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At least 163 records · Page 9Linked to original sources
PubMed2006

Evaluation of new-generation serologic tests for the diagnosis of typhoid fever: data from a community-based surveillance in Calcutta, India.

Although typhoid fever is confirmed by culture of Salmonella enterica serotype Typhi, rapid and simple diagnostic serologic tests would be useful in developing countries. We examined the performance of Widal test in a community field site and compared it with Typhidot and Tubex tests for diagnosis of typhoid fever. Blood samples were collected from 6697 patients with fever for > or =3 days for microscopy, culture, and serologic testing and from randomly selected 172 consenting healthy individuals to assess the baseline Widal anti-Typhi O lipopolysaccharide antibody (anti-TO) and anti-Typhi H flagellar antibody (anti-TH) titers. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the 3 serologic tests were calculated using culture-confirmed typhoid fever cases as "true positives" and paratyphoid fever and malaria cases as "true negatives". Comparing cutoff values for the Widal test, an anti-TO titer of 1/80 was optimal with 58% sensitivity, 85% specificity, 69% PPV, and 77% NPV. Sensitivity was increased to 67% when the Widal test was done on the 5th day of illness and thereafter. The sensitivity, specificity, PPV, and NPV of Typhidot and Tubex were not better than Widal test. There is a need for more efficient rapid diagnostic test for typhoid fever especially during the acute stage of the disease. Until then, culture remains the method of choice.

Antibodies, Bacterial↗
PubMed1995

HEPAXPERT-III: knowledge-based interpretation of serologic tests for hepatitis A, B, C, and D.

1. The HEPAXPERT-III SYSTEM. HEPAXPERT-III--the successor of HEPAXPERT-I[1] and HEPAXPERT-II [2]--is a routinely-used, integrated medical database and knowledge-based system that stores and interprets the results of serologic tests for infection with hepatitis A, B, C, and D viruses. The following tests are included: Anti-HAV, IGM anti-HAV, and HAV in stool; HBsAg, anti-HBs, anti-HBc, IGM anti-HBc, HBeAg, anti-HBe, and anti-HBs titre; Anti-HCV, HCV-immunoblot, and HCV-PCR; Delta-Ag and anti-delta. HEPAXPERT-III provides the following functions: a) screen input of patient's personal data (patient ID, surname, first name, name at birth, date of birth, and sex), administrative data (department requiring the tests and date of specimen sample), and medical data (results of serologic tests); and/or b) automatic transfer of patient's personal, administrative, and medical data by connecting HEPAXPERT-III to a laboratory information system, a hospital information system, or an automated laboratory analyzer; and c) automatic generation of interpretive reports of the obtained serologic findings, including an analysis of possible virus exposition, immunity, disease stage, prognosis, and degree of infectiousness. HEPAXPERT-I and HEPAXPERT-II have been routinely used at the Vienna General Hospital, the teaching hospital of the University of Vienna Medical School. The interpretive reports are well-accepted and lead to several improvements in patient care [3]. HEPAXPERT-III will not only extend the scope of interpretation to hepatitis C and D serologic tests, but will also offer a state-of-the-art graphical user interface. 2. HARDWARE AND SOFTWARE. IBM-compatible personal computer (minimum 80386 SX processor), 8 MB RAM (OS/2) and 4 RM RAM (MS-Windows), resp., graphic adapter (minimum 640x480) and printer supported by OS/2 and MS-Windows 3.1, resp., IBM OS/2-2.1 or higher and MS-Windows 3.1 or higher, resp., and for the OS/2 version IBM Database 2 (DB2/2).

Diagnosis, Computer-Assisted↗
PubMed1998

Use caution with serologic testing for Helicobacter pylori infection in children.

