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[Evaluation of a panel of commercial kits for the detection of serum HIV-specific antibodies, and choice of alternative strategies for the serological diagnosis in Libreville (Gabon)].

Nine commercially available kits for the screening of serum antibodies to the human immunodeficiency virus (HIV) were evaluated with a panel of 170 serum samples from adults in Gabon. The reference procedures showed that 96 samples had no antibodies, while 74 produced antibodies to HIV-1 (n=72) or HIV-2 (n=2). The sensitivity for 2 kits was less than 99% and the specificity of 3 less than 95%. Based on the panel of Gabonese serum samples, 4 of the 9 kits met the World Health Organization (WHO) acceptability criteria: sensitivity greater than 99% and specificity greater than 95%. Three kits available in Gabon that met these criteria were finally retained: Determine HIV-1/2, Genscreen Plus HIV Ag-Ab, and Immunocomb II HIV1&2 BiSpot. Of 18 configurations of alternative diagnosis strategies for HIV infection with these three kits, some WHO strategy II configurations (2 sequential assays) and all the WHO strategy III configurations (3 sequential assays) provided the maximum accuracy in diagnosing HIV infection in Gabon (sensitivity, specificity, positive predictive value, negative predictive value of 100%). The configuration using the Determine HIV-1/2 kit as first screening assay, followed by Genscreen Plus HIV Ag-Ab as a confirmatory assay, and finally, Immunocomb II HIV1&2 BiSpot as the third assay to discriminate samples discordant with the two first assays, was best, with high accuracy and less expense. The configuration of the two sequential rapid assays, Immunocomb II HIV1&2 BiSpot followed by Determine HIV-1/2, was also very accurate and reliable, as well as easiest to carry out (no need for ELISA technology), but it was twice as expensive as the first configuration with three sequential kits. In conclusion, when the laboratory facilities are available, the sequential diagnostic strategy of two rapid assays and a combined ELISA assay constitutes the best configuration, in terms of both accuracy and cost. When laboratory facilities are unavailable, sequential use of two rapid assays constitutes a convenient and accurate configuration, but is much more expensive.

AIDS Serodiagnosis↗

PubMed1990

Concentrations of free thyroxin and albumin in serum in severe nonthyroidal illness: assay artefacts and physiological influences.

Free thyroxin (FT4) estimates by two immunoassays were compared with the concentrations of albumin in serum of apparently euthyroid subjects who either were (n = 99) or were not (n = 327) suffering from severe nonthyroidal illness (sNTI). In neither group was FT4 significantly correlated with albumin (P greater than 0.05), according to a "labeled antibody" radioassay (Amerlex-MAB). On amalgamating both groups, correlation with albumin was positive and significant (P less than 0.001). In the group with sNTI, both FT4 and albumin concentrations were decreased (mean FT4 to 77% and mean albumin to 61% of the respective reference means). For an analog radioimmunoassay (Amerlex-M), FT4 in all groups was significantly (P less than 0.001) correlated with albumin. Correlation coefficients were greater than with Amerlex-MAB for both sNTI and euthyroid groups, as well as for the joint panel. Mean FT4 in sNTI was only 44% of the reference mean. Lower radio-tracer "analog" values in sNTI are exaggerated by additional technical artefacts resulting from tracer binding to albumin.

Adolescent↗

PubMed1986

Evaluation of a proprietary broth medium for microdilution susceptibility testing of nutritionally fastidious bacteria.

For microdilution susceptibility tests with nutritionally fastidious microorganisms, a new clear broth medium developed at Micro-Media Systems, Inc., Potomac, Md., was evaluated in a three-laboratory collaborative study. Replicate tests were performed with 80 isolates (51 Streptococcus spp., 27 Haemophilus influenzae isolates, and 2 Neisseria meningitidis isolates) against 15 antimicrobial agents. In standard 100-microliters volumes, results of tests in the new broth medium were comparable to those in the reference medium (Mueller-Hinton broth with 2 to 3% lysed horse blood), but MICs were somewhat easier to read in the new broth medium. Results of similar tests in smaller panels, containing 40 microliters in each well, were less satisfactory; i.e., growth failures and poorly defined endpoints were more commonly encountered. With drugs other than erythromycin or clindamycin, the 40-microliters panels provided MICs which compared favorably with those obtained by standard reference methods.

