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Background: Laboratory diagnosis of American cutaneous leishmaniasis (ACL) requires a tool amenable to the epidemiological status of ACL in Brazil. Montenegro skin test (MST), an efficient immunological tool used for laboratory diagnosis of ACL, induces delayed-type hypersensitivity (DTH) response to the promastigote antigens of Leishmania; however, human immune responses against infection are modulated by the amastigote of the parasite. Leishmania (V.) lainsoni induces strong cellular immunity in humans; therefore, the antigenic reactivity of its axenic amastigote (AMA antigen) to MST was evaluated for the laboratory diagnosis of ACL. Methods: Among 70 individuals examined, 60 had a laboratory-confirmed diagnosis of ACL; 53 had localized cutaneous leishmaniasis (LCL), and 7 had mucosal leishmaniasis (ML). Patients were treated at the Evandro Chagas Institute's leishmaniasis clinic, Pará State, Brazil. Ten healthy individuals with no history of ACL (control group) were also examined. Leishmania (V.) braziliensis promastigote antigen (PRO) was used to compare the reactivity with that of AMA antigen. Paired Student's t-test, kappa agreement, and Spearman test were used to evaluate the reactivity of AMA and PRO. Results: The mean reactivity of AMA in ACL patients was 19.4 mm ± 13.3, which was higher (P < 0.001) than that of PRO: 12.1 mm ± 8.1. MST reactivity according to the clinical forms revealed that AMA reactivity in LCL and ML, 18.8 mm ± 13.3 and 24.3 mm ± 13.7, was higher (P < 0.001) than that of PRO, 11.8 mm ± 8.2 and 14.6 mm ± 8.4, respectively. Conclusion: AMA reactivity was higher than that of PRO, indicating that AMA is a promising alternative for optimizing MST in the laboratory diagnosis of ACL. [ABSTRACT FROM AUTHOR]

Copyright of China Tropical Medicine is the property of China Tropical Medicine Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Rabies is a viral encephalitis that affects mammals, including humans. Rapid and effective laboratory diagnosis of the rabies virus is critical for public health. This study evaluated the operational, technical, and financial viability of the RT-qPCR in replacement of inoculation in mice for diagnosing rabies in the laboratory routine. A total of 316 samples of mammalian brains were analyzed, 121 positives and 195 negatives, previously diagnosed by direct immunofluorescence (DIF) and mouse inoculation test (MIT). The samples were submitted to the duplex TaqMan RT-qPCR technique. The accuracy, sensitivity, and specificity of RT-qPCR were analyzed. We analyzed the costs for performing the RT-qPCR technique and compared it with the cost of MIT. The results showed 99.37% accuracy, 99.17% sensitivity, and 99.49% specificity by RT-qPCR when related to DIF and MIT results, which proved to be a robust and repeatable technique. The minimum time for a positive diagnosis was reduced in RT-qPCR (1 day) if compared to MIT (9.64 days), with a 17.7% reduction in the cost of the molecular technique. The present study demonstrated that the molecular biology technique is an efficient tool to diagnose rabies in the laboratory routine, being able to replace MIT. [ABSTRACT FROM AUTHOR]

Abstract Background Laboratory diagnosis of American cutaneous leishmaniasis (ACL) requires a tool amenable to the epidemiological status of ACL in Brazil. Montenegro skin test (MST), an efficient immunological tool used for laboratory diagnosis of ACL, induces delayed-type hypersensitivity (DTH) response to the promastigote antigens of Leishmania; however, human immune responses against infection are modulated by the amastigote of the parasite. Leishmania (V.) lainsoni induces strong cellular immunity in humans; therefore, the antigenic reactivity of its axenic amastigote (AMA antigen) to MST was evaluated for the laboratory diagnosis of ACL. Methods Among 70 individuals examined, 60 had a laboratory-confirmed diagnosis of ACL; 53 had localized cutaneous leishmaniasis (LCL), and 7 had mucosal leishmaniasis (ML). Patients were treated at the Evandro Chagas Institute’s leishmaniasis clinic, Pará State, Brazil. Ten healthy individuals with no history of ACL (control group) were also examined. Leishmania (V.) braziliensis promastigote antigen (PRO) was used to compare the reactivity with that of AMA antigen. Paired Student’s t-test, kappa agreement, and Spearman test were used to evaluate the reactivity of AMA and PRO. Results The mean reactivity of AMA in ACL patients was 19.4 mm ± 13.3, which was higher (P

Copyright of Journal of Modern Laboratory Medicine is the property of Journal of Modern Laboratory Medicine Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives Inflammatory arthritis (IA) is considered the last stage of a disease continuum, where features of systemic autoimmunity can appear years before clinical synovitis. Time to progression to IA varies considerably between at-risk individuals, therefore the identification of biomarkers predictive of progression is of major importance. We previously reported on the value of three CD4+T cell subsets as biomarkers of progression. Here, we aim to establish the value of 18 lymphocyte subsets (LS) for predicting progression to IA. Methods Participants were recruited based on a new musculoskeletal complaint and being positive for anti-citrullinated-peptide antibody. Progression (over 10 years) was defined as the development of clinical synovitis. LS analysis was performed for lymphocyte lineages, naive/memory subsets, inflammation-related cells (IRC) and regulatory cells (Treg/B-reg). Modelling used logistic/Cox regressions. Results Of 210 patients included, 93 (44%) progressed to IA, 41/93 (44%) within 12 months (rapid progressors). A total of 5/18 LS were associated with progression [Treg/CD4-naïve/IRC (adjusted P  < 0.0001), CD8 (P  = 0.021), B-reg (P  = 0.015)] and three trends (NK-cells/memory-B-cells/plasmablasts). Unsupervised hierarchical clustering using these eight subsets segregated three clusters of patients, one cluster being enriched [63/109(58%)] and one poor [10/45(22%)] in progressors. Combining all clinical and LS variables, forward logistic regression predicted progression with accuracy = 85.7% and AUC = 0.911, selecting smoking/rheumatoid-factor/HLA-shared-epitope/tender-joint-count-78 and Treg/CD4-naive/CD8/NK-cells/B-reg/plasmablasts. To predict rapid progression, a Cox regression was performed resulting in a model combining smoking/rheumatoid factor and IRC/CD4-naive/Treg/NK-cells/CD8+T cells (AUC = 0.794). Conclusion Overall, progression was predicted by specific LS, suggesting potential triggers for events leading to the development of IA, while rapid progression was associated with a different set of subsets. [ABSTRACT FROM AUTHOR]

The periparturient period is defined as the period immediately preceding and following parturition. Dairy animals encounter obstacles during this period. The goal of the study was to identify the various physiological stressors that ewes encounter during this time and the kind of special care that should be offered to them in order to deal with this problem. Thirty fat-tailed ewes were used in this research. All animals were examined clinically and ultrasonography. Blood samples were taken firstly during the diestrus stage (group 1), then during late gestation (group 2), and finally during postpartum (Group 3). Haematological and biochemical parameters were assessed. The results revealed a significant decrease in RBCs count, haemoglobin concentrations, and hematocrite % during the periparturient phase compared to the diestrus phase. WBCs count exhibited a significant increase during the periparturient period. The metabolic profile involves total protein and albumin, which decreased significantly during the periparturient period compared to the diestrus phase, while urea concentration showed the opposite trend. Total cholesterol and triglycerides showed a significant increase over the periparturient phase. Mineral investigations indicate that ferritin and calcium concentrations decreased significantly throughout the periparturient period compared to the diestrus phase, while phosphorus and magnesium concentrations showed non-significant changes. The study revealed a wide variety of alterations in several clinical, haematological, and biochemical parameters of ewe’s blood throughout the periparturient phase. This study will provide an opportunity to identify management changes for the prophylaxis of ovine diseases, improving overall herd health and animal welfare.