Commercial serologic assays accurately detect adult Helicobacter pylori infection. Their use in children remains controversial. An ELISA to detect H. pylori IgG in children was developed and compared with three commercial assays. ELISA standardization was done with sera from all ages and validation was done with another cohort of sera with known H. pylori status. Three commercial serologic assays were subsequently compared against this pediatric ELISA at independent sites, at which 142 pediatric serum samples from different countries were evaluated. The pediatric ELISA was 91.4% sensitive. Assay 3 demonstrated a sensitivity of 78%. Less sensitivity was observed for assay 1 (70%) and assay 2 (63%). Accuracy of commercial assays was greatly reduced when sera from developing countries and younger ages were evaluated. Results of serologic tests used to diagnose H. pylori should be interpreted with caution when evaluating children with abdominal pain. Accurate serologic assays in children may be more important for epidemiologic research than for clinical decision making.

Adolescent↗
PubMed1999

Serologic testing of horses for granulocytic ehrlichiosis, using indirect fluorescent antibody staining and immunoblot analysis.

OBJECTIVE: To diagnose granulocytic ehrlichiosis in horses, compare results of indirect fluorescent antibody (IFA) staining procedures with those of immunoblot analysis, and compare serologic test findings with polymerase chain reaction (PCR) results. ANIMALS: 69 horses with high rectal temperatures (> or = 39 C) and lethargy, anorexia, or limb edema. PROCEDURE: 43 convalescent serum samples obtained from 38 horses 2 to 18 weeks after onset of illness were analyzed by use of immunoblot procedures and IFA staining methods, using the NCH-1 or BDS ehrlichial strains. Blood samples from 69 acutely ill horses were tested by PCR to detect ehrlichial DNA. RESULTS: Antibodies to Erlichial equi were detected in serum samples obtained during all seasons; seropositivity rates ranged from 50 to 93%. In IFA assays using the BDS or NCH-1 strain, seropositivity rates were 70 and 79%, respectively, whereas in immunoblot analyses using the NCH-1 strain, a seropositivity value of 79% was recorded. By immunoblot analysis, all serum samples of all seropositive horses were reactive to a protein having molecular mass of about 44 kd. Blood samples from 29 of 69 (42%) acutely ill horses contained ehrlichial DNA. CONCLUSION AND CLINICAL RELEVANCE: Results of the various serologic testing procedures were in close agreement with each other. All serologic testing methods are suitable for laboratory diagnosis of equine granulocytic ehrlichiosis.

Animals↗
PubMed1993

[A strategy to control Trypanosomiasis due to Trypanosoma brucei gambiense in an endemic region of Zaire. Association of a serological test and early treatment of suspected cases. Preliminary results].

The authors report results obtained after combination of a serological diagnostic test and the early treatment of suspected cases (a person with a positive serological test without parasitological confirmation) in an area in Zaire where sleeping sickness caused by Trypanosoma brucei gambiense is endemic. The serological test used was Testryp CATT, having a very high sensitivity and quite a high specificity, which is easy to handle in the field and which permits results to be obtained on the spot. The treatment employed was a medication active in the first stage of the disease (hematolymphatic stage), safe to handle, with few side effects and easy to administer (diminazine). This strategy was applied for one year in the area from Fankana-Kalakitini in the Bandundu region in Zaire. The entire population was examined with the classical methods, combined with the serological test Testryp CATT, and this every six months. People positive for the serological test (but negative for the parasite) received one injection of the proposed medication; but people in whom parasites were found got classic treatment. After this period, we were able to demonstrate a clear decline in the incidence rate of new cases (parasite positive), but also in seropositivity rates in the general population. The authors believe that in a circumscribed area where the disease is endemic, the combination of a serological test and early treatment of suspected cases can rapidly diminish the incidence of the disease to an acceptable level.

Agglutination Tests↗
PubMed1986

Evaluation of cross-reactions in Histoplasma capsulatum serologic tests.

