scholarly journals The Laboratory Diagnosis of HIV Infections

2005 ◽  
Vol 16 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Margaret Fearon
Keyword(s):  
Point Of Care ◽  
Diagnostic Testing ◽  
Clinical Information ◽  
Hiv Infections ◽  
Laboratory Diagnosis ◽  
The United States ◽  
Specific Information ◽  
Antibody Testing ◽  
Diagnostic Laboratory ◽  
Laboratory Results

HIV diagnostic testing has come a long way since its inception in the early 1980s. Current enzyme immunoassays are sensitive enough to detect antibody as early as one to two weeks after infection. A variety of other assays are essential to confirm positive antibody screens (Western blot, polymerase chain reaction [PCR]), provide an adjunct to antibody testing (p24 antigen, PCR), or provide additional information for the clinician treating HIV-positive patients (qualitative and quantitative PCR, and genotyping). Most diagnostic laboratories have complex testing algorithms to ensure accuracy of results and optimal use of laboratory resources. The choice of assays is guided by the initial screening results and the clinical information provided by the physician; both are integral to the laboratory's ability to provide an accurate laboratory diagnosis. Laboratories should also provide specific information on specimen collection, storage and transport so that specimen integrity is not compromised, thereby preserving the accuracy of laboratory results. Point of Care tests have become increasingly popular in the United States and some places in Canada over the past several years. These tests provide rapid, on-site HIV results in a format that is relatively easy for clinic staff to perform. However, the performance of these tests requires adherence to good laboratory quality control practices, as well as the backup of a licensed diagnostic laboratory to provide confirmation and resolution of positive or indeterminate results. Laboratory quality assurance programs and the participation in HIV proficiency testing programs are essential to ensure that diagnostic laboratories provide accurate, timely and clinically relevant laboratory results.

scholarly journals The Laboratory Diagnosis ofHaemophilus ducreyi

2005 ◽  
Vol 16 (1) ◽  
pp. 31-34 ◽  
Author(s):  
Michelle Alfa
Keyword(s):  
Diagnostic Testing ◽  
Laboratory Diagnosis ◽  
Primary Method ◽  
Sample Collection ◽  
Culture Methods ◽  
Transmitted Infection ◽  
Diagnostic Laboratory ◽  
Sexually Transmitted ◽  
Alternative Approaches ◽  
Genetic Amplification

Chancroid is a sexually transmitted infection caused byHaemophilus ducreyi. This fastidious, Gram-negative coccobacilli dies rapidly outside the human host, making diagnostic testing using culture methods difficult. This genital ulcer infection is not common in Canada and, therefore, can often be misdiagnosed. The objective of the present paper is to provide practical approaches for the diagnosis of chancroid in Canadian patients where the prevalence of this infection is low. Issues related to sample collection, sample transport and available diagnostic tests are reviewed, and several alternative approaches are outlined. Although antigen detection, serology and genetic amplification methods have all been reported forH ducreyi, none are commercially available. Culture is still the primary method available to most laboratories. However, the special media necessary for direct bedside inoculation is often not available; therefore, communication with the diagnostic laboratory and rapid specimen transport are essential when chancroid is suspected

scholarly journals Geospatial Hotspots Need Point-of-Care Strategies to Stop Highly Infectious Outbreaks

2020 ◽  
Vol 144 (10) ◽  
pp. 1166-1190 ◽  
Author(s):  
Gerald J. Kost
Keyword(s):  
Infectious Disease ◽  
Emergency Response ◽  
Point Of Care ◽  
Diagnostic Testing ◽  
Community Resilience ◽  
The United States ◽  
Standards Of Care ◽  
Healthcare Personnel ◽  
Cloud Databases ◽  
Public Health Practitioners

