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PubMed1989

The prevalence of positive serological tests for syphilis among elderly hospital patients.

Serological tests for syphilis were performed on 659 elderly patients admitted to hospital medical and psychiatric departments. Positive tests were found in 23 patients (3.5% of the sample), 17 women and 6 men. Six were subsequently discovered to have been treated previously for syphilis, and one other had radiological evidence to suggest that she had been treated with bismuth in the pre-penicillin era. Difficulties were encountered in classifying the stage of infection in some patients, particularly those with significant intellectual impairment. Eleven were diagnosed as late latent syphilis, seven as probable late latent syphilis, one as tabes dorsalis, one as possible cardiovascular syphilis, one as possible meningovascular syphilis, and one as late congenital syphilis.

Aged↗

PubMed1980

Counterimmunoelectrophoresis employing coccidioidin in serologic testing for coccidioidomycosis.

Counterimmunoelectrophoresis, was performed for serologic testing for coccidioidomycosis, employing coccidioidin and spherulin as antigens. Results obtained by counterimmunoelectrophoresis were compared with results obtained by complement-fixation and radial immunodiffusion. Of the 37 sera positive by complement-fixation, 28 were positive by counter-immunoelectrophoresis utilizing coccidioidin, whereas only 11 were positive by counterimmunoelectrophoresis utilizing spherulin (although an additional 14 were positive with counterimmunoelectrophoresis employing spherulin when the quantity of spherulin was increased by 50 to 100%). Thirty-three of these complement-fixation-positive sera were positive by immunodiffusion. Counterimmunoelectrophoresis performed with coccidioidin detected antibodies to C. immitis in all patients who had complement-fixation titers greater than 1:4. When combined with latex agglutination, counterimmunoelectrophoresis utilizing coccidiodin had an 86% correlation with complement-fixation for the detection of positive sera.

Antigens, Fungal↗

PubMed1990

Prevalence of reactive serological tests for syphilis in the Jamaican population.

Serological tests for syphilis (STS) were performed on sera from 15,876 members of the general adult population, 3,039 pregnant women and 1,029 children, in order to assess the prevalence and value of reactive STS in Jamaicans; 2.7% of sera from the general adult population, 4.7% from pregnant women and 2.2% from children were reactive in the Venereal Disease Research Laboratory (VDRL) test. Reactive Fluorescent Treponemal Absorption (FTA-ABS) tests occurred in significantly higher frequency in pregnant women (4%) than in the general population (2.2%; p less than 0.001). The prevalence of reactive STS in children did not differ significantly from that of the general adult population. The predictive value of a reactive VDRL test in pregnant women (85%) was higher than that of the general population (79%). These results suggest that adequate screening with the inexpensive VDRL test would enable the early detection and treatment of syphilis, and could prevent increasing incidence of congenital syphilis in Jamaica.

Adult↗

PubMed1989

Comparative evaluation of serological tests in diagnosis of kala azar.

Four serological tests, viz., counter immunoelectrophoresis (CIEP), indirect fluorescent antibody (IFA) test, enzyme linked immunosorbent assay (ELISA) and dot-enzyme linked immunosorbent assay (dot-ELISA) were compared for their sensitivity and specificity for diagnosis and epidemiological studies of kala azar. Sera from patients who were parasite positive (58), parasite negative (16), clinically diagnosed (53), treated (31) and from healthy controls (42) were tested for presence of antibodies by these techniques. Antibodies were detected in treated patients even after 18-24 months by ELISA (77.4%) and dot-ELISA (74.19%). In clinically diagnosed patients antibodies were present in 90.56 per cent by both the tests. The sensitivity and specificity of CIEP was 0.77 and 1.0, for IFA 0.87 and 0.95 respectively and for ELISA and dot-ELISA 0.92 and 0.9 respectively. Due to the requirement of small quantity of reagents and simplicity of the test, dot-ELISA is found to be more suitable for use in peripheral laboratories both for diagnosis and seroepidemiology.

Counterimmunoelectrophoresis↗

PubMed1972

Hepatitis-associated antigen and antibody in Uganda: correlation of serological testing with histopathology.