Cross-reactivity in Histoplasma serologic tests was evaluated by using sera from patients with histoplasmosis and other infections. Serum samples from 127 of 134 (95%) patients with histoplasmosis were judged positive by complement fixation tests, and 121 (90%) showed H bands, M bands, or both by immunodiffusion. Of these 134 patients, cross-reactions were seen to Blastomyces dermatitidis in 53 patients (40%), to Coccidioides immitis in 20 patients (16%), and to Aspergillus fumigatus in 3 patients (2%) by complement fixation. Serum samples from 5 of 99 patients (5%) with other fungal infections and from 5 of 46 patients (11%) with tuberculosis had M precipitin bands by the Histoplasma immunodiffusion test, whereas none of the 123 sera from patients with other bacterial, Mycoplasma, or viral infections showed H or M precipitin bands. In the complement fixation test, positive reactions were observed in 16 of 90 patients (18%) with other fungal infections, in 14 of 41 patients (34%) with tuberculosis, and in 18 of 105 patients (17%) with other bacterial, Mycoplasma, or viral infections. Positive reactions were seen by radioimmunoassay in 54 of 110 patients (49%) with other fungal infections, in 23 of 46 patients (50%) with tuberculosis, and in 35 of 123 patients (28%) with with other bacterial, Mycoplasma, or viral infections. These results demonstrate a wider range of cross-reactions in Histoplasma serology than has been previously recognized, and the cross-reactivity was greatest when observed by radioimmunoassay. Caution should be exercised in the interpretation of serologic data from patients with suspected fungal infections.

Antibodies, Fungal↗
PubMed1997

A WWW-accessible knowledge base for the interpretation of hepatitis serologic tests.

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 anti-bodies (anti-HAV), IgM antibodies to the hepatitis A virus (IgM anti-HAV), hepatitis A virus (HAV in stool, hepatitis B surface antigen (HBsAg) and antibodies (qualitative anti-HBs, quantitative anti-HBs titre), antibodies to hepatitis B core antigen (anti-HBc and IgM anti-HBc), and hepatitis B envelope antigen (HBeAg) and antibodies (anti-HBe). HEPAXPERT/WWW--an implementation of HEPAXPERT-III for WWW--can be reached by URL http://www.swun.com/hepax of the World Wide Web. 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 57344 (B) combinations of findings, the knowledge base of HEPAXPERT/WWW contains 16 rules for 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: (a) the transferred results of the tests; (b) a detailed analysis of the results, including virus exposure, immunity, stage of illness, prognosis, infectiousness, and vaccination recommendation; and (c) optional: an ID to distinguish the origin of the interpretation requests.

Artificial Intelligence↗
PubMedDate not supplied

Immediate endoscopy or initial Helicobacter pylori serological testing for suspected peptic ulcer disease: estimating cost-effectiveness using decision analysis.

OBJECTIVE: To compare the clinical and economic effects of a strategy using immediate endoscopy to a non-invasive strategy utilizing a serologic test for Helicobacter pylori infection for individuals with symptoms suggestive of peptic ulcer disease. DESIGN: Cost-effectiveness analysis evaluating the clinical and economic effects of alternative management strategies of hypothetical patients with suspected peptic ulcer disease in a computer simulation model. INTERVENTION: Two strategies for hypothetical patients with suspected ulcer disease were evaluated: 1) Immediate endoscopy and biopsy for H. pylori, using antisecretory treatment in all patients with documented ulcers and adding antibiotic eradication therapy for those patients with ulcers whose biopsies were positive for H. pylori. 2) Empiric treatment with antisecretory therapy and serologic testing for H. pylori for all patients, using antibiotic eradication therapy only in patients testing positive for H. pylori. MEASUREMENTS: Cost per ulcer cured over a one-year study period. RESULTS: The more cost-effective strategy was the test-and-treat strategy (Strategy 2) with $4481 cost per ulcer cured. The immediate endoscopy strategy resulted in $8045 cost per ulcer cured. The cost-effectiveness advantage of the non-invasive strategy diminished as the cost of endoscopy fell or as the probability of recurrent symptoms rose in patients initially managed without endoscopy. CONCLUSION: Endoscopy, though costly, precisely guided diagnosis and treatment and, thus, potentially reduced the number of patients inappropriately treated. However, cost-effectiveness analysis supports the continued practice of initial non-invasive management of patients with symptoms suggestive of peptic ulcer disease, achieving the benefits of H. pylori eradication through the use of serologic testing to guide antibiotic use.