Anti-Bacterial Agents↗

PubMed1994

High-quality mammography: information for referring providers.

This Quick Reference Guide for Clinicians contains highlights from Quality Determinants of Mammography, Clinical Practice Guideline No. 13 of interest to health care providers who refer women for mammography. The Quality Determinants of Mammography Guideline Panel, a private-sector panel of health care professionals and consumers, developed the Guideline after comprehensively analyzing the research literature and current scientific knowledge concerning elements necessary for high-quality mammography. Specific recommendations are made in the following areas: Components of complete breast cancer screening. Responsibilities of women, mammography facilities, and referring providers as to screening and followup care. Communication of results. Limitations of mammography. Certification of mammography facilities.

Adult↗

PubMed1994

High-quality mammography: information for referring providers. Agency for Health Care Policy and Research.

This Quick Reference Guide for Clinicians contains highlights from Quality Determinants of Mammography, Clinical Practice Guideline No. 13 of interest to health care providers who refer women for mammography. The Quality Determinants of Mammography Guideline Panel, a private-sector panel of health care professionals and consumers, developed the Guideline after comprehensively analyzing the research literature and current scientific knowledge concerning elements necessary for high-quality mammography. Specific recommendations are made in the following areas: Components of complete breast cancer screening; Responsibilities of women, mammography facilities,and referring providers as to screening and followup care; Communication of results; Limitations of mammography; Certification of mammography facilities.

Adult↗

PubMed1994

Impairment of color vision among workers exposed to low concentrations of styrene.

A field study was conducted among 21 male workers exposed to styrene of concentration below 30 ppm in a fiber-reinforced plastic boat manufacturing plant. Twenty-one male workers with similar age groupings, years of education, and social and occupational state served as referents. The mean end-of-shift urinary mandelic acid (MA) and phenylglycoxylic acid (PGA) for the exposed workers were 84 mg/g creatinine and 66 mg/g creatinine, respectively. The Lanthony D-15 Hue Desaturated Panel was used to evaluate color discrimination of the exposed and referent groups. The results of the test were expressed as total color difference score (TCDS). The exposed workers' mean TCDS (a higher score denotes poorer color discrimination ability) was significantly (p < 0.0006) higher than the referents'. Neurobehavioral tests were also conducted, using the World Health Organization's Neurobehavioral Core Test Battery (NCTB). All the results of the NCTB were poorer for the exposed than for the referents. However, significant differences were observed only for Digit Span, Digit Symbol, and Benton Visual Retention tests. These results suggest that low exposure to styrene could affect some psychometric performance and may impair color vision.

Adult↗

PubMed2002

Rapid detection of enterovirus infection by automated RNA extraction and real-time fluorescence PCR.

BACKGROUND: Molecular detection has been shown to be superior to tissue culture for the detection of enteroviruses in cerebrospinal fluid (CSF) specimens. OBJECTIVES: In this study, a qualitative molecular assay based on automated RNA extraction with the MagNA Pure LC and real-time PCR on the LightCycler (LC) instrument was evaluated and compared with an in-house molecular assay. STUDY DESIGN: A total of 109 CSF specimens were investigated for the comparative study. The detection limit of the new molecular assay was determined with 10-fold dilutions of two enterovirus strains and with the Third European Union Concerted Action Enterovirus Proficiency Panel. RESULTS: With the enterovirus strains, the detection limit of the LC assay was found to be 0.1 TCID(50) (50% tissue culture infective dose). When samples of the Third European Union Concerted Action Enterovirus Proficiency Panel were tested, both molecular assays gave identical results to the expected results, which were based upon the results of three reference laboratories using a total of four different molecular methods before distribution of the panel. When clinical specimens were tested, there was a correlation between the LC assay and the in-house assay in 105 of 109 cerebrospinal fluids. CONCLUSIONS: The new molecular assay allows rapid detection of enterovirus RNA in CSF. It was found to be labor saving and showed sufficient sensitivity.