Mycoplasma pneumoniae (MP) is the cause of Mycoplasma pneumoniae pneumonia (MPP) in children and adolescents, with the clinical manifestations highlighted by intermittent irritating cough, accompanied by headache, fever and muscle pain. This paper aimed to study the research status and focal points in MP infection, especially the common laboratory diagnostic methods and clinical treatment of Mycoplasma pneumoniae. Laboratory diagnostic methods include molecular assay, serological antibody detection, rapid antigen detection and isolation and culture. Polymerase chain reaction (PCR) is the gold standard with high sensitivity and specificity. The serological antibody can detect various immune antibodies qualitatively or quantitatively in serum. Rapid antigen can be detected faster, with no equipment environment requirements, which can be used for the early diagnosis of MP infection. While the culture growth cycle is long and insensitive, not recommended for routine diagnosis. Macrolides were the preferred drug for children with MPP, while the drug resistance rate was rising in China. Tetracycline can be substituted but was not recommended for children under 8 years of age, quinolone drugs are not necessary, severe MPP can be combined with glucocorticoids, involving the nervous or immune system can choose gamma globulin. Other treatments for MPP including symptomatic treatment which can alleviate symptoms, improve lung function and improve prognosis. A safe and effective vaccine needed to be developed which can provide protective immunity to children and will reduce the incidence of MPP.

Due to the high rate of geriatric patient visits, scoring systems are needed to predict increasing mortality rates. In this study, we aimed to investigate the in-hospital mortality prediction power of the National Early Warning Score 2 (NEWS2) and the Laboratory Data Decision Tree Early Warning Score (LDT-EWS), which consists of frequently performed laboratory parameters. We retrospectively analyzed 651 geriatric patients who visited the emergency department (ED), were not discharged on the same day from ED, and were hospitalized. The patients were categorized according to their in-hospital mortality status. The NEWS2 and LDT-EWS values of these patients were calculated and compared on the basis of deceased and living patients. Median (interquartile range [IQR]) NEWS2 and LDT-EWS values of the 127 patients who died were found to be statistically significantly higher than those of the patients who survived (NEWS2: 5 [3–8] vs. 3 [1–5]; p < 0.001; LDT-EWS: 8 [7–10] vs. 6 [5–8]; p < 0.001). In the receiver operating characteristic curve analysis, the NEWS2, LDT-EWS, and NEWS2+LDT-EWS—formed by the sum of the two scoring systems—resulted in 0.717, 0.705, and 0.775 area under curve values, respectively. The NEWS2 and LDT-EWS were found to be valuable for predicting in-hospital mortality in geriatric patients. The power of the NEWS2 to predict in-hospital mortality increased when used with the LDT-EWS. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study conducted in the Karadeniz Region in north of Turkey, was to compare the laboratory methods used in the diagnosis of trichomoniasis, to investigate the effects of socio-demographic characteristics and sexual polygamy on the prevalence of the disease, and to determine the miRNA profile that activates T and B cells that form the immune response in patients with trichomoniasis. Methods: Urine samples were collected from 86 male patients who presented to the urology clinic with complaints of urethral discharge between 2018 and 2023, while vaginals wabs were collected from their wives for the study. The clinical samples were analyzed by microscopic examination, culture, PCR and real-time PCR methods. The blood samples collected for miRNA analysis were prepared according to the miRNA kit instructions for use (Qiagen, Hilden, Germany), and the miRNA profile of the patients was determined using the miRNA analyzer (Fluidgm, Germany). Results: The positive predictive value and sensitivity of the real-time PCR method were 17.4% and 100%, respectively, and it was found to be the most sensitive test that can be used for the diagnosis of trichomoniasis. The study found, that sociodemographic characteristics had no effect on the prevalence of trichomoniasis, but sexual poygamy had an effect on the prevalence of the disease. Of the 60 miRNAs that activate T and B cells in trichomoniasis patients, 20 were downregulated, 11 were upregulated and 29 were left unchanged. Conclusion: The use of the real-time PCR method in the laboratory diagnosis of trichomoniasis, enables early and rapid diagnosis of the disease. This allow, the disease to be treated early, preventing it the disease from spreading and becoming a public health problem. New information about the immunity of the disease was obtained by determining the expression levels of miRNAs that activate T and B cells in trichomoniasis patients. [ABSTRACT FROM AUTHOR]

A fluorescence immunochromatography (FIC) kit was developed recently using fluorescent silica nanoparticles coated with a recombinant C-terminal fragment of the surface lectin intermediate subunit (C-Igl) of Entamoeba histolytica to establish rapid serodiagnosis of amebiasis. We further evaluated the system using serum samples from 52 Thai patients with amebiasis. Of the patients, 50 (96%) tested positive using FIC. The samples were also tested using enzyme-linked immunosorbent assay (ELISA) with C-Igl as the antigen. Two samples were negative on ELISA but positive on FIC. The correlation coefficient between the fluorescence intensity using FIC and the optical density value using ELISA was 0.5390, indicating a moderate correlation between the two tests. Serum samples from 20 patients with malaria and 22 patients with Clostridioides difficile infection were also tested using FIC. The false-positive rates were 4/20 (20%) and 1/22 (4%) in patients with malaria and C. difficile infection, respectively. Combining the data from the present study with our previous study, the sensitivity and specificity of FIC were determined to be 98.5% and 95.2%, respectively. The results of the 50 samples were studied using a fluorescence scope and a fluorescence intensity reader, and the findings were compared. Disagreements were found in only two samples showing near-borderline fluorescence intensity, indicating that the use of scope was adequate for judging the results. These results demonstrate that FIC is a simple and rapid test for the serodiagnosis of amebiasis. [ABSTRACT FROM AUTHOR]

