocompetent patients and as a screening test for recent infection in pregnant women. The persistence of ISAGA reactivity, however, is such that additional serological assessment is required to define the risk of congenital infection.
Wheat-germ agglutination (WGA) was used to identify 168 strains of Neisseria gonorrhoeae and 105 strains of other Neisseria species in a routine laboratory. About one-third of the meningococci reacted with the lectin and titres with some organisms varied on repeat testing. The technique is regarded as unreliable for the identification of Neisseria species.
For the serodiagnosis of syphilis a quantitative passive agglutination (MCA-TP) test for antibodies to Treponema pallidum was performed with chemically stable microcapsules with no antigenic activity instead of with conventional sheep erythrocytes. The microcapsules were easily sensitised with the antigen of sonicated Treponema pallidum by treatment with glutaraldehyde. Compared with the Treponema pallidum haemagglutination test (TPHA) the MCA-TP test was superior for detecting cases of primary syphilis. Furthermore, the decrease in antibody titre during treatment was more evident in this test than in the FTA-ABS or the TPHA tests. The MCA-TP test performed on IgM and IgG gel-filtered fractions of sera from patients with syphilis proved that the sensitised microcapsule antigen reacted sharply with the IgM antibodies specific to syphilis.
A comparative evaluation of a new serological test for human immunodeficiency virus (HIV) was carried out. The test used the agglutination of gelatin particles coated with HIV antigen. It was found to be more sensitive than current enzyme linked immunosorbent assays (ELISAs) and more specific than the western blot test. Because of its simplicity, it promises to be of value, especially in developing countries.
A new whole cell agglutination test for active tuberculosis, for which encouraging results have recently been reported, has been carried out on the serum of 112 subjects. The results have been disappointing; the test had no predictive value in the diagnosis of active tuberculosis.
Samples of faeces and of serum were collected from pigs of various ages on 21 farms. Faecal samples were cultured on trypticase soy agar containing 5 per cent citrated bovine blood and 400 micrograms per ml spectinomycin, incubated at 42 degrees C in Gaspak jars under an atmosphere of 80 per cent hydrogen: 20 per cent carbon dioxide. Antibody titres to Treponema hyodysenteriae were determined by a microtitration agglutination method using merthiolate-inactivated whole cell antigen prepared from a beta-haemolytic isolate. Results indicated that mean titres in pigs from which beta-haemolytic T hyodysenteriae was isolated were significantly higher than in pigs which yielded isolates of weak beta-haemolytic T innocens or in culturally negative pigs (P less than 0.0225). Mean titres of herds where beta-haemolytic T hyodysenteriae was isolated were significantly higher (P less than 0.005) than the mean titres of either of the other two groups. However, mean titres of herds where no isolates were obtained were not significantly different from mean titres of herds where weak beta-haemolytic T innocens was isolated.
Samples of faeces and serum were collected from pigs of various ages on 21 farms. Faecal samples were cultured on trypticase soy agar containing 5% citrated bovine blood and 400 microgram per ml spectinomycin, incubated at 42 degrees C in Gaspak jars under an atmosphere of 80% hydrogen: 20% carbon dioxide. Antibody titres to Treponema hyodysenteriae were determined by a microtitration agglutination method using merthiolate-inactivated whole cell antigen prepared from a beta- haemolytic isolate. Results indicated that mean titres in pigs from which beta- haemolytic T hyodysenteriae was isolated were significantly higher than in pigs which yielded isolates of weak beta- haemolytic T innocens or in culturally negative pigs (P less than 0.0225). Mean titres of herds where beta- haemolytic T hyodysenteriae was isolated were significantly higher (P less than 0.005) than the mean titres of either of the other two groups. However, mean titres of herds where no isolates were obtained were not significantly different from mean titres of herds where weak beta- haemolytic T innocens was isolated.
Triphenyltetrazolium chloride stained Brucella abortus 0 and Yersinia enterocolitica 09 0 and 0H antigens were used in the microplate agglutination test. It was shown that the results of these tests could be used to differentiate anti-brucella antibodies from antibodies induced by motile Y enterocolitica 09 in cattle sera.
Preimplantation rat blastocysts were examined in vitro for concanavalin A agglutinability and antigenic properties on the 5th day of development after flushing and after 24 h in culture, following regional differentiation. Differences were found between the two trophoblastic cell populations with regard to cell membrane receptors to concanavalin A. Immunoadherence hemagglutination tests show that the early trophoblast possesses antigenic properties, which are similarly present in the mural and polar cells of the early preimplantation blastocyst. With later differentiation in vitro, differences can be found between the two trophoblastic cell populations with regard to detectable surface antigens.