Adult↗

PubMed2004

Evaluation of tests for antibodies against bovine herpesvirus 1 performed in national reference laboratories in Europe.

Sets of serum and milk samples were collected from various countries and prepared, lyophilised and distributed by 1 laboratory to 12 reference laboratories in Europe. The serum sets contained the three European bovine herpesvirus 1 (BHV1) reference serum samples (EU1, EU2 and EU3), serum samples from naturally and experimentally BHV1-infected cattle, from vaccinated, and vaccinated-challenged cattle, from uninfected cattle, and a series of serum dilutions. In addition, sets of milk samples were distributed. The samples were tested for antibodies against BHV1 in virus neutralisation tests, in gB-specific ELISAs, in indirect ELISAs and in gE-specific ELISAs. It was found that the virus neutralisation test and the gB-specific ELISAs were most sensitive for the detection of antibodies in serum, whereas for assaying milk samples the indirect ELISAs were the tests of choice. The results show that the quality of most laboratories appeared to be adequate, but that one laboratory performed considerably below an acceptable level of quality. Four samples from the panel have been proposed that might be selected as reference sera in addition to the three European reference samples.

Animals↗

PubMed2007

The use of local isolates in Western blots improves serological diagnosis of Lyme disease in Scotland.

Nine Scottish Borrelia burgdorferi isolates were investigated in IgG Western blot tests. Sera previously found to be positive and negative when tested by routine Western blots prepared from reference strain B. burgdorferi sensu stricto antigen had different outcomes with these isolates. Two isolates, E5 (Borrelia afzelii) and G4 (B. burgdorferi sensu stricto) performed well, reproducing Western blot-positive results in 90 and 95% of tests, respectively. When antigens from both isolates were incorporated into a single IgG Western blot, the results of a panel of sera were improved when compared to the routine reference strain IgG Western blot. All of the sera positive by the routine Western blot remained positive using the Scottish isolate antigen mix. Twenty-three of the 25 negative sera remained negative and two produced an equivocal result. Of the 15 samples that tested IgG Western blot equivocal with the B. burgdorferi sensu stricto reference strain, 11 (73%) became weak or strong positive when tested with the B. afzelii/B. burgdorferi sensu stricto antigen mix (chi(2)=14.35, Yates' correction, P<0.001). In seven of these, a clinical picture of Lyme disease was consistent with the new results. The use of Scottish strains of B. afzelii and B. burgdorferi sensu stricto to provide antigen for the IgG Western blot improves the diagnosis of Lyme disease for patients in Scotland.

Antibodies, Bacterial↗

PubMed2006

American Society of Clinical Oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant setting.

PURPOSE: To update the 1999 American Society of Clinical Oncology (ASCO) guideline on breast cancer follow-up and management in the adjuvant setting. METHODS: An ASCO Expert Panel reviewed pertinent information from the literature through March 2006. More weight was given to studies that tested a hypothesis directly relating testing to one of the primary outcomes in a randomized design. RESULTS: The evidence supports regular history, physical examination, and mammography as the cornerstone of appropriate breast cancer follow-up. All patients should have a careful history and physical examination performed by a physician experienced in the surveillance of cancer patients and in breast examination. Examinations should be performed every 3 to 6 months for the first 3 years, every 6 to 12 months for years 4 and 5, and annually thereafter. For those who have undergone breast-conserving surgery, a post-treatment mammogram should be obtained 1 year after the initial mammogram and at least 6 months after completion of radiation therapy. Thereafter, unless otherwise indicated, a yearly mammographic evaluation should be performed. Patients at high risk for familial breast cancer syndromes should be referred for genetic counseling. The use of CBCs, chemistry panels, bone scans, chest radiographs, liver ultrasounds, computed tomography scans, [18F]fluorodeoxyglucose-positron emission tomography scanning, magnetic resonance imaging, or tumor markers (carcinoembryonic antigen, CA 15-3, and CA 27.29) is not recommended for routine breast cancer follow-up in an otherwise asymptomatic patient with no specific findings on clinical examination. CONCLUSION: Careful history taking, physical examination, and regular mammography are recommended for appropriate detection of breast cancer recurrence.