Simple Summary: Cattle ringworm is a mycotic infection of the bovine skin caused by dermatophytes that are also transmissible to humans. To limit the spread of bovine ringworm, calves at auction markets in Styria, Austria, are visually inspected and excluded from auction if they display skin lesions that are typical of ringworm. To investigate whether these clinical assessments correspond to laboratory diagnoses, samples from skin lesions were examined through microscopy, culture, and nested PCR approaches; the relatedness of the isolated dermatophytes was determined using multi-locus sequence typing (MLST). Overall, the clinical assessments were largely supported through the results of the nested PCR laboratory diagnosis, possessing an analytical sensitivity superior to that of the culture approach. Thus, this represents a fast and sensitive diagnostic test for the detection and identification of dermatophytes. Most of the isolated dermatophytes were assigned to a unique Trichophyton (T.) verrucosum MLST genotype, indicating that ringworm in calves at auction was predominantly caused by a single T. verrucosum strain. To limit the spread of bovine ringworm, control measures such as movement restrictions are highly recommended. In this context, calves at auction markets in Styria, Austria, displaying skin lesions characteristic for bovine ringworm, are excluded from the auctions. To investigate whether these clinical assessments correspond to laboratory diagnosis, a total of 166 samples taken from skin lesions assigned to the three clinical categories 'ringworm very likely (v), likely (l) or unlikely (u)' were mycologically examined using microscopy, culture, and nested PCR followed by amplicon sequencing. Further, the relationships of isolated dermatophytes were determined through multi-locus sequence typing (MLST). Overall, a high agreement between clinical assessment and laboratory results were observed with microscopy and nested PCR, providing more consistent results and molecular detection possessing an analytical sensitivity superior to that of cultural isolation (culture 21.7% vs. nested PCR 48.2%). Phylogenetic analyses revealed that most of the isolated dermatophytes belong to a unique Trichophyton verrucosum MLST genotype. In conclusion, clinical assessments were largely confirmed through laboratory diagnosis with nested PCR and sequencing, providing rapid, sensitive, and species-specific detection of dermatophytes in calves at auction markets displaying skin lesions typical for ringworm; this seems to be predominantly caused by a single Trichophyton verrucosum strain. [ABSTRACT FROM AUTHOR]

Due to the extensive host range of influenza A viruses, it is difficult to determine the best diagnostic algorithm to efficiently screen samples from a variety of host species for influenza A viruses. While there are some influenza diagnostic algorithms that are specific to host species, to our knowledge, no single algorithm exists for the characterization of influenza A viruses across multiple host species. In this paper, we propose an algorithm that can serve as a guide for screening human, animal, and environmental samples for influenza A viruses of high human and animal health importance. [ABSTRACT FROM AUTHOR]

Introduction: VWD diagnosis is challenging requiring multiple VWF activity tests using many individual assays. We have developed an ELISA‐based VWF Multiplex Activity Assay (VWF‐MAA) to address this concern; however, the ability of the VWF‐MAA to discriminate between type 1 VWD, variant VWD, and normal subjects has not been evaluated. Aim: To evaluate the VWF‐MAA and its ability to differentiate between type 1 VWD, variant VWD and normal subjects in individuals undergoing an initial laboratory evaluation for bleeding. Methods: A total of 177 plasma samples from the Zimmerman Program: Comparative Effectiveness in the Diagnosis of VWD were evaluated from 11 centres across the US and Canada. The VWF‐MAA was compared to Versiti Blood Research Institute (VBRI) and Local Center (LC) assigned VWD diagnosis. Results: Overall, 129/177 (72.9%) were correctly assigned as normal (non‐VWD), type 1, or variant VWD compared to the VBRI assigned diagnosis. VWF‐MAA assigned non‐VWD accurately in 29/57 (50.9%) samples, and type 1 VWD accurately in 93/110 (84.6%) samples. Considering LC diagnosis where there was agreement with VWF‐MAA and not VBRI diagnosis, type 1 VWD was accurate in 105/110 (95.5%) samples. Bland‐Altman analysis demonstrated good correlation between laboratory methods. VWD, types 2A, 2B, 1C VWD were also assigned by the VWF‐MAA. Conclusions: We demonstrate that the VWF‐MAA has utility in differentiating type 1 VWD, variant VWD and normal subjects in individuals undergoing an initial laboratory evaluation for bleeding. [ABSTRACT FROM AUTHOR]

Cutaneous leishmaniasis (CL) in Sri Lanka is caused by Leishmania donovani, a parasite widely known to cause visceral leishmaniasis. Despite the fact that CL is not generally believed to elicit serological immune responses, recent studies show the presence of antibody responses against this atypical form of CL. This study assesses the potential of using recombinant K39 (rK39), KMP11, and crude parasite antigen-based indirect ELISAs as serological diagnostic tools and measures of exposure for CL in Sri Lanka. The study used serum samples from confirmed CL patients (n = 266) and apparently healthy individuals from endemic settings (n = 411). Serum samples from individuals residing in non-endemic areas were used as negative controls. In-house indirect ELISAs were optimized and validated for recombinant antigens. Previously validated crude parasite extract-based indirect ELISA was performed for comparison. The statistical analyses were performed using SPSS v26.0. The rK39 (sensitivity = 71.2%, specificity = 64%) and KMP11 (sensitivity = 79.2%, specificity = 71.4%) based indirect ELISA were shown to be less suitable for the diagnosis of CL, while crude parasite extract-based indirect ELISA (sensitivity = 82.4%, specificity = 85.7%) might be a better method of diagnosis. All 03 ELISAs seemed to be good methods as measures of exposure since correlations were observed between the seropositivity of all 03 ELISAs (rK39: p = 0.037, KMP11: p = 0.007, CrudeAg: p = 0.000) with provincial case incidences. The findings will be important in identifying the disease hotspots in order to design the control measures for CL induced by L. donovani in Sri Lanka. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to determine an optimal cutoff value for the newly available HemosIL-AcuStar-HIT-IgG assay (AcuStar) for the diagnosis of heparin-induced thrombocytopenia (HIT). Method We evaluated the performance of AcuStar using serotonin release assay (SRA) as the gold standard and incorporated 4T score calculation in a cohort of suspected HIT cases. Statistical analysis was performed to determine optimal cutoff value for the diagnosis of HIT. Result A diagnosis of HIT can be excluded with a platelet factor 4 (PF4) value of <0.4 U/mL by AcuStar and 4T score in the low-risk category (≤3). All other cases will require confirmation with a functional test. Conclusion Our study resulted in the implementation of a diagnostic algorithm for laboratory diagnosis of HIT, which incorporates pretest calculation of 4T score and AcuStar as a screening test, with reflex confirmation by SRA. This new algorithm resulted in extended hours of test availability and a more rapid turnaround time in reporting PF4 results. [ABSTRACT FROM AUTHOR]

The aim of the paper was to highlight the importance and relevance of the proactive approach of microscopic laboratory techniques for prevention and control of major silkworm diseases thus contributing to the improvement of silkworm health and to augmentation of the sericulture production. The examinations were carried out by direct microscopy and laboratory diagnostic methods for specific diseases (bacterial, parasitic, mycotic and viral) according to the methodology of the OIE Manual, adapted to the conditions of the Laboratory of Genetics, Breeding and Pathology of Silkworms of S.C.S. Baneasa, Bucharest. Direct microscopical and bacterioscopic examinations were carried out to exclude the risk of the presence of pathogens in future generations selected for the conservation of the genetic background. Samples collected from the 84 breeds under conservation were subjected to direct microscopy and bacterioscopic examinations on two developmental stages of silkworms - egg and larval stage (L3). The results of the laboratory examinations required the elimination of inappropriate biological material from the reproduction, that allowed obtaining disease-free reproductive material of the best quality. In the present research paper, we demonstrated the importance of the proactive approach of microscopic laboratory techniques for prevention and control of major silkworm diseases in order to select breeds, lines and hybrids of silkworms with resistance to diseases owned by S.C.S. Baneasa, Bucharest. [ABSTRACT FROM AUTHOR]