Computer Simulation↗
PubMed2002

Performance and use of HSV type-specific serology test kits.

Herpes simplex virus type-specific serology tests based on glycoprotein gG-1 and/or gG-2 are important diagnostic tools to establish aetiology of genital symptoms and identify patients with unrecognized genital herpes. Clinicians can now select from three very different Food and Drug Administration-licensed kits. Diagnology's POCkittrade mark HSV-2 is a point of care test for herpes simplex virus type 2 (HSV-2) antibodies. Clinicians can perform this test while the patient waits. Focus Technologies' HerpeSelect enzymelinked immunosorbent assays (ELISAs) for herpes simplex virus type 1 (HSV-1) and HSV-2 are more traditional tests that can be semiautomated for high throughput at low cost in laboratories. Focus Technologies' HerpeSelect Immunoblot is a novel strip immunoblot that can be used for low volume testing in laboratories or even by healthcare facilities that are accredited for moderately complex testing. This review summarizes the performance data of these tests and describes how to interpret their results. Finally, situations that warrant follow-up testing are described along with suggested strategies for such testing.

Antibodies, Viral↗
PubMed1983

Essential mixed cryoglobulinaemia with false-positive serological tests for syphilis.

Analysis of serum from a patient with cutaneous leukocytoclastic vasculitis showed a mixed cryoglobulin with a monoclonal IgM kappa-antiglobulin component (6.5 mg/ml), strong rheumatoid factor activity (latex titre 1/5000), and positive serological tests for syphilis (fluorescent treponemal antibody-absorbed and Treponema pallidum haemagglutination assay). After removal of antiglobulin activity by immunoabsorption with heat-aggregated gammaglobulin all serological test results for treponemal infection became negative. Serological tests for syphilis and rheumatoid factor on the supernatant from whole serum (minus cryoglobulin) remained positive though at a lower titre (latex 1/1250). Cryoglobulin isolated from whole serum retained rheumatoid and TPHA reactivity but was negative in the FTA-ABS test. The IgM and IgG cryoglobulin components purified by gel filtration on Sepharose showed no antitreponemal reactivity even when tested individually. Reducing the concentration of cryoglobulin to 1.5 mg/ml by plasma exchange converted the test results for syphilis to doubtful-positive or negative. These results indicated that high concentrations of antiglobulin activity may be associated with falsely positive specific antitreponemal test results and that this phenomenon depends on the concentration of cryoglobulin in the test sample.

Cryoglobulinemia↗
PubMed1989

Incidence of inapparent active mycobacterial infections in France detected by an IgG serological test based on antigen 60.

A serological test detecting circulating mycobacterial antibodies of the IgG type applied to various populations. The test detected no positive cases among old age people in a retirement home. Among sexually active women, 3% were positive. This percentage of antigen 60-positive cases was also found among asymptomatic HIV seropositives. The percentage augmented to 5.7% when hospital attendants were analyzed and augmented further to 14% when people known to have had contact with a man suffering from pulmonary tuberculosis were analyzed.

Adult↗
PubMed1991

The application of epitope mapping in the development of a new serological test for systemic candidosis.

A new serological test for systemic candidosis was developed by raising a rabbit antiserum probe against a specific epitope on Candida albicans, hsp 90. A major fragment at the carboxy terminal end of this immunodominant candidal antigen was epitope mapped by Geysen's method. An epitope, recognised by all infected patients with antibody to the 47 kDa antigen, was synthesized and conjugated to keyhole limpet haemocyanin. A rabbit was successfully immunized against this synthesized peptide epitope and this antiserum was compared, in a dot-immunobinding assay, with unfractionated hyperimmune rabbit antiserum to C. albicans and an affinity-purified rabbit antiserum to the 47 kDa antigen. The epitope-specific antibody probe was more sensitive than the hyperimmune candidal antiserum but less sensitive than the affinity-purified antibody against the 47 kDa antigen, which recognised multiple epitopes. This probe is technically easy to prepare in large amounts and gives no false positives.

