PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Diagnostic Tests, Routine”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources
PubMed2025

Rapid pan-microbial metagenomics for pathogen detection and personalised therapy in the intensive care unit: a single-centre prospective observational study.

BACKGROUND: Most clinical metagenomic studies do not provide rapid results, detect pathogens from all microbial kingdoms, or measure clinical impacts. We aimed to evaluate the feasibility, performance, and clinical impacts of a rapid pan-microbial respiratory metagenomic service for patients admitted to intensive care units (ICUs). METHODS: This was a single-centre observational study of a rapid metagenomics service that tests respiratory samples from ICU patients at Guy's and St Thomas' hospitals, London, UK, between Dec 5, 2023, and April 12, 2024. Testing used a previously published pan-microbial metagenomics workflow, which simultaneously detects bacteria, fungi, and DNA and RNA viruses; provides same-day preliminary results after 2 h; and provides final results after 24 h. Patients were included if they were aged 18 years or older, admitted to the ICU, had confirmed respiratory failure requiring supplemental oxygen or advanced airway support, and had at least one of the following: (1) clinical suspicion of lower respiratory tract infection based on clinical, biochemical, or radiological findings, (2) sepsis of unknown origin, and (3) concern from an intensive care physician regarding inflammatory pathology. Patients with a suspected or confirmed containment level three organism were excluded. The outcome was performance characteristics of the metagenomic test compared with routine diagnostic testing, detection of additional pathogens by metagenomics, change in antimicrobial prescribing within 24 h of testing, and initiation of immunomodulation. FINDINGS: We processed 114 samples (1-5 per day) from 74 patients (39 [53%] female and 35 [47%] male). 107 (94%) of 114 samples passed quality control, of which 101 (94%) provided same-day preliminary results. Bacteria were detected in 45 (43%) of 104 tested specimens, fungal organisms in 17 (16%) of 104 tested specimens, and viruses in 28 (34%) of 83 tested specimens. Sensitivity in lower respiratory tract samples after 24 h was 97% (95% CI 87-100) for bacteria, 89% (65-99) for fungi, and 89% (71-98) for viruses, with only one false positive for bacteria. Metagenomics identified 42 pathogens not detected by other tests in 32 (30%) of 107 samples. Antimicrobial therapy was changed after metagenomic results from 30 (28%) of 107 samples: 22 (21%) were de-escalated and eight (7%) were escalated. Metagenomics contributed to the initiation of immunomodulation in 15 (20%) of 74 patients for a range of inflammatory conditions. Pathogens with clinical significance to local infection control or national public health were found in ten (14%) of 74 patients, including three invasive Group A streptococci, two parvovirus B19, and one each of HIV-1, measles virus, Mycobacterium tuberculosis, Neisseria meningitidis, and Mycoplasma pneumoniae. INTERPRETATION: Respiratory metagenomics for ICU patients showed good performance and turnaround time, and diverse clinical and public health benefits. This ability to inform both personalised patient therapy and infectious disease surveillance needs evaluation in multicentre studies. FUNDING: None.

Humans↗
PubMed1998

A quantitative HCV-PCR test for routine diagnostics.

The aim of this study was to develop a reliable and simple method for hepatitis C virus (HCV)-PCR using standard, automated laboratory equipment. HCV-RNA was extracted from serum and amplified in a single PCR with an internal standard. The PCR product was detected using fluoroimmunoassay. Quantification was based on external and internal standards. Linearity was observed over a wide range (10-10(7) geq). Mean inter and intra serial coefficients of variation were 35% and 23%, respectively. The limit of quantification was 1000 geq/ml based on intra and inter serial variations, while levels of 110 geq/ml were always detectable. Lower concentrations were intermittently positive. The ability to separate HCV-signals in healthy and infected persons was good, based on the distribution of HCV-signals from 353 random blood donors and 191 patient samples. To illustrate the applicability of the test, HCV-RNA quantification was performed in 11 patients during treatment with interferon alpha-2b. Ten of 11 patients showed a decline in HCV-RNA within the first few weeks of treatment. After four weeks most patients were still HCV-RNA positive but below the limit of quantification. The present method for quantification of HCV-RNA was shown to have sensitivity at the level of nested PCR techniques. Until now HCV-PCR has been complicated, time-consuming and costly, and therefore not suitable for routine diagnostics. The PCR method described here is easy to perform, fast and cost-effective.

Base Sequence↗
PubMed1996

[Maternal-fetal transmission of the acquired immunodeficiency virus. Authors' experience].

