A 1-year evaluation of Syva MicroTrak Chlamydia enzyme immunoassay with selective confirmation by direct fluorescent-antibody assay in a high-volume laboratory.
TThe Syva MicroTrak Chlamydia enzyme immunoassay (EIA; Syva Company, San Jose, Calif.) with cytospin and direct fluorescent-antibody assay (DFA) confirmation was evaluated on 43,630 urogenital specimens over a 1-year period in the Provincial Laboratory in Regina, Saskatchewan, Canada. This was a two-phase study intended to define a testing algorithm for Chlamydia trachomatis that would be both highly accurate and cost-effective in our high-volume (> 3,000 tests per month) laboratory. The prevalence of C. trachomatis infection in our population is moderate (8 to 9%). In phase 1, we tested 6,022 male and female urogenital specimens by EIA. All specimens with optical densities above the cutoff value and those within 30% below the cutoff value were retested by DFA. This was 648 specimens (10.8% of the total). A total of 100% (211 of 211) of the specimens with optical densities equal to or greater than 1.00 absorbance unit (AU) above the cutoff value, 98.2% (175 of 178) of the specimens with optical densities of between 0.500 and 0.999 AU above the cutoff value, and 83% (167 of 201) of the specimens with optical densities within 0.499 AU above the cutoff value were confirmed to be positive. A total of 12% (7 of 58) of the specimens with optical densities within 30% below the cutoff value were positive by DFA. In phase 2, we tested 37,608 specimens (32,495 from females; 5,113 from males) by EIA. Only those specimens with optical densities of between 0.499 AU above and 30% below the cutoff value required confirmation on the basis of data from phase 1 of the study. This was 4.5% of all specimens tested. This decrease in the proportion of specimens requiring confirmation provides a significant cost savings to the laboratory. The testing algorithm gives us a 1-day turnaround time to the final confirmed test results. The MicroTrak EIA performed very well in both phases of the study, with a sensitivity, specificity, positive predictive value, and negative predictive value of 96.1, 99.1, 90.3, and 99.7%, respectively, in phase 2. We suggest that for laboratories that use EIA for Chlamydia testing, a study such as this one will identify an appropriate optical density range for confirmatory testing for samples from that particular population.
BACKGROUND: Type-2 autoimmune hepatitis is a subgroup of chronic hepatitis characterized by the presence of liver/kidney microsomal autoantibodies type 1 (LKM-1). A frequent association with chronic hepatitis C suggests that hepatitis virus might trigger autoimmune reactivity. LKM-1-positive chronic hepatitis is not uncommon in southern Europe but is rarely seen in the USA and the UK. The prevalence in Scandinavia is hitherto unknown. METHODS: We used an automated prototype LKM-1 immunometry-based assay (IMx) to detect LKM-1 antibodies in sera from 350 Swedish patients with chronic liver diseases (100 with primary biliary cirrhosis, 80 with primary sclerosing cholangitis, 100 with hepatitis C, and 70 patients with various forms of chronic hepatitis, including 36 autoimmune cases), and from 17 children with autoimmune hepatitis. Sera reactive in the IMx assay were subjected to immunofluorescence testing. RESULTS: No clearly LKM-reactive sera were detected. Serum samples from 29 patients were borderline reactive in the IMx assay but tested negative in the confirmatory immunofluorescence test. Positive tests in the former assay were likely caused by reactivity against microsomal antigens other than LKM-1/cytochrome P450IID6. CONCLUSIONS: LKM-1-positive type-2 autoimmune hepatitis is very rare in Sweden. Furthermore, chronic hepatitis C did not trigger this type of autoimmune reactivity in our patients, probably owing to genetic insusceptibility.
Domestic Q fever is rare in the Nordic countries; the infection is acquired abroad in the majority of cases. This is the first Nordic report of a fatal case of Q fever, which occurred in an Icelandic cancer patient who had travelled to the Canary Islands.
Comparison of clinical symptoms in Lyme disease (LD) in various age groups.
150 patients with verified LD were divided into 4 age groups: under 15 years (group 1), 16-40 years (group 2), 41-60 years (group 3), over 60 years (group 4). Antibodies to Borrelia burgdorteri were detected with indirect immunofluorescence and Western blot.
LD clinical symptoms differed in the age groups. Patients of group 1 had more prevalent infectious syndrome with fever but they had no radiculoneuritis and polyneuritis. Patients of group 2 more frequently suffered of carditis and secondary erythema. Groups 3 and 4 were characterized by infectious syndrome, secondary erythema and aseptic meningitis, joint lesions being more frequent in group 3, nervous system lesions--in group 4.
Age peculiarities of LD symptoms are very important. In particular, joint syndrome is responsible for lingering course of LD.
Purified chlamydial bodies were solubilized by detergent solutions used in the following sequence: 1) 1% sarcosil, 2) 1% sarcosil + 10 mM dithiotreitol, 3) 2% sodium dodecyl sulfate + 10 mM dithiotreitol. After the third stage a good yield of protein, corresponding to major outer membrane protein as to its molecular weight and antigenic properties was obtained.
The etiological structure of influenza-like was analyzed in the population in cities and towns and in Russia as a whole in November 1998 to April 1999 by the findings of immunofluorescence and serological surveys of patients with acute respiratory viral infections (ARVI). By the results of both tests, the proportion of the incidence of influenza A (H3N2) was largest, the decreasing order in their significance was as follows: adenoviruses, type 3 parainfluenza virus, RSV, influenza B virus, influenza A(H1N1), types 2 and 1 parainfluenza virus. All influenza viruses A(H1N1) were isolated in Samara in February 1999. Three of them were similar to the reference strain A/Johannesburg/82/96 in antigenic properties, two strains appeared to be its drift variants. No A/Beijing/262/95 (H1N1)-like viruses recommended for incorporation as part of vaccines were detected. All influenza A(H3N2) viruses were drift variants of strain A/Sydney/05/97, and all influenza B viruses were similar to the reference strain B/Harbin/07/94 in antigenic structure.
Several laboratories have reported that new plasma membrane peptides appear in rodent and human cells after induction of in-vitro resistance to vinca alkaloids, anthracyclines and other anti-neoplastic drugs. Recently, murine monoclonal antibodies have been produced that recognize surface components of such drug-resistant cells. The work presented here describes the development of an in-vivo animal model of this phenomenon using a rat myeloid leukemia. Brown Norway rats were made leukemic with promyelocytes of the BNML line and subsequently were treated with 7.7 mg kg-1 of daunorubicin. After eight cycles of passage-treatment-regrowth, the resulting cells reacted with this antibody in immunofluorescence and cytotoxicity assays. Animals injected with cells that had been pre-incubated with antibody in the absence of complement survived significantly longer than did the controls. Further prolongation of survival occurred when the cells were treated with a second antibody of a different specificity. These results demonstrate that some of the changes associated with in-vitro drug resistance occur also in vivo and potentially may be exploited as a focus for immunotherapy.
Morphological, serological, DNA-homology and immunofluorescence studies of a rapidly fatal malignant lymphoma in a 25-year-old Sweden male revealed most of the characteristics of an EBV-associated Burkitt lymphoma. The various findings are discussed in relation to previously reported observations on endemic (African) and non-endemic Burkitt lymphomas.