Context.— Point-of-care testing (POCT), diagnostic testing at or near the site of patient care, is inherently spatial, that is, performed at points of need, and also intrinsically temporal, because it produces fast actionable results. Outbreaks generate geospatial “hotspots.” POC strategies help control hotspots, detect spread, and speed treatment of highly infectious diseases. Objectives.— To stop outbreaks, accelerate detection, facilitate emergency response for epidemics, mobilize public health practitioners, enhance community resilience, and improve crisis standards of care. Data Sources.— PubMed, World-Wide Web, newsprint, and others were searched until Coronavirus infectious disease-19 was declared a pandemic, the United States, a national emergency, and Europe, the epicenter. Coverage comprised interviews in Asia, email to/from Wuhan, papers, articles, chapters, documents, maps, flowcharts, schematics, and geospatial-associated concepts. EndNote X9.1 (Clarivate Analytics) consolidated literature as abstracts, ULRs, and PDFs, recovering 136 hotspot articles. More than 500 geospatial science articles were assessed for relevance to POCT. Conclusions.— POCT can interrupt spirals of dysfunction and delay by enhancing disease detection, decision-making, contagion containment, and safe spacing, thereby softening outbreak surges and diminishing risk before human, economic, and cultural losses mount. POCT results identify where infected individuals spread Coronavirus infectious disease-19, when delays cause death, and how to deploy resources. Results in national cloud databases help optimize outbreak control, mitigation, emergency response, and community resilience. The Coronavirus infectious disease-19 pandemic demonstrates unequivocally that governments must support POCT and multidisciplinary healthcare personnel must learn its principles, then adopt POC geospatial strategies, so that onsite diagnostic testing can ramp up to meet needs in times of crisis.

scholarly journals Case report of the patient source of the Babesia microti R1 reference strain and implications for travelers

2017 ◽  
Vol 25 (1) ◽  
Author(s):  
Philipp Stahl ◽  
Yves Poinsignon ◽  
Pascal Pouedras ◽  
Vasilica Ciubotaru ◽  
Laurence Berry ◽  
...  
Keyword(s):  
Cell Biology ◽  
Febrile Illness ◽  
Clinical Information ◽  
The United States ◽  
Babesia Microti ◽  
Cape Cod ◽  
Antibody Testing ◽  
Worldwide Distribution ◽  
The Usa ◽  
Endemic Areas

AbstractBackgroundIn 2002, a previously healthy 69-year-old man travelled to France from the United States and presented to our hospital with a febrile illness that subsequently was determined to be babesiosis. The blood isolated from this patient served as a source for propagation of the Babesia microti R1 strain with subsequent sequencing and annotation of the parasite genome.MethodsUpon admission, we obtained a medical history, performed a physical examination, and examined his blood for the presence of a blood borne pathogen by microscopy, PCR and indirect immunofluorescence antibody testing. Once the diagnosis of babesiosis was made, we reviewed the literature to assess the distribution of B. microti-associated babesiosis cases in immunocompetent patients from outside the USA.ResultsThe patient recalled a tick bite during the previous month on Cape Cod, Massachusetts. The diagnosis was confirmed by identification of Babesia-infected red blood cells on blood smears, amplification of B. microti DNA in blood by PCR and the presence of B. microti antibody in the serum. This strain was the first isolate of B. microti to be fully sequenced and its annotated genome serves as a reference for molecular and cell biology studies aimed at understanding B. microti pathophysiology and developing diagnostic tests and therapies. A review of babesiosis cases demonstrates a worldwide distribution of B. microti and identifies potential emerging endemic areas where travelers may be at risk of contracting B. microti infection.ConclusionThis case provides clinical information about the patient infected with the R1 isolate and a review of travel risk, diagnosis and treatment of babesiosis in endemic and non-endemic areas.

scholarly journals Laboratory Methods for COVID-19 Diagnosis

2021 ◽  
pp. 1-7
Author(s):  
Jonathan Nyebuchi ◽  
Emeji, Roseline ◽  
Konne Felix Eedee
Keyword(s):  
Rna Virus ◽  
Point Of Care ◽  
Diagnostic Testing ◽  
Screening Method ◽  
Laboratory Diagnosis ◽  
Laboratory Methods ◽  
Gold Standard Method ◽  
Laboratory Techniques ◽  
Primary Focus ◽  
And Control