Severe fever with thrombocytopenia syndrome (SFTS) is an acute infectious disease prevalent in East Asia with a high mortality rate (5%–30%). Reverse transcription loop‐mediated isothermal amplification (RT‐LAMP), a rapid nucleic acid‐based diagnostic technique, is a useful alternative for the clinical diagnosis of SFTS, particularly in resource‐limited hospitals or rural clinics in SFTS virus‐endemic regions. However, the actual clinical sensitivity and specificity of RT‐LAMP remain unclear. This study evaluated the field application of RT‐LAMP. This prospective field study included 130 patients with laboratory‐confirmed SFTS from Yantai, Shandong Province, China. Two sets of RT‐LAMP primers were validated, and one set of RT‐LAMP assays was optimized for field detection. Nucleic acids of serially collected serum/plasma samples were identified using quantitative reverse transcription polymerase chain reaction (RT‐qPCR) and RT‐LAMP. In laboratory tests, we optimized the detection time of primer set 2 for the RT‐LAMP to 60 min. Notably, the onsite testing of 279 plasma samples from patients with SFTS revealed that the sensitivity and specificity of the test were 81.9% and 96.3%, respectively. We also analyzed samples with different durations of the disease, and our study showed that the sensitivity of RT‐LAMP detection at the beginning of admission was 89.92%. Univariate analysis showed that the detection rate of RT‐LAMP was similar to that of RT‐qPCR in the first 5 days of the disease course and was lower than that of RT‐qPCR on Days 6 and 14–15 of the disease course. The positive detection rate in patients aged ≥ 65 years was significantly higher than that in younger age groups. RT‐LAMP is a simple, suitable, and rapid clinical detection method of SFTS onsite screening. It is more suitable for screening patients in the early stages of the disease and analyzing samples obtained from patients aged ≥ 65 years before the 6th day of the disease course. [ABSTRACT FROM AUTHOR]

Chronic pulmonary aspergillosis (CPA) is a chronic progressive lung disease associated with a poor prognosis and a 5-year mortality rate of approximately 40–50%. The disease is characterized by slowly progressive destruction of the lung parenchyma, in the form of multiple cavities, nodules, infiltrates or fibrosis. CPA can be challenging to diagnose due to its non-specific symptoms and similarities with other respiratory conditions combined with the poor awareness of the medical community about the disease. This can result in delayed treatment even for years and worsening of the patient's condition. Serological tests certainly play a significant role in diagnosing CPA but cannot be interpreted without radiological confirmation of CPA. Although many data are published on this hot topic, there is yet no single definitive test for diagnosing CPA, and a multidisciplinary approach which involves a combination of clinical picture, radiological findings, microbiological results and exclusion of other mimicking diseases, is essential for the accurate diagnosis of CPA. [ABSTRACT FROM AUTHOR]

Background: The prevalence of respiratory infections is largely underexplored in Kuwait. The aim of our study is to determine the etiology of infections from patients who are SARS-CoV-2 negative hospitalized with severe lower respiratory tract infections (LRTIs) in Kuwait during the coronavirus disease 2019 (COVID-19) pandemic. Methods: We conducted an observational cross-sectional study among severe LRTI patients between September 2021 and March 2022. Respiratory samples from 545 non-COVID-19 severe LRTIs patients were prospectively evaluated with FTD Respiratory 21 Plus® real-time PCR, targeting 20 different viruses and 1 atypical bacterial pathogen. Results: Among all 545 hospitalized cases, 411 (75.4 %) tested positive for at least one respiratory pathogen. The most common were rhinovirus (HRV) (32.7 %), respiratory syncytial virus (RSV) (20.9 %), metapneumovirus (HMPV) (14.1 %), bocavirus (13.2 %), and influenza A (12.7 %). The proportion of pathogens detected was highest in the under-5 age group, while HKU1 (44.4 %) predominated in the elderly (>50 years). Conclusion: Our study reveals a high prevalence of respiratory viruses in severe acute lower respiratory tract infections among non-COVID-19 hospitalized patients in Kuwait. HRV remains the main etiology affecting the country, particularly in infants. These results underscore the necessity of employing multiplex PCR for accurate diagnosis and describing the epidemiology of infections among severe lower respiratory tract infections. This will facilitate the use of specific antiviral therapy and help avoid excessive or inappropriate antibiotic therapy.

ABSTRACT: Rabies is a viral encephalitis that affects mammals, including humans. Rapid and effective laboratory diagnosis of the rabies virus is critical for public health. This study evaluated the operational, technical, and financial viability of the RT-qPCR in replacement of inoculation in mice for diagnosing rabies in the laboratory routine. A total of 316 samples of mammalian brains were analyzed, 121 positives and 195 negatives, previously diagnosed by direct immunofluorescence (DIF) and mouse inoculation test (MIT). The samples were submitted to the duplex TaqMan RT-qPCR technique. The accuracy, sensitivity, and specificity of RT-qPCR were analyzed. We analyzed the costs for performing the RT-qPCR technique and compared it with the cost of MIT. The results showed 99.37% accuracy, 99.17% sensitivity, and 99.49% specificity by RT-qPCR when related to DIF and MIT results, which proved to be a robust and repeatable technique. The minimum time for a positive diagnosis was reduced in RT-qPCR (1 day) if compared to MIT (9.64 days), with a 17.7% reduction in the cost of the molecular technique. The present study demonstrated that the molecular biology technique is an efficient tool to diagnose rabies in the laboratory routine, being able to replace MIT.

Urinary tract infections (UTIs) are among the most common bacterial infections in the United States and are a major driver of antibiotic use, both appropriate and inappropriate, across healthcare settings. Novel UTI diagnostics are a strategy that might enable better UTI treatment. Members of the Antibacterial Resistance Leadership Group Laboratory Center and the Infectious Diseases Society of America Diagnostics Committee convened to envision ideal future UTI diagnostics, with a view towards improving delivery of healthcare, patient outcomes and experiences, and antibiotic use, addressing which types of UTI diagnostics are needed and how companies might approach development of novel UTI diagnostics.