Histopathological findings in 91 Ugandan patients with cirrhosis were studied in relation to serological tests for the hepatitis-associated antigen (H.A.A.) and antibody (anti-H.A.A.). H.A.A. was present in 30 (32.9%) of the 91 patients as opposed to 7 (3.1%) out of 224 controls drawn from the same population (P<0.001). Younger subjects and males were more frequently positive. There was no difference in the presence of anti-H.A.A. between patients and controls. Correlation of the results of serological testing with histopathological features showed that macronodular ("posthepatitic," "postnecrotic") types of cirrhosis, which predominate in Uganda, were associated with the presence of H.A.A. but that the much less common micronodular ("nutritional," fatty, portal) type of cirrhosis was not. Evidence was found, on the other hand, for a direct role of alcoholism in the latter. Detailed histological analysis also showed two types of cellular change-liver cell swelling and dysplasia-to be associated with the presence of H.A.A. The data suggest an aetiological role for H.A.A. in most cases of cirrhosis in Uganda and these may be identified by histological criteria.

Age Factors↗

PubMedDate not supplied

Predictive value of serologic tests for syphilis in otology.

Otologic syphilis (luetic inner ear disease) usually is diagnosed by positive serologic tests and by exclusion of other possible causes. Because the FTA-ABS for syphilis is exquisitely sensitive in all but early primary cases, a positive FTA-ABS result and coincident inner ear disease often are thought to be diagnostic of syphilitic inner ear disease. The result is a management dilemma: are there false-positive results in misdiagnosed cases? Over 4 years, the authors performed a prospective study with time-matched controls to determine the predictive value of serologic tests and prevalence of syphilis in otology. Thirty-one cases of otologic syphilis were diagnosed in 5,439 new (different) patients with otologic complaints. In the geographic area studied, this prevalence (570/100,000) was 25-fold greater than that of all reported cases of syphilis in the general population (22.7/100,000). The defined sensitivity of the FTA-ABS (100%) was nearly twofold greater than the measured sensitivity of the rapid plasma reagin (RPR, 55%) in otologic syphilis. Specificities were comparable; therefore, a positive FTA-ABS had higher predictive value than a positive RPR. The prevalence-related predictive value of a positive FTA-ABS (22%) was more than twice that of the RPR (9%) in otology. The predictive value of a positive FTA-ABS in otology was 11-fold greater than that of the FTA-ABS in the general population (2%). Therefore, in suspect cases the FTA-ABS should be used to screen for otologic syphilis in an otologic practice. At a prevalence of 570 cases in 100,000 patients, only 22% of otologic patients with positive FTA-ABS results actually have otologic syphilis. Because disease morbidity can be far worse than treatment morbidity, however, positive results should be considered true-positives to avoid misdiagnosis in potentially infected patients. In suspect cases with positive FTA-ABS, therefore, treatment should be recommended unless specific contraindications exist.

Adolescent↗

PubMed2006

Is serological testing a reliable tool in laboratory diagnosis of syphilis? Meta-analysis of eight external quality control surveys performed by the german infection serology proficiency testing program.

The accuracy of diagnostic tests is critical for successful control of epidemic outbreaks of syphilis. The reliability of syphilis serology in the nonspecialist laboratory has always been questioned, but actual data dealing with this issue are sparse. Here, the results of eight proficiency testing sentinel surveys for diagnostic laboratories in Germany between 2000 and 2003 were analyzed. Screening tests such as Treponema pallidum hemagglutination assay (mean accuracy, 91.4% [qualitative], 75.4% [quantitative]), Treponema pallidum particle agglutination assay (mean accuracy, 98.1% [qualitative], 82.9% [quantitative]), and enzyme-linked immunosorbent assays (ELISAs) (mean qualitative accuracy, 95%) were more reliable than Venereal Disease Research Laboratory (VDRL) testing (mean accuracy, 89.6% [qualitative], 71.1% [quantitative]), the fluorescent treponemal antibody absorption test (FTA-ABS) (mean accuracy, 88% [qualitative], 65.8% [quantitative]), and immunoblot assays (mean qualitative accuracy, 87.3%). Clearly, immunoglobulin M (IgM) tests were more difficult to manage than IgG tests. False-negative results for samples that have been unambiguously determined to be IgM and anti-lipoid antibody positive accounted for 4.7% of results in the IgM ELISA, 6.9% in the VDRL test, 18.5% in the IgM FTA-ABS, and 23.0% in the IgM immunoblot assay. For negative samples, the mean percentage of false-positive results was 4.1% in the VDRL test, 5.4% in the IgM ELISA, 0.7% in the IgM FTA-ABS, and 1.4% in the IgM immunoblot assay. On average, 18.3% of participants misclassified samples from patients with active syphilis as past infection without indicating the need for further treatment. Moreover, 10.2% of laboratories wrongly reported serological evidence for active infection in samples from patients with past syphilis or in sera from seronegative blood donors. Consequently, the continuous participation of laboratories in proficiency testing and further standardization of tests is strongly recommended to achieve better quality of syphilis serology.