Coronaviruses are a group of related RNA viruses that cause disease in mammals and birds. Covid-19 infection occurs due to an RNA virus which is single-stranded, called SARS-CoV-2; this virus is similar to SARS-CoV. This review throws light on the available laboratory techniques used for testing coronavirus. Certain challenges are encountered during the development of a diagnostic test for a novel pathogen, which depends on sensitivity of the method, that is, the potential in detecting very low pathogen level for early laboratory diagnosis, produce little or no interference with other strains of the virus, and produce results rapidly. Since the time of incubation and clinical manifestation of the infection are relatively the same with SARS, the widespread and effect of COVID-19 globally serve as the basis why the development of quick and reliable laboratory methods are necessary. Samples that could be collected for covid-19 testing includes blood (especially for screening purpose), nasal and throat swab. Currently, the gold standard method for laboratory diagnosis of Covid-19 infection is RT-PCR, which serves as a confirmatory method for Covid-19 testing. EIA and SVN laboratory techniques are other techniques used in detecting the viral infection. In addition, Rapid Diagnostic Testing (RDT) are currently developed for point-of-care testing, and often used as a screening method of Covid-19 infections. Early detection of the virus remains the primary focus for the treatment and control of SARS-CoV-2 infections. Therefore, this review was aimed at the available laboratory methods used in the diagnosis for coronavirus infection.

scholarly journals An Update on Advances in COVID-19 Laboratory Diagnosis and Testing Guidelines in India

2021 ◽  
Vol 9 ◽  
Author(s):  
K. S. Rajesh Kumar ◽  
Suhail Sayeed Mufti ◽  
Vinu Sarathy ◽  
Diganta Hazarika ◽  
Radheshyam Naik
Keyword(s):  
Large Scale ◽  
Vaccine Development ◽  
Point Of Care ◽  
Diagnostic Testing ◽  
Public Health Intervention ◽  
Laboratory Diagnosis ◽  
Accurate Diagnosis ◽  
Nucleic Acid Amplification ◽  
Rt Pcr ◽  
Outbreak Management

The declaration of COVID-19 as a global pandemic has warranted the urgent need for technologies and tools to be deployed for confirming diagnosis of suspected cases. Diagnostic testing for COVID-19 is critical for understanding epidemiology, contract-tracing, case management, and to repress the transmission of the SARS-CoV-2. Currently, the Nucleic Acid Amplification Test (NAAT)-based RT-PCR technique is a gold standard test used for routine diagnosis of COVID-19 infection. While there are many commercially available RT-PCR assay kits available in the market, selection of highly sensitive, specific, and validated assays is most crucial for the accurate diagnosis of COVID-19 infection. Laboratory diagnosis of SARS-CoV-2 is extremely important in the disease and outbreak management. Development of rapid point of care tests with better sensitivity and specificity is the critical need of the hour as this will help accurate diagnosis and aid in containing the spread of SARS-CoV-2 infection. Early detection of viral infection greatly enhances implementation of specific public health intervention, such as infection control, environmental decontamination, and the closure of specific high-risk zones. Large-scale sequencing of SARS-CoV-2 genome isolated from affected populations across the world needs to be carried to monitor mutations that might affect performance of molecular tests. Creation of genome repositories and open-source genetic databases for use by global researchers is clearly the way forward to manage COVID-19 outbreak and accelerate vaccine development. This review summarizes various molecular diagnostics methods, technical guidelines, and advanced testing strategies adopted in India for laboratory diagnosis of COVID-19.

scholarly journals Geospatial Spread of Antimicrobial Resistance, Bacterial and Fungal Threats to COVID-19 Survival, and Point-of-Care Solutions

2020 ◽  
Author(s):  
Gerald J. Kost
Keyword(s):  
Antimicrobial Resistance ◽  
San Francisco ◽  
Point Of Care ◽  
Diagnostic Testing ◽  
The United States ◽  
Pathogen Resistance ◽  
Standards Of Care ◽  
Healthcare Personnel ◽  
Diagnostic Challenge ◽  
Antimicrobial Drugs

ABSTRACT Context. Point-of-care testing (POCT) is inherently spatial, that is, performed where needed, and intrinsically temporal, because it accelerates decision making. POCT efficiency and effectiveness have the potential to facilitate antimicrobial resistance (AMR) detection, decrease risks of co-infections for critically ill COVID-19 patients, and improve the cost-effectiveness of healthcare. Objectives. To assess AMR identification using POCT, describe the United States AMR Diagnostic Challenge, and improve global standards of care for infectious diseases. Data Sources PubMed, WWW, and other sources were searched for papers focusing on AMR and POCT. EndNote X9.1 (Clarivate Analytics) consolidated abstracts, URLs, and PDFs representing ~500 articles assessed for relevance. Panelist insights at Tri•Con 2020 in San Francisco and finalist POC technologies competing for a US $20,000,000 AMR prize are summarized. Conclusions. Co-infections represent high risks for COVID-19 patients. POCT potentially will help target specific pathogens, refine choices for antimicrobial drugs, and prevent excess morbidity and mortality. POC assays that identify patterns of pathogen resistance can help tell us how infected individuals spread AMR, where geospatial hotspots are located, when delays cause death, and how to deploy preventative resources. Shared AMR data “clouds” could help reduce critical care burden during pandemics and optimize therapeutic options, similar to use of antibiograms in individual hospitals. Multidisciplinary healthcare personnel should learn the principles and practice of POCT, so they can meet needs with rapid diagnostic testing. The stakes are high. AMR is projected to cause millions of deaths annually and cumulative financial loses in the trillions by 2050.