The aim of the study was to assess the effectiveness of the developed anthrax magnoimmunosorbents (MIS) for the selective concentration of Bacillus anthracis spores and to increase the sensitivity of anthrax agent detection techniques, including when testing soil samples.Materials and methods. We used 10 vaccine strains of B. anthracis and 30 strains of closely related bacilli of the genus Bacillus (B. cereus – 15, B. thuringiensis – 10, B. megaterium – 5) with typical species properties. The work was performed on three experimental batches of magnoimmunosorbents. DNA extraction and PCR setting was carried out in compliance with the instructions for reagent panel for B. anthracis DNA detection “ApliSens Bacillus anthracis-FRT”.Results and discussion. It is shown that when using MIS, the sensitivity of the cultural method is increased by at least 7 times (taking into account the possibility of sorption of 1–10 or more spores on a sorbent particle). The sensitivity of the PCR method is improved by 10 times and amounts to 50 B. anthracis spores per 1 ml for the samples concentrated with the help of MIS. The sensitivity of the bacteriological method using MIS increases by a factor of 7.5 when testing the artificially contaminated with B. anthracis soil samples. Hence, application of the developed MIS makes it possible to significantly enhance the sensitivity of anthrax agent detection methods and can be considered as an effective means of sample preparation for the investigation of environmental objects (soil).

Bacterial vaginosis (BV), an imbalance of normal vaginal microecology, is manifested as a mixed infection. It is characterized by a decrease of normal hydrogen peroxide-producing lactobacillus and an overgrowth of anaerobic bacteria (mobiluncus, prevotella) and facultative bacteria (gardnerella vaginalis, atopo vaginalis). BV is a risk factor for pelvic inflammatory disease, infertility, sexually transmitted pathogens (human papillomavirus, human immunodeficiency virus, neisseria gonorrhoeae, chlamydia trachomatis, etc.) infection. In addition, BV during pregnancy can lead to adverse obstetrical outcomes, including early miscarriage, premature delivery, postpartum endometritis, and low birth weight. The pathogens causing BV are diverse and have a high recurrence rate after treatment. About 10% to 50% of BV patients have no clinical symptoms and are easy to miss diagnosis. Rapid and accurate laboratory detection can provide timely diagnosis and treatment for BV patients and avoid adverse outcomes. Therefore, this paper reviews the research progress of diagnostic criteria, vaginal microecological evaluation and novel detection methods for BV, in order to provide reference for clinical diagnosis and treatment of BV.

Acute bacterial meningitis (ABM) is a life threatening infection in children, associated with long term complications and high mortality rate.1,2 Gram staining and culture are routinely used for diagnosis of ABM. Antigen detection by latex agglutination can provide prompt results thereby facilitating early initiation of empirical antibiotic treatment. To estimate the proportion of Laboratory confirmed cases among children admitted with clinical suspicion of acute bacterial meningitis in a tertiary care hospital. To compare and analyse the diagnostic efficacy of Culture, Gram stain and antigen detection by Latex agglutination in Cerebrospinal fluid (CSF) samples for laboratory detection of Acute bacterial meningitis. CSF samples from pediatric patients with clinical suspicion of ABM were analysed by Gram stain, culture and Antigen detection by Latex agglutination method. Results were recorded and analysed. Of the 50 clinically suspected cases, 13(26%) were confirmed as Acute bacterial meningitis by laboratory investigations. Among the organisms identified, Streptococcus pneumoniae was the most common isolate in 5(38.46%) cases followed by Neisseria meningitidis, Klebsiella pneumoniae and Acinetobacter baumannii in 2(15.38%) cases each and Escherichia coli and Group B Streptococcus in 1(7.69%) case each. Among the confirmed cases, 7(53%) samples showed culture positivity while Gram stain identified 8(61.53%)cases. Latex agglutination test showed positivity in 9(69.23%) cases. In life threatening infections like acute bacterial meningitis, where early diagnosis and prompt treatment is of utmost importance, Latex agglutination test can provide results within minutes facilitating early initiation of empirical therapy, making it an effective adjunct to gram stain and culture.

Objectives The number of reported cases of Legionnaires’ disease (LD) in the Republic of Korea surged nationally in 2016; however, in 2022, this number was higher in Jeju Province than the previous national peak. A descriptive epidemiological study was conducted to analyze trends in the incidence of reported LD cases in Jeju Island from 2015 to 2022. Methods The data for this study were obtained from case reports submitted to the Korea Disease Control and Prevention Agency through its Disease and Health Integrated Management System. The selection criteria were cases or suspected cases of LD reported among Jeju residents between 2015 and 2022. The 95% confidence interval of the crude incidence rate was calculated using the Poisson distribution. Results Since 2020, the incidence rate of LD in Jeju has risen sharply, showing a statistically significant difference from the national incidence rate. A particular medical institution in Jeju reported a significant number of LD cases. Screening with the urine antigen test (UAT) also increased significantly. Conclusion Our findings indicate that the rapid increase in cases of LD in Jeju Province since 2020 was due to the characteristics of medical-care use among Jeju residents, which were focused on a specific medical institution. According to their clinical practice guidelines, this medical institution conducted UATs to screen patients suspected of pneumonia.

Trypanosoma cruzi infection is diagnosed by parasitological, molecular, and serological tests. Molecular methods based on DNA amplification provide a more sensitive alternative to classical parasitological techniques for detecting evidence of T. cruzi parasitemia, and are the preferred tests for congenital and oral transmission cases and parasite reactivation in chronically infected immunosuppressed individuals. In newborns at risk of vertical transmission, simplified diagnostic algorithms that provide timely results can reduce the high follow-up losses observed with current algorithms. Molecular methods have also proved useful for monitoring T. cruzi infection in solid organ transplantation recipients, regardless of host immune status, allowing parasite detection even before symptom manifestation. Furthermore, in the absence of other biomarkers and a practical test of cure, and given the limitations of serological methods, recent clinical guidelines have included polymerase chain reaction (PCR) to detect therapeutic failure after antiparasitic treatment in chronically infected adults. Increasing evidence supports the use of molecular tests in a clinical context, given the improved sensitivity and specificity of current assays – characteristics which largely depend on epidemiological factors and genetic and antigenic variability among T. cruzi strains. Further development and registration of commercial PCR kits will improve the use of molecular tests. We discuss the attributes of PCR and other molecular tests for clinical management in people with T. cruzi infection.

Background: Eating disorders have become increasingly prevalent over the years; the age at which they appear has decreased, and they can lead to serious illness or death. Therefore, the number of studies on the matter has increased. Eating disorders like anorexia nervosa (AN) and bulimia nervosa (BN) are affected by many factors including mental illnesses that can have serious physical and psychological consequences. Accordingly, the present study aimed to compare the clinical and metabolic features of patients with AN and BN and identify potential biomarkers for distinguishing between the two disorders. Methods: Clinical data of 41 participants who sought treatment for eating disorders between 2012 and 2022, including 29 AN patients and 12 BN patients, were obtained from NPIstanbul Brain Hospital in Istanbul, Turkey. The study included the clinical variables of both outpatient and inpatient treatments. Principal component analysis (PCA) was utilized to gain insights into differentiating AN and BN patients based on clinical characteristics, while machine learning techniques were applied to identify eating disorders. Findings: The study found that thyroid hormone levels in patients with AN and BN were influenced by non-thyroidal illness syndrome (NTIS), which could be attributed to various factors, including psychiatric disorders, substance abuse, and medication use. Lipid profile comparisons revealed higher triglyceride levels in the BN group (P < 0.05), indicating increased triglyceride synthesis and storage as an energy source. Liver function tests showed lower levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in BN patients (P < 0.05), while higher prolactin levels (P < 0.05) suggested an altered hypothalamicpituitary-gonadal axis. Imbalances in minerals such as calcium and magnesium (P < 0.05) were observed in individuals with eating disorders. PCA effectively differentiated AN and BN patients based on clinical features, and the Naïve Bayes (NB) model showed promising results in identifying eating disorders. Conclusion: The findings of the study provide important insights into AN and BN patients' clinical features and may help guide future research and treatment strategies for these conditions. [ABSTRACT FROM AUTHOR]