UNLABELLED: The determination of human immunodeficiency virus (HIV) status of the newborn remains a major diagnostic problem as a routine test, which detects antibodies to HIV, is of limited value in evaluating newborns. However, the risk of infection for a baby whose mother is an HIV carrier is not yet clear. OBJECTIVE: A prospective study to evaluate maternal transmission of HIV in our population. In order to provide a better estimate of the effect of some of the risk factors associated with HIV transmission we present a stratification of the transmission rate by these factors. STUDY DESIGN: Between January 1990 and December 1994 were examined a total of 10.949 pregnancies. To evaluate maternal HIV transmission to the fetus we considered a positive routine diagnostic test, which detects antibodies to HIV, of definite significance only at the age of 18 months or over. RESULTS: Our prospective study shows an overall transmission rate in our population of 31.25%. Maternal disease stage, as reflected by CD4+ cell count, prematurity, mode of delivery (episiotomy) was correlated with HIV transmission. CONCLUSIONS: Although some risk factors have been recognized, our understanding of the various modes of transmission is still limited. We conclude from our experience and previous studies that the risk of maternal to newborn transmission of HIV must be determined according to the specific characteristics of each parturient population.

Acquired Immunodeficiency Syndrome↗
PubMed1977

Evaluation of conventional diagnostic tests for detection of recurrent carcinoma of the cervix.

The use of routine diagnostic tests to evaluate patients periodically after treatment for carcinoma of the cervix has been reviewed. Of 169 patients treated at Brooke Army Medical Center for carcinoma of the cervix, 73 were evaluated after their treatment by a group of six diagnostic tests referred to collectively as an oncologic survey. The survey consisted of an intravenous pyelogram (IVP), chest roentgenogram, barium enema, cystoscopy, proctoscopy, and bone scan. Although 16 patients developed recurrent tumor, the oncologic survey detected only three recurrences that had not already been suspected by physical examination. Only the IVP and chest roentgenogram were of sufficient benefit to suggest their routine use for the detection of recurrent cancer. The other tests included in the oncologic survey were not beneficial when used routinely and should be reserved to evaluate patients otherwise suspected of recurrent cancer.

Barium Sulfate↗
PubMed1990

Minimal criteria for identification of Moraxella (Branhamella) catarrhalis.

A study was performed which aimed at testing the reliability of our routine diagnostic tests for identification of Moraxella (Branhamella) catarrhalis in clinical samples from the respiratory tract. A preliminary diagnosis of 122 isolates as Moraxella catarrhalis was obtained by using colony morphology and results of Gram stain and oxidase test as the sole diagnostic criteria. By using additional tests we could show that the preliminary diagnosis was incorrect for 21 isolates, which were classified as different Neisseria species. 20 of these were isolated from sputum samples. We propose that at least a test for DNA hydrolysis should be included in the routine procedure for identification of Moraxella catarrhalis in sputum.

Deoxyribonucleases↗
PubMed2000

Diagnostic testing for HIV type 1 RNA in seronegative blood.

We studied the feasibility of routine diagnostic testing for HIV-1 RNA at a publicly funded testing site. HIV-1 RNA was determined with a commercial polymerase chain reaction assay in pooled seronegative blood samples submitted for HIV testing to a public health laboratory. Recovery of HIV-1 RNA from the samples was estimated as at least 8% of viral RNA that was found in freshly prepared plasma. We estimated that screening for HIV-1 RNA in serum pools would result in the identification of blood specimens from more than 95% of acutely infected patients. The frequency of HIV-1 RNA in seronegative blood samples was estimated to be between 19 and 601 per 10(6) submitted specimens. The ratio of HIV-1 RNA positive and seronegative samples to specimens with HIV-1 antibodies confirmed by Western blot was estimated to be between 0.2% and 6.6%. The reagent costs for identifying 1 HIV-infected blood sample were 10-fold higher with the commercially available HIV-1 RNA assay compared with the HIV antibody enzyme-linked immunosorbent assay. Diagnostic testing for HIV-1 RNA may be warranted in high-risk populations since acutely infected patients may benefit most from anti-retroviral therapy and are thought to contribute disproportionately to the HIV epidemic.

Blotting, Western↗
PubMed1979

One hundred digitalis blood levels. A utilization review.

