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PubMed1999

Evaluation of two serological tests for the diagnosis of chlamydial respiratory disease.

Serological tests for chlamydial infection are one of the most frequently used methods in the diagnosis of atypical respiratory infections. Use of serological tests has implicated chlamydial infections in asthma, arthritis and coronary heart disease, but the specificity of chlamydial serology tests has been questioned. The immunofluorescence test is the most sensitive and specific serological test available for detection of chlamydial antibodies. This study compares two commercially available immunofluorescent antibody tests. The SeroFIA test using purified elementary bodies of Chlamydia pneumoniae, C. psittaci and C. trachomatis, detected 24 cases of acute C. pneumoniae infection, whereas the Spot IF test using whole cell antigen of C. psittaci and C. trachomatis, misdiagnosed 20 of these as psittacosis and missed four cases.

Antibodies, Bacterial↗
PubMed1996

False-positive legionella titres in routine clinical serology testing detected by absorption with campylobacter: implications for the serological diagnosis of legionnaires' disease.

A simple absorption step using blocking fluid prepared from a selected campylobacter strain was introduced in parallel with routine legionella serology tests. Over 12 months, 2716 patients were tested for legionella antibodies by the Indirect Fluorescent Antibody Test of whom 58 (2.1%) had a positive titre (> or = 16) in one or more sera. Campylobacter blocking fluid significantly reduced the legionella titres in 17 of these patients (29%) including four patients with diagnostic serology results (two of whom had pneumonia) and 13 patients with non-diagnostic titres. Absorption with campylobacter however had no effect on the legionella titres in 10 patients with positive serology, in whom legionnaires' disease had been confirmed by culture of Legionella pneumophila from sputum or detection of legionella urinary antigen by ELISA. These results indicate that the serological cross-reaction between legionella and campylobacter is encountered in routine legionella serology tests. The important implications for the diagnosis of legionnaires' disease are discussed.

Campylobacter↗
PubMed2005

Serologic testing for celiac disease in young adults--a cost-effect analysis.

In recent years, there has been a marked increase in the diagnostic workups for celiac disease among military personnel, thereby significantly increasing overall laboratory testing expenditures and burden. We evaluated the serologic testing procedure in symptomatic young adults, using a "cost-effect" approach. We evaluated the serologic screening policy for celiac disease among serologically tested military personnel. The study population was divided into subgroups according to the clinical presentation prior to screening: isolated (low-risk) and combined complaints (high-risk). Sensitivity, specificity, and predictive values of serologic markers for celiac disease were evaluated. Cost analyses were based on diagnostic expenditures. Cost-effect ratio is expressed as cost per newly diagnosed patients, and cost minimization as cost per screened individuals. Five hundred thirty-eight military personnel were serologically tested for celiac disease. Eight new cases of celiac were diagnosed, all of whom belonged to the high-risk subgroup and tested positive for at least two positive serologic tests (tTG + EMA or tTG + AGA IgG + EMA). EMA Ab measured the highest sensitivity, specificity, and predictive values. Average screening expenditure was U.S. $287 per patient. The lowest cost-effect and cost minimization ratios were achieved by implementing a two-step single-marker screening protocol for high-risk subjects and one-step follow-up for low-risk subjects. Among patient population of young adults, selective diagnostic workup could result in cost-minimization without risking quality of diagnosis. From a cost-effect perspective, implemented screening procedures need to be dependent on subgroup: low-risk, clinical follow-up; and high-risk, serological testing for EMA and, only if positive, possibly a small-bowel biopsy.

Adult↗
PubMed2004

Recommendations for the selective use of herpes simplex virus type 2 serological tests.

BACKGROUND: Herpes simplex virus (HSV) type-specific serological tests are now widely available, but indications for their use have not been well defined. The California Sexually Transmitted Diseases (STD) Controllers Association convened a committee of clinicians and researchers to make recommendations for the use of type-specific HSV type 2 (HSV-2) serological tests. METHODS: By means of a systematic review of the literature, evidence to support screening in selected high-risk groups was compiled. Screening recommendations were developed by applying standard screening criteria to each specific population. RESULTS: The committee concluded that, in addition to serological testing for the diagnostic evaluation of patients with symptoms, screening of asymptomatic patients is likely to be beneficial among the following groups: those at high risk for STDs and human immunodeficiency virus (HIV) infection who are motivated to reduce their sexual risk behavior, HIV-infected patients, and patients with sex partners with genital herpes. In contrast, universal screening for HSV-2 infection in pregnant women is unlikely to be beneficial. CONCLUSIONS: The targeted use of HSV-2 serological tests for specific diagnostic situations and selected populations should benefit patients, providers, and the community. Until more data become available, these recommendations provide justification for selective diagnostic and screening uses of HSV-2 serological tests.