Breast Neoplasms↗

PubMed2005

Analysis of antigenic profiles of inactivated poliovirus vaccine and vaccine-derived polioviruses by block-ELISA method.

A new block-ELISA test for quantitative evaluation of relative reactivity of antigenic sites was developed and used to reveal the detailed epitope structure of inactivated poliovirus vaccines (IPV) and live poliovirus strains. Poliovirus was captured on ELISA plates coated with rabbit anti-poliovirus IgG and blocked by monoclonal antibodies (Mabs) specific to individual epitopes before the remaining reactive antigenic sites were quantified by polyclonal anti-poliovirus IgG conjugate. The decrease of conjugate binding by the pre-treatment with a Mab reflects its contribution to the overall reactivity of poliovirus antigen. The level of block activity of Mabs for a given antigen can be expressed as a percent of reduction of antigenic reactivity as determined by ELISA test. It can be normalized by expressing this value as a ratio to the block activity of a reference sample. The data on the blocking-activity of a panel of monoclonal antibodies specific to different antigenic sites represents the epitope composition (antigenic profile) of a sample. Quantitative differences in epitope composition were determined for nine samples of inactivated poliovirus vaccine (IPV) and compared with the International Reference Reagent. This method could be used for monitoring consistency of IPV production, comparison of vaccines made by different manufacturers, and for the analysis of antigenically modified strains of attenuated poliovirus. Antigenic structures of two isolates of type 1 vaccine-derived poliovirus (VDPV) were compared with the structures of parental Sabin 1 and wild-type Mahoney strains using 17 monoclonal antibodies and revealed significant differences, suggesting that the method can be used for screening of field isolates and rapid identification of antigenically divergent VDPV strains.

Animals↗

PubMed1998

Accuracy of death certificates for coding coronary heart disease as the cause of death.

BACKGROUND: Death certificates are widely used in epidemiologic and clinical investigations and for national statistics. OBJECTIVE: To examine the accuracy of death certificates for coding coronary heart disease as the underlying cause of death. DESIGN: Community-based inception cohort followed since 1948. SETTING: Framingham, Massachusetts. PATIENTS: 2683 deceased Framingham Heart Study participants. MEASUREMENTS: Sensitivity, specificity, and predictive values of the death certificate. The reference standard was cause of death adjudicated by a panel of three physicians. RESULTS: Among 2683 decedents, the death certificate coded coronary heart disease as the underlying cause of death for 942; the physician panel assigned coronary heart disease for 758. The death certificate had a sensitivity of 83.8% (95% CI, 81.1 % to 86.4%), positive predictive value of 67.4% (CI, 64.4% to 70.4%), specificity of 84.1% (CI, 82.4% to 85.7%), and negative predictive value of 92.9% (CI, 91.7% to 94.1%) for coronary heart disease. The death certificate assigned coronary heart disease in 51.2% of 242 deaths (9.0% of total deaths) for which the physician panel could not determine a cause. Compared with the physician panel, the death certificate attributed 24.3% more deaths to coronary heart disease overall and more than twice as many deaths to coronary heart disease in decedents who were at least 85 years of age. When deaths that were assigned unknown cause by the physician panel were excluded, the death certificate still assigned more deaths to coronary heart disease (7.9% overall and 43.1% in the oldest age group). CONCLUSIONS: Coronary heart disease may be overrepresented as a cause of death on death certificates. National mortality statistics, which are based on death certificate data, may overestimate the frequency of coronary heart disease by 7.9% to 24.3% overall and by as much as two-fold in older persons.