Amino Acid Sequence↗
PubMed2001

Effect of immunization with recombinant OspA on serologic tests for Lyme borreliosis.

This study evaluated the effects of vaccination with OspA on the use of serologic tests as aids in the diagnosis of Lyme borreliosis. Sera from control and OspA-immunized mice and from OspA-immunized human volunteers were tested for serologic reactivity to Borrelia burgdorferi. Testing was performed with samples obtained prior to administration of vaccine and at 30 days following administration of an initial and a second dose of OspA vaccine. The assays used to assess serologic reactivity included an in-house-developed enzyme-linked immunosorbent assay (ELISA), an in-house-developed Western blot assay, two commercial Western blot tests, and a commercially available dot blot assay. Data obtained from this study demonstrate that immunization with the OspA vaccine will cause ELISA to yield positive results (as reported previously) for the majority of vaccine recipients. Results obtained from Western blot analysis indicate that vaccination with recombinant OspA induces production of antibodies which bind to several different borrelial proteins. The degree of reactivity detected by Western blotting varied greatly between the three assays used. The in-house assay showed the least reactivity, while one commercial Western blot test actually yielded positive test results for infection with B. burgdorferi. The usefulness of all three Western blot assays for the diagnosis of potential infection in a vaccine recipient is severely limited by the extensive reactivity caused by vaccination alone. Antibodies produced in response to OspA vaccination did not significantly affect the performance of the dot blot test; thus, it could provide a reliable means to test for infection with B. burgdorferi in OspA vaccine recipients.

Adult↗
PubMed1997

Comparison between a rapid office-based and ELISA serologic test in screening for Helicobacter pylori in children.

BACKGROUND: The rapid diagnostic serological test for detection of Helicobacter pylori (H. pylori) infection in children has a significant advantage over the standard enzyme immunoassay (EIA) method, for its simplicity and rapid availability of results in a physician's office setting. We compared the immunochromatographic test with a standard enzyme immunoassay test in the pediatric population. MATERIALS AND METHODS: A retrospective analysis of 1147 serum samples from asymptomatic children and prospective analysis of 62 serum samples from symptomatic children undergoing diagnostic upper endoscopy were evaluated for the detection of H. pylori antibody by two commercially available serology tests. Each serum sample was tested by a rapid test (FlexSure HP, SmithKline Diagnostics, Inc.) and compared to the standard EIA method (HM-CAP, Enteric Products, Inc.). RESULTS: The rapid test, FlexSure HP, was comparable to the rapid EIA test in screening for H. pylori infection in symptomatic and asymptomatic children with sensitivity and specificity of 83-90% and 90-100%, respectively. Both methods had a comparable sensitivity and specificity for the detection of H. pylori-associated gastritis (60-70% and 94%, respectively). CONCLUSION: The rapid test is comparable to the standard EIA test and may be used by physicians in symptomatic children. The use of FlexSure HP as a screening tool for the prevalence of H. pylori infection in asymptomatic children may be limited by its low positive predictive value compared to the EIA method.

Adolescent↗
PubMed2006

Poor performance of a novel serological test for diagnosis of pulmonary tuberculosis in Bangui, Central African Republic.

We assessed the performance of a serological test for tuberculosis (SDHO Laboratories Inc., Canada) in our setting. Among 68 of 99 suspected pulmonary tuberculosis patients who were scored as having tuberculosis on the basis of Mycobacterium tuberculosis-positive culture, the sensitivity of the serological test was lower than that of sputum smear microscopic examination (20.6% versus 80.9%, respectively; P < 0.000001).

Adolescent↗