Female↗
PubMed2006

A rapid serologic test and immunoblotting for the detection of Helicobacter pylori infection in children.

The gold standard for the diagnosis of Helicobacter pylori infection requires an endoscopic biopsy of gastric mucosa for histological examination, urease test and culture. Noninvasive serological tests are useful as a screening test for H. pylori infection. The aim of this study was to evaluate the performance of a rapid office-based serologic test, using immunochromatography ICM, and the immunoblotting for the diagnosis of H. pylori infection in Thai children. Eighty-two symptomatic children, 30 boys and 52 girls (mean age 9.2+/-3.8 years; range, 1.2-16.0 years) who had no previous treatment for H. pylori underwent upper endoscopy. Biopsies were obtained from the gastric body and antrum for histopathology and rapid urease test. Serum samples collected from all patients were tested for H. pylori IgG antibodies using ICM (Assure H. pylori Rapid Test, Genelabs Diagnostics, Singapore). Immunoblotting (HelicoBlot 2.1, Genelabs Diagnostics, Singapore) was tested in sera of 75 patients to detect antibodies to specific antigens of H. pylori. Positive H. pylori status was defined as positive for both histology and rapid urease test. Of 82 patients, 25 (30.5%) were H. pylori positive, 56 (68.3%) were H. pylori negative and one was equivocal. ICM assay yielded a positive result in 24 of the 25 H. pylori-positive patients (96.0%) and 3 of the 56 H. pylori-negative patients (5.4%). The immunoblotting yielded a positive result in all of 22 H. pylori-positive patients (100%) and in 2 of the 52 H. pylori-negative patients (3.8%). Obtained ICM's sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 96.0, 94.6, 88.9, 98.1 and 95.1%, with immunoblotting 100.0, 96.2, 91.6, 100.0, and 97.3%, respectively. The immunochromatographic and immunoblot tests are non-invasive, reliable and useful for the diagnosis of H. pylori infection in Thai children.

Adolescent↗
PubMed1983

Evaluation of a monoclonal antibody (TB72) based serological test for tuberculosis.

A serological test for tuberculosis (TB), based on competitive inhibition by human sera of antigen binding by a murine monoclonal antibody (TB72) has been performed using solid phase radioimmunoassay. The test was evaluated on sera from patients with pulmonary or extra-pulmonary active TB as well as from control hospitalized patients--half of whom had various chest complaints. Positive values were found in 74% of all or 55% of untreated active pulmonary TB. Patients with extrapulmonary TB segregated, whereby antibody titres were increased in cases of pleural, peritoneal, pericardial or bone infection but only marginal or negative values were found in the majority of patients with lymphatic and genitourinary infection. None of the subjects with suspected but excluded tuberculosis or sarcoidosis had demonstrable TB72 antibodies. Generally there was a positive correlation between the levels of TB72 like and 'total' Mycobacterium tuberculosis sonicate binding antibodies. In particular, the titre of sonicate binding antibodies did not exceed background levels in patients with active pulmonary tuberculosis who were negative in the TB72 competition test. None of these false negative patients received drug therapy whereas most patients with the highest antibody levels were under chemotherapy for 1-8 months prior to serum testing. The serodiagnostic value of the TB72 based competition test has been discussed.

Adult↗
PubMed1996

Serological tests for monitoring Helicobacter pylori eradication treatment.

Serological tests for the detection of Helicobacter pylori-specific antibodies are useful in epidemiological studies, as a pre-endoscopic screening procedure, and as therapeutic follow-up. For the latter application, they represent an alternative to invasive and expensive diagnostic methods such as endoscopy and breath test, respectively. However, serological tests are suitable only for long-term treatment monitoring in adults. As the significant reduction of specific antibodies, and not seronegativity by itself, is regarded as a criterion of therapeutic success, it is always necessary to establish the antibody kinetics. Enzyme-linked immunosorbent assay (ELISA) based tests are best suited for this. The most relevant antibody class to be detected is H. pylori-specific IgG. The main indication for employing serology is the therapeutic follow-up of patients who, on the whole, are free of complaints.

Adult↗
PubMed2002

The Dutch Brucella abortus monitoring programme for cattle: the impact of false-positive serological reactions and comparison of serological tests.