Adult↗

PubMed1997

Quality assessment by expert opinion in melanoma pathology: experience of the pathology panel of the Dutch Melanoma Working Party.

Some cutaneous melanocytic lesions are notoriously difficult to diagnose by histopathology. For that reason, the Pathology Panel of the Dutch Melanoma Working Party was instituted and is regularly approached to provide an expert opinion on problem cases. In order to identify the most common diagnostic problems, 1069 consecutive referral cases of submitted lesions (1992 to 1994 inclusive) were analysed. About 60 per cent of the requests came from small laboratories, with up to three consultant pathologists. Two-thirds of the lesions reviewed concerned women and nearly 50 per cent of the patients were 30 years of age or younger. In 8 per cent of the cases, the referring pathologists felt unable to make a confident diagnosis; in 14 per cent, melanoma was suspected; and in 12 per cent, a differential diagnosis only had been formulated. The panel felt able to provide an unequivocal diagnosis in 93 per cent of the requests. Of the 158 lesions classified as 'invasive melanoma' by the referring pathologists, 22 were considered to be benign by the panel. Conversely, 108 invasive melanomas (panel diagnosis) had originally been considered as benign lesions, dysplastic naevi or melanoma in situ. These high numbers of discordancies reflect the intrinsic difficulty of the differential diagnoses in this selected material submitted to the panel. Diagnostic difficulties were most often encountered with Spitz naevi and dysplastic naevi. Although the rate of overdiagnosis and underdiagnosis is quite high, in the majority of cases the diagnosis of the referring pathologist matched the diagnosis of the panel. This may reflect a proper awareness of difficult melanocytic lesions in pathology practice. The activities of the Pathology Panel of the Dutch Melanoma Working Party contribute to the improvement of the quality of diagnosis in cutaneous melanocytic lesions, as they increase the number of unequivocal diagnoses and reduce the number of incorrect diagnoses. On the basis of the systematic comparison of the diagnosis by the referring pathologist and the panel, postgraduate teaching and quality control can be more focused on specific diagnostic problems.

Adolescent↗

PubMed1997

Antigenic lipopolysaccharide components of Legionella pneumophila recognized by monoclonal antibodies: possibilities and limitations for division of the species into serogroups.

Legionella pneumophila accounts for the majority of cases of Legionnaires' disease. By using rabbit antisera, the species has been divided into 14 numbered and 1 unnumbered serogroups. To recognize the antigenic diversity of the lipopolysaccharide (LPS) responsible for this classification, the Dresden Legionella LPS MAb panel, containing 98 monoclonal antibodies (MAbs), was created. Each serogroup reference strain possesses at least one specific epitope not found on any other reference strain and therefore designated the serogroup-specific epitope. When the appropriate MAbs were used for serotyping of 1,064 human and environmental isolates, 1,045 (98%) could be placed into the known serogroups. In most cases (97%), this was in agreement with the polyclonal typing. Of the 29 isolates that showed strong cross-reactivities with the rabbit antiserum panel, 11 could be typed easily by MAbs; for the remaining 18, however, only serogroup-cross-reactive epitopes could be determined. Below the serogroup level, monoclonal subtypes were found for 11 serogroups. Altogether, the Dresden Legionella LPS MAb panel was able to divide the 1,064 isolates tested into 64 phenons, indicating its usefulness for both serogrouping and subgrouping of L. pneumophila strains. In order to compare the identities of patient and environmental isolates, testing their reactivity with MAbs should be the first step, especially if large numbers of colonies are to be typed. Only in cases of identical patterns are the more time consuming and expensive genetic fingerprints necessary. Moreover, the MAbs can also be used for specific antigen detection in respiratory specimens on the serogroup or subgroup level.