This study investigates the impact of sample type on the measurement of 25-OH-vitamin D using the Liaison XL (Diasorin) and Cobas e801 (Roche). This investigation was motivated by the need to optimize sample volume usage, which led us to adopt the use of heparin plasma, an alternative proposed by Diasorin in their specification. Discordant and unexplainable results were observed, prompting us to evaluate the effect of sample type on the accuracy of the 25-OH-vitamin D measurements. We collected 34 different paired samples from a randomly selected patients who had two types of tubes taken simultaneously: serum-gel and lithium-heparin plasma tubes. The 25-OH-vitamin D levels were measured using Cobas e801 and Liaison. Statistical analysis was performed using the Mann-Whitney test to calculate the p-value. Biases were also calculated. When comparing the heparin matrix with the serum matrix on the Liaison XL analyzer, a higher proportion (p <.0001; 79% versus 64%) of patients were classified in the 'normal group', while fewer were classified in the 'insufficiency' or 'deficiency group'. The heparin tubes on the Liaison XL analyzer showed a mean bias of 57.5%) (p-value <.001; 95%CI: 37.6–77.4) compared to the serum tubes. On the other hand, the heparin tubes on the Cobas e801 analyzer showed a mean bias of −0.2% (95%CI: −4.8 to 4.5) compared to the serum tubes. It is imperative for laboratory professionals to be aware of this interference for an accurate measurement of 25-OH-vitamin D levels on the Liaison XL. Further research is needed to understand the mechanism of this interference. [ABSTRACT FROM AUTHOR]

Objectives: Quantitative reverse transcription-polymerase chain reaction (qPCR) is used as the gold standard method to diagnose COVID-19 infection caused by SARS-CoV-2 which is the cause of the most important epidemic in world history. It was aimed to compare the results of two of the most commonly used commercial kits for the diagnosis of SARS-CoV-2 mutation in our laboratory during the pandemic. Methods: Our study included 5000 SARS-CoV-2 PCR positive nasopharyngeal swab samples (2500 L452R mutation positive samples, 2500 L452R mutation negative samples). PCR positivity and negativity of the L452R mutation of the positive SARS-CoV-2 positive samples were identified with the Diagnovital® (DIAGNO5plex NS SARS-CoV-2 Real Time PCR Kit [A1 Life Sciences Istanbul]) kit. The mentioned samples were also studied with a different commercial PCR kit, Bio-Speedy® (SARS-CoV-2 Emerging Plus Real Time PCR Kit [Bioeksen R&D Technologies Istanbul]). Results: A total of 5000 samples included in the study were concluded as SARS-CoV-2 positive with both tests. One hundred and fifty of 2500 samples that were found positive for SARS-CoV-2 but negative for L452R mutations with the Diagnovital® kit were found positive with the Bio-Speedy® kit for SARS-CoV-2. The compatability between the two kits was found to be high (Kappa = 0.940). The mean Ct values of the samples found positive with the Diagnovital® kit and Bio-Speedy® kit were 24.15 ± 6.75 and 20.72 ± 7.17, respectively and the difference was statistically significant. Conclusions: It was determined the two commercial kits included in the study were extremely compatible based on their analysis. Therefore both kits can be used safely for COVID-19 symptomatic patients. [ABSTRACT FROM AUTHOR]

Acute bacterial meningitis (ABM) is a life threatening infection in children, associated with long term complications and high mortality rate.1,2 Gram staining and culture are routinely used for diagnosis of ABM. Antigen detection by latex agglutination can provide prompt results thereby facilitating early initiation of empirical antibiotic treatment. To estimate the proportion of Laboratory confirmed cases among children admitted with clinical suspicion of acute bacterial meningitis in a tertiary care hospital. To compare and analyse the diagnostic efficacy of Culture, Gram stain and antigen detection by Latex agglutination in Cerebrospinal fluid (CSF) samples for laboratory detection of Acute bacterial meningitis. CSF samples from pediatric patients with clinical suspicion of ABM were analysed by Gram stain, culture and Antigen detection by Latex agglutination method. Results were recorded and analysed. Of the 50 clinically suspected cases, 13(26%) were confirmed as Acute bacterial meningitis by laboratory investigations. Among the organisms identified, Streptococcus pneumoniae was the most common isolate in 5(38.46%) cases followed by Neisseria meningitidis, Klebsiella pneumoniae and Acinetobacter baumannii in 2(15.38%) cases each and Escherichia coli and Group B Streptococcus in 1(7.69%) case each. Among the confirmed cases, 7(53%) samples showed culture positivity while Gram stain identified 8(61.53%)cases. Latex agglutination test showed positivity in 9(69.23%) cases. In life threatening infections like acute bacterial meningitis, where early diagnosis and prompt treatment is of utmost importance, Latex agglutination test can provide results within minutes facilitating early initiation of empirical therapy, making it an effective adjunct to gram stain and culture. [ABSTRACT FROM AUTHOR]

Monkeypox infection outbreaks have been observed sporadically in Africa, usually as a result of interaction with wildlife reservoirs. The genomes of the new strain range in size from 184.7 to 198.0 kb and are identified with 143–214 open reading frames. Viral cores are rapidly carried on microtubules away from the cell's perimeter and deeper into the cytoplasm once the virus and cell membranes fuse. Depending on the kind of exposure, patients with monkeypox may experience a febrile prodrome 5–13 days after exposure, which frequently includes lymphadenopathy, malaise, headaches, and muscle aches. A different diagnostic approach is available for monkeypox, including histopathological analysis, electron microscopy, immunoassays, polymerase chain reaction, genome sequencing, microarrays, loop‐mediated isothermal amplification technology and CRISPR (i.e., "clustered regularly interspaced short palindromic repeats"). There are currently no particular, clinically effective treatments available for the monkeypox virus. An initial treatment is cidofovir. As a monophosphate nucleotide analog, cidofovir is transformed into an inhibitor of viral DNA polymerase by cellular kinases, which is analogous to cidofovir's function in inhibiting viral DNA synthesis. The European Medicine Agency and the Food and Drug Administration have both granted permission for IMVAMUNE, a replication‐deficient, attenuated third‐generation modified vaccinia Ankara vaccine, to be used for the prevention of smallpox and monkeypox in adults. [ABSTRACT FROM AUTHOR]

Tandem mass spectrometry is an important analytical tool for clinical laboratories, but tests developed and validated in-house (laboratory developed tests, or LDTs) require special consideration. In late 2022, the forecast for United States (U.S.) federal regulation of LDTs changed unexpectedly when the VALID Act was not passed by the U.S. Congress. This Act would have modified the Food and Drug Administration's (FDA's) role to increase regulatory oversight for LDT providers. In this revised context, we review optimization of quantitative mass spectrometry LDT validation and suggest avenues other than an additional FDA mandate to achieve uniform best practice. Common challenges, logistical barriers, and recommendations for easing the burden of best-quality quantitative mass spectrometry LDT method validation are discussed.