One hundred consecutive digitalis serum level determination requests and results were analyzed to evaluate the rational of ordering the test and utilizing the results at his hospital. Sixty-six percent of the reasons given for ordering the test were categorized as "acceptable". As many as 25% of physicians requesting the test considered digitalis levels as "routine" diagnostic tests in a patient taking these drugs. There were 12 levels within the potentially toxic range, 19 below the usual therapeutic range. The physicians modified their therapeutic management in 38 patients as a result of their knowledge of the digitalis level in blood. It is concluded that digitalis level determinations at this hospital are reasonably well utilized and that knowledge of the digitalis levels improve the accuracy of digitalis utilization in at least one third of the patients in whom this test is done.

Adult↗
PubMed1998

Evaluation of the suitability of a commercial bovine viral diarrhoea virus antigen capture ELISA for diagnostic testing.

The suitability of a commercial bovine viral diarrhoea virus (BVDV) antigen capture enzyme-linked immunosorbent assay (ELISA) for routine diagnostic testing of bovine serum samples was evaluated by comparing the ELISA results of 214 sera with those obtained after two passages in roller tube cultures of fetal bovine lung cells and immunofluorescent staining using fluorescein isothiocyanate-conjugated hyperimmune BVDV anti-serum. In addition, 208 of these samples were tested by virus isolation in a microtitre system followed by indirect immunoperoxidase staining using a pool of two non-competing pestivirus specific monoclonal antibodies. The sensitivity of the ELISA compared with virus isolation followed by immunofluorescent and immunoperoxidase staining was 47.8 and 45.8%, respectively. The corresponding figures of specificity and overall correlation were 95.3 and 95.1%, and 90.2 and 89.4%. Twenty-two of 24 pestivirus isolates from the positive blood samples were typed as BVDV-like by monoclonal antibodies, indicating that the poor sensitivity of the ELISA was not due to the presence of atypical pestiviruses in the test sample. These results suggest that this ELISA is not suitable for testing blood samples for BVDV in a diagnostic laboratory.

Animals↗
PubMed2002

Impact of HIV vaccination on laboratory diagnosis: case reports.

BACKGROUND: It has not been clearly demonstrated whether HIV vaccination can complicate routine HIV testing. In this report, we describe the laboratory data of two prisoners who received rgp120 vaccine in a phase III trial underway in Thailand. These data indicate that previous vaccination may complicate the interpretation of screening HIV diagnostic tests. CASE PRESENTATION: The participants were identified from a cohort study on "Health factors related to HIV-1 and other viral infections among incarcerated people" that was approved by The Ethical Committee for Research in Human Subjects, Ministry of Public Health, Thailand. HIV diagnosis was definitively established with serial specimens using multi-screening tests, Western blot and diagnostic PCR.Anti-HIV screening tests consistently exhibited either weakly reactive or inconclusive results. The band patterns of the Western blot analysis corresponded to those found in individuals who received the rgp120 vaccination. Definite results were established using diagnostic PCR, which exhibited consistently negative results with follow-up specimens. Such problems in HIV testing are not easily resolved in the routine clinical setting in Thailand. CONCLUSIONS: These data demonstrate that HIV-1 vaccination interferes with routine diagnostic tests. Similar cases will not be uncommon in Thailand, where 2,545 people have already participated in a phase III trial.

AIDS Serodiagnosis↗
PubMed2002

Field evaluation of a rapid immunochromatographic test for tuberculosis.

Rapid diagnostic tests for tuberculosis (TB) are needed to facilitate early treatment of TB and prevention of Mycobacterium tuberculosis transmission. The ICT Tuberculosis test is a rapid, card-based immunochromatographic test for detection of antibodies directed against M. tuberculosis antigens. The objective of the study was to evaluate the performance of the ICT Tuberculosis test for the diagnosis of active pulmonary TB (PTB) with whole blood, plasma, and serum from patients suspected of having PTB and from asymptomatic controls in a setting with a high prevalence of PTB. Seventy patients suspected of having PTB (and who were later confirmed to have or not to have PTB by use of M. tuberculosis culture as the "gold standard") and 42 controls were studied. Twenty-one controls were neither vaccinated with Mycobacterium bovis bacillus Calmette-Guérin (BCG) nor tuberculin skin test (TST) positive (group A controls), and 21 controls were TST positive and/or had previously been vaccinated with BCG (group B controls). Study subjects were drawn from one hospital and one primary health care unit in Rio de Janeiro City, Brazil. One version of the test (ICT-1) was evaluated by using whole blood, plasma, and serum samples. Sera obtained for this study were frozen and later tested with a manufacturer-modified version of the test (ICT-2). Among the patients suspected of having PTB, the sensitivities of the ICT-1 with whole blood, serum, and plasma were 83, 65, and 70%, respectively, and the specificities were 46, 67, and 56%, respectively. Among the group A controls, the specificities of ICT-1 with the three specimen types were 95, 100, and 95%, respectively. Among the group B controls, the specificities of ICT-1 with the three specimen types were 71, 86, and 86%, respectively. Among the patients suspected of having PTB, the sensitivity of ICT-2 was 70% and the specificity was 65%. Among the group A controls, the specificity of ICT-2 was 95%, and among the group B controls, the specificity of ICT-2 was 81%. With a 29% observed prevalence of PTB among patients suspected of having PTB, the positive predictive values of the ICT tests ranged from 39 to 50% and the negative predictive values ranged from 82 to 87%. The ICT Tuberculosis tests were not sufficiently predictive to warrant their widespread use as routine diagnostic tests for PTB in this setting. However, further evaluation of these tests in specific epidemiologic settings may be warranted.