The Dutch national Brucella abortus eradication programme for cattle started in 1959. Sporadic cases occurred yearly until 1995; the last infected herd was culled in 1996. In August 1999 the Netherlands was declared officially free of bovine brucellosis by the European Union. Before 1999, the programme to monitor the official Brucella-free status of bovine herds was primarily based on periodical testing of dairy herds with the milk ring test (MRT) and serological testing of all animals older than 1 year of age from non-dairy herds, using the micro-agglutination test (MAT) as screening test. In addition, serum samples of cattle that aborted were tested with the MAT. The high number of false positive reactions in both tests and the serum agglutination test (SAT) and complement fixation test (CFT) used for confirmation seemed to result in unnecessary blockade of herds, subsequent testing and slaughter of animals. For this reason, a validation study was performed in which three indirect enzyme-linked immunosorbent assays (ELISAs), the CFT and the SAT were compared using a panel of sera from brucellosis-free cattle, sera from experimentally infected cattle, and sera from cattle experimentally infected with bacteria which are known to induce cross-reactive antibodies (Pasteurella, Salmonella, Yersinia, and Escherichia). Moreover, four ELISAs and the MRT were compared using a panel of 1000 bulk milk samples from Brucella-free herds and 12 milk samples from Brucella abortus- infected cattle. It is concluded that the ELISA obtained from ID-Lelystad is the most suitable test to monitor the brucelosis free status of herds because it gives rise to fewer false-positive reactions than the SAT.

Agglutination Tests↗
PubMed2007

Characteristics of persons with recently acquired HIV infection: application of the serologic testing algorithm for recent HIV seroconversion in 10 US cities.

BACKGROUND: Information about the characteristics of persons whose HIV diagnosis was made soon after infection contributes to a better understanding of the HIV epidemic and to appropriate targeting of care and prevention efforts. METHODS: In 10 US cities from 1997 through 2001, specimens from consenting persons for whom a diagnosis of HIV was made within the past 12 months in were tested using the serologic testing algorithm for recent HIV seroconversion. The characteristics of those whose HIV diagnosis occurred within 170 days (on average) from seroconversion were identified. RESULTS: For 191 (20%) of the 964 participants, an HIV diagnosis was made during the period of recent infection. These diagnoses of recent infection were made more frequently among men (21.7%), whites (29.3%), men who have sex with men (25.5%), persons with a known HIV-infected partner (24.9%), and persons with a diagnosis of gonorrhea made in the 12 months before interview (27.0%). Recent infection was diagnosed less frequently among African Americans (15.5%), Latinos (15.5), and heterosexual men (14.7%) and women (14.4%). CONCLUSIONS: To increase early diagnosis of HIV, HIV testing should be more routinely offered to persons with a recent history of sexually transmitted diseases and to African Americans and Latinos in a variety of settings.

AIDS Serodiagnosis↗
PubMedDate not supplied

Comparison of serological tests for the detection of natural heartworm infection in cats.

Serological tests were performed on 380 cats with necropsy-confirmed heartworm disease to compare the performance of currently available commercial laboratory and point-of-care heart-worm serological tests in a heartworm-endemic area. Overall, antigen tests detected 79.3% to 86.2% of heartworm infections and were highly specific. Most cats with false-negative antigen tests had a single male worm. Antibody tests detected 62.1% to 72.4% of heartworm infections and had a wider range of false-positive results (1.4% to 19.1%) than antigen tests (0.3% to 2.0%). Serological tests for feline heartworm infection varied in diagnostic performance. Combining results from antigen and antibody tests achieved greater sensitivity than using either test alone.

Animals↗
PubMed1996

Evaluation of a serological test for diagnosis of Helicobacter pylori infection in children.

A serological test for the diagnosis of Helicobacter pylori infection (Cobas Core Roche, IgG, 2nd Generation; Roche, France) was compared with the examination of biopsy samples (culture and histology) obtained after endoscopy in 115 children to assess its value. In 94 children (42 positive and 52 negative), results were concordant. In 10 children a positive serological test was associated with an absence of Helicobacter pylori, while in 11 others a negative serological test was associated with a positive culture. Sensitivity of the test was 79.2% and specificity 83.9%. A relationship between IgG titers and age (r = 0.31, p < 0.05) was found. Serological tests could be useful for the diagnosis of Helicobacter pylori infection, but a negative test result does not rule out infection, particularly in children under 10 years of age.

Adolescent↗
PubMed1978

Efficiency of serologic tests in the diagnosis of systemic candidiasis.

Candida antibody tests for systemic candidiasis were conducted on 53 sera from patients with the disease and 170 sera from control patients by agar gel diffusion, counterimmunoelectrophoresis (CIE), latex agglutination, and whole-cell agglutination. The agar gel diffusion test and CIE had sensitivity, specificity, and efficiency of approximately 90%. The whole-cell agglutination test scored significantly lower, whereas the latex test scored in between. The agar gel diffusion test had the highest reproducibility and the whole-cell agglutination test the lowest in tests of identical sera by six independent laboratories. The agar gel diffusion and CIE tests make significant contributions to the diagnosis of systemic candidiasis.

Agglutination Tests↗