Animals↗

PubMed2000

Calibration of HCV working reagents for NAT assays against the HCV international standard. The Collaborative Study Group.

BACKGROUND AND OBJECTIVES: Five HCV RNA reference reagents, the Paul Ehrlich Institut (PEI) reference 75, the National Institute for Biological Standards and Control (NIBSC) reagent 96/586, the Central Laboratory of the Netherlands Red Cross Blood Transfusion Service (CLB) Pelispy HCV RNA run control S2001, the Istituto Superiore di Sanità (ISS) reagent 0498 and the CBER panel member No. 1, were calibrated against the WHO International Standard, 96/790. MATERIALS AND METHODS: The reference materials were calibrated in a collaborative study organised by NIBSC. Nineteen laboratories, using a range of qualitative and quantitative assays returned results. RESULTS: The concentrations of the reagents were: 25,000 IU/ml for the PEI material, 710 IU/ml for the NIBSC material 96/586, 1,000 IU/ml for the CLB material, 1,700 IU/ml for the ISS material 0498 and 250 IU/ml for the CBER panel member No. 1. CONCLUSIONS: The calibration of these five reference reagents for HCV RNA nucleic acid amplification technology (NAT) assays enables them to be used for standardisation and validation of assays. Such calibrants are essential for meeting the requirements of the European Medicinal Evaluation Agency (EMEA) for the testing of plasma pools and donations for HCV RNA for the release of blood products and the PEI requirements for the release testing of erythrocyte and thrombocyte concentrates.

Calibration↗

PubMed1999

Performance of broiler chicks fed on diets containing urea ammoniated neem (Azadirachta indica) kernel cake.

1. The performance, nutrient utilisation, blood profile, carcase composition, gross pathology and sensory evaluation of meat from broiler chicks fed from 3 to 42 d on diets containing urea ammoniated neem (Azadirachta indica, A.juss) kernel cake (NKC) as a protein supplement to replace peanut meal (PNM), were evaluated. NKC was ammoniated with urea at 15 (UANKC 1) or 25 g (UANKC 2)/kg and incorporated into the test diets to replace either half (134.5 g/kg (L-UANKC 1) and 127.5 g/kg (L-UANKC 2), respectively) or all (269, g/kg (H-UANKC 1) and 255.0 g/kg (H-UANKC 2), respectively) of the nitrogen provided by the PNM. 2. The growth, food intake and efficiency of nutrient utilisation of the birds were comparable between the reference and L-UANKC 1 and 2 diets but were depressed on the other UANKC diets. 3. The retention of dry matter (DM), crude fibre (CF), nitrogen-free extract, total carbohydrate, gross energy, acid detergent fibre, calcium and phosphorus were similar among groups, except lower DM and higher CF and phosphorus retentions were noted in chicks fed on the H-UANKC 1, H-UANKC 2 and L-UANKC 2 diets. All the chicks were in positive nitrogen balance and percentage nitrogen retention did not differ between the reference and test diets. 4. Haemoglobin, total erythrocyte count and aspartate amino transferase activity were unaffected by diet, but total leucocyte count was higher in chicks fed on the H-UANKC 1 and 2 diets and alanine amino transferase activities were lower in chicks fed on the test diets. Blood urea increased as the amount of urea in the diets increased. 5. Most of the physico-chemical carcase characteristics from birds fed on the L-UANKC 2 were comparable to those from birds fed on the reference diet. No bitter taste was noticed in cooked meat from any diet by the sensory panel. 6. Incorporation of L-UANKC 2 was economical and responses were comparable to those observed on the reference diet. 7. It was concluded that NKC detoxified with 25 g urea/kg can economically and successfully replace half the nitrogen of PNM in broiler diets thereby mitigating the chronic shortage of costly oil cakes in developing countries.