Background: Measles is a highly contagious illness. Sri Lanka (SL) has eliminated the measles in 2019. The country is at risk of importation of measles and there could be vaccine-associated measles like illnesses. Therefore, it is important to investigate patients with fever, rash to differentiate the wild-type from vaccine-type excluding other suspected pathogens to direct infection prevention and control strategies. The objective is to describe the laboratory investigation procedure in an immunocompetent child, developed fever, rash following measles containing vaccine in post-measles eliminated period, SL. Methods: This laboratory based investigation was carried out in National Measles Laboratory, SL. Blood and throat swab were received from a patient with fever, rash, cough and coryza developed at tenth day of receiving the measles containing live-attenuated vaccine. Samples were tested for measles, rubella, and other relevant pathogens according to the laboratory testing algorithm for an immunocompetent child with fever, rash and flu like symptoms. Results: Measles vaccine type A, Edmonston-strain virus was detected after sequencing in throat swab and measles IgM and IgG were positive at sixth-week of illness-onset. In addition, influenza A RNA was detected in throat swab at day-three with detectable parvoB19 IgM in blood sample received at sixth-week of post-onset symptoms. Conclusions: Measles like illness of this immunocompetent child who received measles containing vaccine could be due to measles vaccine-type A or influenza infection. In a measles eliminated, resource-limited setting in SL, there should be a well-defined, testing algorithm to exclude prevalent possible pathogens according to epidemiological and clinical information.

Introduction: The objective of the current study was to test our hypothesis that older patients sustaining high energy trauma need to be evaluated for their comorbidities similar to geriatric patients sustaining low energy trauma. Materials and methods: This study was a retrospective- prospective analysis of 173 patients of more than 50 years of age enrolled between November 2017 and December 2018. Herewith, we have compared retrospectively collected laboratory investigations of 124 fragility fracture patients with prospectively collected laboratory investigations of 49 patients with high energy trauma. The laboratory investigations, including the liver function tests, renal function tests, indices of calcium metabolism, serum electrolytes, complete blood counts, and bone mineral density (BMD) scores. Results: Both groups were similar to each other as far as baseline demographic characteristics were concerned. The proportion of female patients and patients with non-osteoporotic range BMD (T-score >-2.5) was significantly higher in the high-energy fracture group (P value 148mmol/L) 23.2%, Anaemia (10.4mg/dl) 16.3%, Vitamin D deficiency (

IntroductionThe provincial malaria diagnosis reference laboratories review and assess malaria cases diagnosed in health facilities for supporting the malaria elimination efforts and preventing re-transmission of imported malaria. The study aimed to evaluate the detection capability of malaria diagnosis in China from 2014 to 2021.MethodsData on malaria cases reported in the provincial-level administrative divisions (PLADs) of Anhui, Henan, Hubei, Guangxi, and Zhejiang from 2014 to 2021 were collected and analyzed.ResultsIn total, 5,770 malaria cases were reported from 2014 to 2021, and 99.05% (5,715/5,770) were submitted to the provincial malaria diagnosis reference laboratories. The median time between malaria cases being reported and the samples being received by reference laboratories was 6 days (Interquartile range, IQR:3–12 days) from 2017 to 2021. Diagnosis of 5,680 samples in the laboratory were confirmed by provincial reference laboratories, including 3,970 cases of Plasmodium falciparum, 414 of P. vivax, 1,055 of P. ovale, 158 of P. malariae, 1 of P. knowlesi, and 82 of mixed infections. Plasmodium species of 5,141 confirmed cases were consistent with the initial diagnosis, with a species accuracy rate of 90.53% (5,141/5,679). The accuracy of P. falciparum diagnosis in health facilities was higher than that of non-falciparum species. The inconsistency between microscopy and nested polymerase chain reaction (nPCR) results of confirmatory diagnosis was mainly in malaria-positive versus malaria-negative cases, as well as in mixed versus single infection cases.ConclusionThe provincial malaria diagnosis reference laboratories have played an important role in ensuring the accuracy and reliability of Plasmodium diagnosis in health facilities. However, the results of this study imply that capacity training for the identification of Plasmodium species in health facilities is warranted.

Objective: Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) has caused a global pandemic with more than 664 million confirmed cases and more than 6.7 million deaths worldwide. In pandemic, several studies have been done about the relationship of some biochemical and hematological parameters with COVID 19 in order to assist diagnosis and treatment. However, a lot of information is not completely complete and there are contradictions in the data. In the present study, it was focused to compare the biochemical parameters of patients and healthy individuals due to COVID 19 by investigating the relationship between age and gender. Methods: The 317 individuals who consulted to the Pandemic Outpatient Clinic with the suspicion of COVID 19 between February 2022 and November 2022 were evaluated by laboratory tests. In present study, biochemical parameter values of individuals with positive and negative COVID 19 test outcomes were used as material. These biochemical parameters were compared statistically based on different age ranges and gender groups. Results: It was ascertained that the values such as urea (UREA), creatine (KREA), ferritin (FER), aspartate transaminase (AST), alanine transaminase (ALT), high sensitivity troponin I (HSTI), creatine kinase (CK) and C reactive protein (CRP) in male patients with COVID 19 were higher than female patients with COVID 19. Moreover, it was detected that there was a statistically significant increase in parameters such as GLU, FER, AST, lactate dehydrogenase (LDH), HSTI, CK and CRP in COVID 19 patients aged 18-65 years. Conclusions: Many biomarkers of prognostic importance are expensive, ordinary and pricey-effective biomarkers such as FER, AST, LDH, HSTI, CK and CRP can be used to monitor disease in patients with COVID 19 infection. [ABSTRACT FROM AUTHOR]

The currently available biomarkers generally lack the specificity and sensitivity needed for the diagnosis and follow-up of patients with mitochondrial diseases (MDs). In this group of rare genetic disorders (mutations in approximately 350 genes associated with MDs), all clinical presentations, ages of disease onset and inheritance types are possible. Blood, urine, and cerebrospinal fluid surrogates are well-established biomarkers that are used in clinical practice to assess MD. One of the main challenges is validating specific and sensitive biomarkers for the diagnosis of disease and prediction of disease progression. Profiling of lactate, amino acids, organic acids, and acylcarnitine species is routinely conducted to assess MD patients. New biomarkers, including some proteins and circulating cell-free mitochondrial DNA, with increased diagnostic specificity have been identified in the last decade and have been proposed as potentially useful in the assessment of clinical outcomes. Despite these advances, even these new biomarkers are not sufficiently specific and sensitive to assess MD progression, and new biomarkers that indicate MD progression are urgently needed to monitor the success of novel therapeutic strategies. In this report, we review the mitochondrial biomarkers that are currently analyzed in clinical laboratories, new biomarkers, an overview of the most common laboratory diagnostic techniques, and future directions regarding targeted versus untargeted metabolomic and genomic approaches in the clinical laboratory setting. Brief descriptions of the current methodologies are also provided. [ABSTRACT FROM AUTHOR]