Adult↗
PubMed1987

The diagnostic properties of laboratory tests for rabies.

We have prospectively followed 915 victims bitten by 664 dogs between January 1984 and December 1985 to assess death and severe neurological disability. These dogs were brought either by the owner or bite victims to Ta Pra Diagnostic Centre for detection of rabies. Each patient was followed every three months by mail for at least one year after the bite. In addition, intensive follow-up in the community was undertaken on 235 patients who failed to respond to mail follow-up, all 23 who reported events as well as 523 of the 720 mail-responders. Hospital records were examined for all patients requiring treatment. All patients with non-fatal events were also examined at the university hospital. Blind independent comparison of the three diagnostic tests (Sellers stain, fluorescent antibody test and mouse inoculation test) for the presence or absence of rabies in animal brains were performed to assess the accuracy of local routine diagnostic test methods. In case of disagreement between test methods, the result on mouse inoculation was considered definitive for the presence or absence of rabies. Test results were mailed to all victims. Seven hundred and twenty out of 955 subjects responded to the mail follow-up giving a response rate of 75.4%. Intensive follow-ups were successful in all subjects who responded. Of 235 subjects who did not respond to the mail follow-up, only 195 (83%) were located. The remaining 40 bite victims who did not respond to mail follow-up and could not be located were all bitten by animals who did not have rabies.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2004

Potential serological use of a recombinant protein that is a replica of a Mycobacterium tuberculosis protein found in the urine of infected mice.

The recent availability of numerous well-characterized Mycobacterium tuberculosis recombinant proteins has revived interest in the serological diagnosis of tuberculosis. Several promising results have been reported, particularly when more than one antigen is used in the test. However, thus far these antigens have not been used in routine diagnostic tests because they lack sufficient sensitivity. In addition, with the exception of one antigen, most recombinant M. tuberculosis proteins do not identify the majority of tuberculosis patients coinfected with human immunodeficiency virus (HIV). Here, we report a newer M. tuberculosis protein that is a promising candidate for increasing the sensitivity of the serological tests, in particular for patients coinfected with HIV. The protein was found in the urine of mice during the early stages of infection with M. tuberculosis (10 to 14 days), thus suggesting that the antigen is abundantly released during the in vivo growth of the mycobacterium. Reverse genetics was used to produce the recombinant protein, which we named U1 (for urine protein 1). Using a conventional enzyme-linked immunosorbent assay (ELISA), antibody to U1 could be detected in 60% of patients with pulmonary tuberculosis with no signs of coinfection with HIV (n = 83). Conversely, anti-U1 antibody was detected in 87% of the sera from tuberculosis patients coinfected with HIV (n = 47). Out of 12 HIV-infected nontuberculosis patients' sera, 9 did not react with U1 and three sera gave borderline ELISA signals (signal/cutoff of < or =1.75). These results suggest that the high efficiency of U1 in identifying tuberculosis patients coinfected with HIV may be related to abundant release of this protein during the initial phase of the HIV coinfection. The immediate availability of the antigen at a time point in which the patient's immune system is still competent would lead to a secondary immune response to U1 that persists for months in the patient's serum.

Animals↗
PubMed2006

Antiphospholipid antibody testing: which are most useful for diagnosis?

Laboratory diagnosis of APS relies on the demonstration of a positive test for aPL. In clinical practice, the gold standard tests are those that detect beta2GPI-dependent aCL or LA. The question on the use of anti-beta2GPI asa routine diagnostic test remains unanswered, and testing for these antibodies should be only performed in very selected cases and not as an alternative to aCL or LA testing. Clinical utility and standardization are still lacking for other aPL specificities; therefore, their application as routine diagnostic tools is not recommended.

Antibodies, Anticardiolipin↗