Antibodies, Bacterial↗

PubMed1980

Serologic testing for amoebiasis.

The diagnosis of amoebiasis presents problems, particularly if one relies on finding the organism. Thus, serologic tests are expedient. A gel diffusion precipitin test (GDP), commercially available, simple to perform, and inexpensive, was compared with the indirect hemagglutination test (IHA). 257 Patients' sera were tested; 14 had amoebic colitis, 21 had amoebic liver abscess, 63 had suspected amoebic liver abscess, and 46 had inflammatory bowel disease. GDP tests were positive in 85% of amoebic colitis and 95% of amoebic liver abscess patients; IHA was positive in 91% of amoebic colitis and 94% of abscess patients. Within 6 mo, GDP tests became negative in 66% of patients. IHA tests were observed positive up to 20 yr. The performance characteristics of diagnostic methods in amoebiasis, fecal examination, IHA and GDP, show serologic tests have superior sensitivity and predictive value in recognizing invasive disease.

Dysentery, Amebic↗

PubMed1978

Comparison of the results of some serological tests for bovine brucellosis.

A total of 1887 bovine sera positive to the Rose Bengal plate test were subjected to other serological tests for bovine brucellosis: the complement fixation test using warm fixation (CFTW),the serum agglutination test (SAT) and the radioimmunoassay (RIA). The SAT was generally much less sensitive than the CFTW. Many sera, however, gave positive reactions in the SAT but no reaction in the CFTW or the RIA. These SAT reactions were attributed to IgM antibody. Comparison between the results of the CFTW and the RIA led to the conclusion that 200 ng could be used as a minimum diagnostic reaction in the RIA.

Agglutination Tests↗

PubMed1989

Panuveitis with positive serological tests for syphilis and Lyme disease.

The Treponema pallidum hemagglutination test and the fluorescent treponemal antigen absorption test are commonly considered highly specific serologic tests for syphilis. We describe a patient with panuveitis and a positive serologic result for syphilis; however, in the absence of clinical findings, additional tests for Lyme disease (borreliosis) were positive as well, although by Western blot test the diagnosis was tentative. The clinical appearance of the panuveitis was similar to that of syphilitic uveitis accompanied by pseudopigmentosa-like areas in the anterior retina. In the presence of uveitis with an otherwise unexplained positive serologic result for syphilis, the differential diagnosis of Lyme disease should be considered.

Diagnosis, Differential↗

PubMed1985

Comparative sensitivity of different serological tests for detecting chlamydial antibodies in perihepatitis.

The value of several serological tests was assessed by studying sera from 30 women with clinical findings of perihepatitis and a high chlamydial antibody titre in the indirect immunofluorescence antibody test (IFAT). The other tests included the complement fixation test and enzyme immunoassays in which the antigen comprised either partially purified particles (EIA kit) or purified major outer membrane protein (MOMP EIA) of Chlamydia trachomatis L2 or lipopolysaccharide isolated from an Re mutant of Salmonella (Re LPS EIA). High IgG titres were noted in most (88-96%) of the patients by MOMP EIA and EIA kit, and in fewer patients (50%) by Re LPS EIA or complement fixation test. Seroconversion was found in 11-44% of the patients for IgG and in 28-36% for IgM; high IgG titre was thus the best diagnostic indicator for each test. The enzyme immunoassay tests have the advantage of being automated either with partially purified corpuscular or purified MOMP antigen and would allow a sensitive easy screening for chlamydial aetiology of women with pain of the right upper quadrant.

Antibodies, Bacterial↗

PubMed1994

The value of different serological tests in serotyping of Actinobacillus pleuropneumoniae strains.