Several biophysical techniques were used to study the uromodulin isoforms in experimental models of the urine (ionic composition, osmolality, and pH) in the presence of intact uromodulin and its isoforms isolated from patients with urolithiasis. A prototype medical device for screening persons with preclinical urolithiasis was tested. A concept of targeted therapy of urolithiasis by modulating the uromodulin properties was advanced. [ABSTRACT FROM AUTHOR]

Laboratory diagnostic services are essential to drive evidence-based treatment decisions, manage outbreaks, and provide population-level data. Many low- and middle-income countries (LMICs) lack sufficient diagnostic capacity, often further exacerbated in conflict-affected areas. This project assessed laboratory services in conflict-affected LMICs to understand gaps and opportunities for improving laboratory capacity. The World Health Organization Laboratory Assessment Tool Facility Questionnaire (WHO Laboratory Tool) and Stepwise Laboratory Improvement Process Towards Accreditation (SLIPTA) checklist were used to assess five laboratories in Eastern Democratic Republic of the Congo (DRC) and five in Gaza, Palestine. Total scores and percentage outcomes by indicator were calculated. Average WHO Laboratory Tool score across all facilities was 41% (range 32–50%) in DRC and 78% (range 72–84%) in Gaza. Lowest scoring indicators in DRC were Biorisk management (13%, range 8–21%), Documentation (14%, range 6–21%), and in Gaza, were Facilities (59%, range 46–75%) and Documentation (60%, range 44–76%). Highest scoring indicators in DRC were Facilities (70%, range 45–83%) and Data and Information Management (61%, range 38–80%), and in Gaza were Data Information and Management (96%) and Public Health Function (91%, range 88–94%). In DRC, no laboratory achieved a SLIPTA star rating. In Gaza, two laboratories had a 3-star SLIPTA rating, one had a 2-star rating and two had a 1-star rating. Laboratory systems in conflict-affected LMICs have significant gaps. Implementating improvement strategies in such settings may be especially challenging. [ABSTRACT FROM AUTHOR]

Background and Aim: Rhodotorula mucilaginosa (R. mucilaginosa) has emerged as a potential pathogen in immunosuppressed hosts. This fungal agent rarely causes onychomycosis in immunocompetent hosts. In this study, onychomycosis caused by this strain on different fingernails and toenails in an Immunocompetent young adult is reported. Case Report: The patient was an 18-year-old woman with clinical symptoms of powdery, hyperkeratosis brief around erythema in the distal part of a toenail and deformity with a groove on surface of a fingernail who was referred to the Medical Mycology Laboratory of Hazrat Ghaem therapeutic center. After diagnostic procedures, he was treated with oral itraconazole 200 mg/day for 2 months along with topical clotrimazole and sulfacetamide ointment and was cured. The nails responded satisfactorily to the treatment. After two months of stopping the drug, the absence of fungus elements in the clinical samples was confirmed. Diagnosis and identification of the fungus was confirmed by morphological characteristics, culture, and DNA molecular method, and R. mucilaginosa was reported as the etiological agent of onychomycosis. Antifungal drug susceptibility was determined in laboratory using the disk diffusion method according to CLSI guidelines. Conclusion: The isolated species was reported as an unusual species of onychomycosis, which needs to be considered by mycology laboratory and clinical specialists for its sensitivity to ketoconazole, itraconazole, and econazole and its resistance to amphotericin B and nystatin. [ABSTRACT FROM AUTHOR]

David Bolaji Akinbo,1,2 Olutayo Ifedayo Ajayi3 1Department of Medical Laboratory Science, College of Medicine and Health Sciences, Afe Babalola University, Ado – Ekiti, Ekiti State, Nigeria; 2Department of Food, Nutrition, Dietetics and Health, College of Health and Human Sciences, Kansas State University, Manhattan, KS, USA; 3Department of Physiology, School of Basic Medical Sciences, College of Medical Sciences, University of Benin, Benin City, Edo State, NigeriaCorrespondence: David Bolaji Akinbo, Email dakinbo@ksu.eduAbstract: Cancer-associated thrombosis (CAT) is a leading cause of mortality in cancer patients and its incidence varies in different parts of the world. Venous thromboembolism (VTE) is a prominent manifestation of CAT, and significantly impacts morbidity and survival compared to arterial thrombosis in cancer patients. Several risk factors for developing VTE such as chemotherapy and immobilization have also been found co-existing with cancer patients and contributing to the increased risk of VTE in cancer patients than in non-cancer patients. This review highlights recent mechanisms in the pathogenesis of hypercoagulable syndromes associated with cancer, multiple mechanisms implicated in promoting cancer-associated thrombosis and their diagnostic approaches. Cancer cells interact with every part of the hemostatic system; generating their own procoagulant factors, through stimulation of the prothrombotic properties of other blood cell components or the initiation of clotting by cancer therapies which can all directly activate the coagulation cascade and contribute to the VTE experienced in CAT. It is our hope that the multiple interconnections between the hemostatic system and cancer biology and the improved biomarkers reported in this study can be relevant in establishing a predictive model for VTE, optimize early detection of asymptomatic microthrombosis for more personalized prophylactic strategies and incorporate effective therapeutic options and patient management to reduce mortality and morbidity, and improve the quality of life of affected cancer patients.Keywords: thrombosis, hemostasis, venous thromboembolism, Trousseau’s syndrome, laboratory diagnosis, cancer

Nosocomial pneumonia on average occurs in 8–20% of patients in the Intensive care unit (ICU) and in 27% of patients under mechanical ventilation (ventilator). The pnemonia prevalence depends on the duration of respiratory support, and is an independent predictor of adverse outcome in critically ill patients requiring mechanical ventilation. The study objective is to develop measures to prevent nosocomial ventilator-associated pneumonias (VAP) in surgical intensive care units. We analyzed the measures to prevent ventilator-associated respiratory tract infections in the surgical intensive care department (ICU) for 10 years (2004–2013). The prevalence of ventilator-associated respiratory tract infections is the highest (87.65±11.76%) in the stucture of health care-associated infections. The improved surveillance system produced the reliable data on the incidence density (increase from 3.9±0.8 in 2004 and 11.7±1.4 in 2007, per 1 000 ALV/day). Pathogens VAP were characterized by multiple drug resistance. The greatest resistance was found to aminoglycosides in the isolated microorganisms (69.5±6.8%). The percentage of desinfectant resistant strains ranged from 1.1±0.6% (chlorine-based disinfectants) to 13.13±4.8% (to quarternary ammonium based disinfectants). VAP prevention in the surgical ICU should be comprehensive and include a hospital-wide preventive measures.