Polymeric nanoparticles covalently functionalized with derivatized D-mannose molecules were synthesized and characterized. These nanoparticles have an average size of approximately 160 nm in diameter, thus bearing a large number of surface-tethered mannose moieties for multivalent interactions with adhesins on bacterial cells. Specifically, the mannosylated nanoparticles bind strongly with Escherichia coli, allowing the convenient visualization of adhesion interactions under a conventional electron microscope. Since a single nanoparticle is capable of binding more than one cell, the adhesion interactions result in significant nanoparticle-mediated cell agglutination according to electron microscopy imaging. Potential applications of the mannosylated nanoparticles in the inhibition of enteropathogenic infections are discussed.
Results obtained in an enzyme-linked immunosorbent assay (ELISA), an indirect fluorescent antibody test (IFA), and a modified direct agglutination test (MAT) for Toxoplasma gondii antibodies from examination of fetal fluids from 377 aborted ovine fetuses were compared. Sixty-seven samples were positive by MAT (titers 1:16 to greater than 1:65,536), 58 were positive by ELISA, and 62 were positive by immunoglobulin G-IFA. The MAT was preferred because it required less time, labor, and special equipment. It was simple to run, could be done on serum from any species without modification, and it was more effective than the IFA for detecting toxoplasma antibodies in severely autolyzed fetuses. No advantage was found in determining immunoglobulin M antibodies in ovine fetal sera.
The incidence of visceral leishmaniasis (VL) in Ethiopia has dramatically increased over the last 10 years, coinciding with the advent of the HIV epidemic. HIV co-infection in VL patients results in atypical, clinical and serological presentations, and may hamper serological diagnosis of VL. The performance of direct agglutination tests (DAT) in the diagnosis of VL in 103 Ethiopian patients with or without HIV infection was therefore investigated. The DAT results indicated that 96 of the patients had leishmanial infections, although amastigotes were only detected in samples from 91. Data on HIV status showed that 50.7% of all patients but 56.0% of the parasitologically confirmed cases of VL patients were HIV-positive. Based on the 95 patients who were each examined both by DAT and parasitological methods, the overall sensitivity of the DAT was 97.7%. Among the parasitologically confirmed cases of VL, a false-negative DAT result was obtained for two (3.9%) of the 51 cases who had HIV co-infection and for none of the 40 HIV-negative cases. In contrast to the observations made in Europe, DAT in Ethiopia therefore remain reasonably sensitive in the diagnosis of VL during HIV co-infection. The results are discussed in view of the possibility of distinctive antibody responses induced by Leishmania donovani donovani and L. d. infantum in HIV-infected patients.
The value of a direct agglutination test (DAT) in the detection of subclinical infections with Leishmania donovani has recently been investigated in the Indian state of Bihar, after the sensitivity and specificity of the test had been determined. When used to screen sera from 108 parasitologically confirmed cases of visceral leishmaniasis, 50 patients with active, non-leishmanial infection, and 641 healthy controls living close to, or distant from, an endemic area, the test was found to be 91.7% sensitive and 100% specific if a titre of 1:800 was used as the threshold for seropositivity. During a longitudinal clinical study in a rural, VL-endemic area of the Indian state of Bihar, the test was used, with 1:800 set as the threshold titre, to determine the baseline prevalence of infection with L. donovani among villagers who, though showing no symptoms of VL, had recently been febrile for at least 2 weeks. The 234 subjects of this study were either VL-case contacts [i.e. members of households in which there were active or cured VL cases (N=78)] or the members of control households with no cases or history of the disease (N=156). The results of DAT at the start of the study indicated that 49 (20.9%) of the subjects--29 (37.2%) of the VL-case contacts and 20 (12.8%) of the other subjects--were seropositive and therefore probably had subclinical infections with L. donovani. During the subsequent 9 months of follow-up, however, only eight of the subjects found seropositive at the start of the study--seven (24.1%) of the seropositive case contacts but only one (5.0%) of the other seropositives--developed symptomatic VL, all by month 6 of the follow-up. Compared with their neighbours, therefore, individuals who shared households with active or cured cases of VL appeared at greater risk not only of L. donovani infection (indicating focal transmission) but also of developing symptomatic disease once infected. Curiously, among the seropositive case contacts, those from the households that harboured active cases of VL at the baseline survey were less likely to develop symptomatic VL during the 9 months of follow-up than those from households that harboured only cured cases (18.8% v. 30.8%). The wide-spread use of DAT could allow the detection and early treatment of latent L. donovani infections and so contribute to the elimination of VL, at least as a public-health problem, from India.