Immune sera were raised in rabbits against 12 serotypes of Actinobacillus pleuropneumoniae biotype I in order to compare serological tests for simplicity and sensitivity in serotype determination. The serological tests included the tube agglutination test with and without 2-mercaptoethanol addition, the indirect haemagglutination test with and without 2-mercaptoethanol, the immunodiffusion test and the coagglutination test. All these tests proved suitable for serotype determination with the reference strains; however, cross-reactions of varying degree were observed in all of them. Owing to its simplicity, rapidity and specificity, the coagglutination test appears to be the most suitable for primary serotyping. A more definite answer to the question could be obtained by serotyping strains isolated from field cases.

Actinobacillus pleuropneumoniae↗

PubMed1999

Evaluation of the utility of serological tests in the diagnosis of candidemia.

BACKGROUND: It has been observed that the incidence and prevalence of candida infections in critically ill non-immunocompromised patients has increased. This study aims to evaluate the utility of the use of serological tests (double immunodiffusion and Cand-Tec Test) for the determination of candidemia. METHODS: A retrospective evaluation is made of 214 patients admitted to the Intensive Care Unit (ICU) of the Agostino Gemelli University Polyclinic during a period of 42 months. The double immunodiffusion technique was utilized for the determination of Candida antibodies. The Cand-Tec latex agglutination test was performed to evaluate the presence of Candida antigen. Four hundred and fifty-five antigen and antibody tests were performed. RESULTS: Thirty-six patients (16.8%) developed an invasive candidiasis. The sensitivity and specificity of antibody detection tests was 29 and 67 respectively; the positive predictive value was 15 and the negative predictive value was 82. The sensitivity and specificity of the antigen detection test ranged between 82 and 3 and between 8 and 98 respectively according to different cut-off titre; the positive predictive value was low (13-17%) and the negative predictive value decreased from 70 to 29. CONCLUSIONS: The utility of the use of serological tests in the diagnosis of candidemia is extremely limited. The gold standard for the determination of Candida sepsis remains the demonstration of candida in blood or in tissues.

Candidiasis↗

PubMed2004

Comparison of four serological tests for the diagnosis of Chagas disease in a Colombian endemic area.

The performance of 4 serological tests for the diagnosis of Chagas disease was evaluated in Santander, Colombia, a region still presenting active transmission. Serum samples from 638 individuals were submitted to an enzyme immunoassay test (EIA), using total lysate of a local Trypanosoma cruzi strain and 52.5% were positive (335/638). A subset of this group (94 positive individuals and 90 seronegatives) was randomly selected for further serological confirmation. Three additional tests were used--indirect immunofluorescence (IIF) and 2 distinct enzyme-linked immunosorbent assays using total lysate of the Y strain (EIA BM) and a mixture of 2 recombinant antigens (EIA RA). Seventy-nine patients were seropositive in all tests (84.0%-79/94). The number of positive sera with the IIF, EIA RA and EIA BM was 84/94 (89.4%), 80/94 (85.1%) and 79/94 (84.0%), respectively. In 15 out of the 94 EIA seropositive patients (16.0%), 10 individuals were negative in all 3 tests (10.6%-10/94). One was negative in the EIA BM and positive in the other two tests (1.1%-1/94) and 4 patients were positive, solely, in the IIF assay (4.3%-4/94). Relative to the 90 EIA negative individuals, 89 were confirmed in all other tests (98.9%-89/90). One individual, although seronegative in the IIF, was positive in both confirmatory EIA tests (1.1%-1/90). In addition, 120 blood specimens were submitted to PCR amplification. This group consisted of 79 confirmed seropositive cases, 16 individuals with discordant serological results and 25 validated seronegative individuals. The PCR was able to detect the presence of parasite DNA in 67 out of the 79 seropositive patients (84.8%), in 8 individuals with discordant serology (50.0%) and in only one seronegative individual (4.0%). The results pointed to the necessity for performing more than one serological test, preferentially with antigens from autochthonous strains, to achieve a reliable diagnosis of Chagas disease in Colombia.

Animals↗

PubMed1995

Comparison of serologic tests and bacteriologic culture for detection of brucellosis in swine from naturally infected herds.