Ammonia↗

PubMed2002

Appropriateness of coronary revascularization for patients with chronic stable angina or following an acute myocardial infarction: multinational versus Dutch criteria.

OBJECTIVE: We convened a multinational panel to develop appropriateness criteria for percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass graft (CABG). To assess the applicability of these criteria, we applied them to patients referred for coronary revascularization. Finally, to understand how multinational criteria may differ from criteria developed by a panel of physicians from one country, we compared the appropriateness ratings using the multinational panel's criteria and those made using similar criteria previously developed by a panel of Dutch physicians. METHODS: We conducted a prospective survey and review of the medical records of 2363 consecutive patients presenting with chronic stable angina or following a myocardial infarction who were referred for PTCA (n=1137) or CABG (n= 1226) at ten Dutch hospitals performing coronary revascularization. Appropriateness was measured using two sets of criteria developed by: (1) a Dutch panel of cardiologists and cardiothoracic surgeons in 1991; and (2) a similarly composed European panel in 1998. RESULTS: More PTCA referrals were rated inappropriate by Dutch criteria compared with multinational criteria among both patients with chronic stable angina (34.8 versus 6.1%; P< 0.001) and those with a recent myocardial infarction (28.1 versus 0.9%; P< 0.001). Among those patients referred for bypass surgery, the Dutch criteria judged a greater proportion of cases inappropriate than multinational criteria did for patients with chronic stable angina (3.7 versus 1.5%, P< 0.001). The proportion of cases rated inappropriate for bypass surgery among patients following a myocardial infarction was similar between the two panels (3.9 versus 2.4%, respectively; P=0.40). After reclassifying the data for two of the clinical factors used in the appropriateness criteria (lesion morphology and intensity of medical therapy) based on evidence that appeared in the literature after the Dutch panel met, we found no significant differences between the Dutch and multinational panels' appropriateness ratings. CONCLUSIONS: While fewer cases were judged inappropriate using the multinational criteria compared with the Dutch criteria, the differences in ratings were related primarily to the clinical factors used by each panel. These findings support the review of appropriateness criteria, and other forms of clinical guidelines, to ensure that they are current with the clinical evidence before using them to assess clinical care. Developing such criteria using a multinational panel, in contrast to multiple single country panels, would be a more efficient use of resources.

Adult↗

PubMed1994

Evaluation of two commercial systems for identification of coagulase-negative staphylococci to species level.

Bloodstream (224) and urine (nine) isolates of coagulase-negative staphylococci (CNS) were evaluated using MicroScan Pos ID and Rapid Pos ID panels. A modification of the conventional method of Kloos and Schleifer served as the reference method. The isolates were selected to include a broad range of CNS species, including 44 S. epidermidis, 50 S. hominis, 39 S. warneri, 33 S. capitis, 21 S. haemolyticus, 12 S. simulans, 11 S. saprophyticus, six S. cohnii, five S. lugdunensis, three S. xylosus, four S. auricularis, two S. schleiferi, two S. intermedius, and one S. sciuri. The Pos ID panel had an overall rate of agreement (correct plus probably correct) with the reference method of 79%, including 95% for S. epidermidis, 95% for S. haemolyticus, 64% for S. hominis, 67% for S. simulans, 79% for S. warneri, and 100% for S. saprophyticus. The Rapid Pos ID panel had an overall rate of agreement (correct plus probably correct) of 76%, including 91% for S. epidermidis, 90% for S. haemolyticus, 64% for S. hominis, 58% for S. simulans, 77% for S. warneri, and 100% for S. saprophyticus. Both systems are acceptable for the identification of the clinically significant species S. haemolyticus, S. saprophyticus, and S. epidermidis, but are less reliable for the infrequently isolated species of CNS.

Bacteremia↗