OBJECTIVE: To compare results of 6 serologic tests with results of bacteriologic culture for Brucella suis in swine. DESIGN: Prospective study. ANIMALS: Two hundred twenty-one swine from 39 naturally infected herds. PROCEDURE: Blood samples and lymph nodes were collected at slaughter. Serologic tests conducted were the particle concentration fluorescence immunoassay, the automated complement fixation assay, the card test, the buffered acidified plate antigen assay, the standard tube test, and the rivanol test. Lymph nodes were plated on Farrell's medium and serum-enriched agar for bacteriologic culture. RESULTS: Sensitivities ranged from 57 (automated complement fixation assay) to 83% (standard tube test). Specificities ranged from 62 (standard tube test) to 95% (rivanol test). Brucella suis was isolated from 46 of the 221 (21%) pigs. For 8 of the 46 culture-positive pigs, results of all 6 tests were negative. CLINICAL IMPLICATIONS: Data illustrate the difficulty of eliminating brucellosis by means of a test-and-removal program and support the policy of slaughtering infected herds.

Animals↗

PubMedDate not supplied

Knowledge-based interpretation of serologic tests for hepatitis on the World Wide Web.

HEPAXPERT is a knowledge-based system that interprets the results of routine serologic tests for infection with hepatitis A and B viruses. The following tests are included: hepatitis A virus antibodies, IgM antibodies to the hepatitis A virus, hepatitis A virus in stool, hepatitis B surface antigen and antibodies, antibodies to hepatitis B core antigen, and hepatitis B envelope antigen and antibodies. HEPAXPERT/WWW, an implementation of HEPAXPERT-III for the World Wide Web, can be reached by URL http://www.med-expert.co.at/hepax. After selecting HEPAXPERT/WWW, serologic test results can be entered and will be transferred as an E-mail message for subsequent interpretation, which is done off-line with HEPAXPERT-III. The textual interpretation is sent back via E-mail. Each qualitative test for hepatitis A and B antibodies and antigens may produce one of four possible results: positive, negative, borderline, and not tested. To cover the resulting 64 (A) and 57,344 (B) combinations of findings, the knowledge base of HEPAXPERT/WWW contains 16 rules of hepatitis A and 131 rules for hepatitis B serology interpretation. This basic knowledge is structured such that all possible combinations of findings can be interpreted, and there is no overlap in the premises underlying the rules. The reports that the system automatically generates include the transferred results of the tests; a detailed analysis of the results, including virus exposure, immunity, stage of illness, prognosis, infectiousness, and vaccination recommendation; and, as an option, an identification, to distinguish the origin of the interpretation requests.

Austria↗

PubMed1999

Evaluation of a serologic test for the diagnosis of tuberculosis.

The ICT TB test, a new, simple, serologic diagnostic test for tuberculosis (TB), was performed on serum samples from individuals seen at an urban teaching hospital and a local health department clinic. The study population included cases of TB, disease with mycobacteria other than tuberculosis (MOTT), non-mycobacterial pulmonary disease, and healthy controls. In contrast to prior studies, we found the ICT TB test had little value in detection of new cases of TB (overall sensitivity was 20%). It had very low sensitivity (4%) in the first month of disease. The sensitivity improved in patients tested at least 3 months after clinical presentation, but still remained fairly low. The test was also positive in 30% cases of disease caused by MOTT demonstrating cross-reactivity. It was negative in all human immunodeficiency virus (HIV) positive cases of TB or MOTT. The overall specificity was 89%. At least part of the discrepancy between our results and those of previous investigators may be attributable to differences in the respective study populations, including incidence of HIV disease and duration of tuberculosis illness prior to testing.

Adult↗

PubMed1988

Are serological tests of value in diagnosing and monitoring response to treatment of syphilis in patients infected with human immunodeficiency virus?

To assess the value of serological tests in diagnosing and monitoring the response to treatment of syphilis in patients infected with the human immunodeficiency virus (HIV), case notes of eight homosexual men with a history of treated syphilis, positive reactions to serological tests for syphilis, and documented subsequent conversion to HIV seropositivity were studied. No change was noted in serological markers of syphilis after HIV infection. The case notes of one man with primary syphilis, four men with secondary syphilis, and three men with latent syphilis, of whom all were HIV seropositive, were also studied. In seven of these patients the serological responses to infection and after treatment were consistent with the experience of syphilis in HIV seronegative patients. In one man treated for secondary syphilis, and confirmed as HIV seropositive eight months after treatment, the rapid plasma reagin (RPR) test result continued to be positive at a high titre for up to 20 months after treatment.

Acquired Immunodeficiency Syndrome↗