scholarly journals Recognition of Diagnostic Gaps for Laboratory Diagnosis of Fungal Diseases: Expert Opinion from the Fungal Diagnostics Laboratories Consortium (FDLC)

2021 ◽  
Author(s):  
Sean X. Zhang ◽  
N. Esther Babady ◽  
Kimberly E. Hanson ◽  
Amanda T. Harrington ◽  
Paige M.K. Larkin ◽  
...  
Keyword(s):  
Expert Opinion ◽  
Fungal Pathogens ◽  
Fungal Infections ◽  
Point Of Care ◽  
Antifungal Susceptibility ◽  
Diagnostic Algorithm ◽  
Laboratory Diagnosis ◽  
The United States ◽  
Diagnostic Challenge ◽  
Flight Mass Spectrometry

Fungal infections are a rising threat to our immunocompromised patient population as well as other non-immunocompromised patients with various medical conditions. However, little progress has been made in the past decade to improve fungal diagnostics. To jointly address this diagnostic challenge, the Fungal Diagnostics Laboratory Consortium (FDLC) was recently created. The FDLC consists of 26 laboratories from the United States and Canada that routinely provide fungal diagnostic services for patient care. A survey of fungal diagnostic capacity among the 26 members of the FDLC was recently completed, identifying the following diagnostic gaps: lack of molecular detection of mucormycosis; lack of an optimal diagnostic algorithm incorporating fungal biomarkers and molecular tools for early and accurate diagnosis of Pneumocystis pneumonia, aspergillosis, candidemia, and endemic mycoses; lack of a standardized molecular approach to identify fungal pathogens directly in formalin-fixed paraffin-embedded tissues; lack of robust databases to enhance mold identification with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry; suboptimal diagnostic approaches for mold blood cultures, tissue culture processing for Mucorales, and fungal respiratory cultures for cystic fibrosis patients; inadequate capacity for fungal point-of-care testing, to detect and identify new, emerging or under-recognized, rare or uncommon fungal pathogens, and performance of antifungal susceptibility testing. In this commentary, the FDLC delineates the most pressing unmet diagnostic needs and provides expert opinion on how to fulfill them. Most importantly, the FDLC provides a robust laboratory network to tackle these diagnostic gaps and ultimately to improve and enhance the clinical laboratory’s capability to rapidly and accurately diagnose fungal infections.

scholarly journals Empowering Equitable Data Use Partnerships and Indigenous Data Sovereignties Amid Pandemic Genomics

2021 ◽  
Vol 9 ◽  
Author(s):  
Rodney C. Haring ◽  
Jessica W. Blanchard ◽  
Josephine D. Korchmaros ◽  
Justin R. Lund ◽  
Emily A. Haozous ◽  
...  
Keyword(s):  
Public Health ◽  
Diagnostic Testing ◽  
Data Use ◽  
Indigenous Communities ◽  
The United States ◽  
Relationship Building ◽  
Antibody Testing ◽  
Testing Specimen ◽  
Unrestricted Access ◽  
Tribal Nations

The COVID-19 pandemic has inequitably impacted Indigenous communities in the United States. In this emergency state that highlighted existing inadequacies in US government and tribal public health infrastructures, many tribal nations contracted with commercial entities and other organization types to conduct rapid diagnostic and antibody testing, often based on proprietary technologies specific to the novel pathogen. They also partnered with public-private enterprises on clinical trials to further the development of vaccines. Indigenous people contributed biological samples for assessment and, in many cases, broadly consented for indefinite use for future genomics research. A concern is that the need for crisis aid may have placed Indigenous communities in a position to forego critical review of data use agreements by tribal research governances. In effect, tribal nations were placed in the unenviable position of trading short-term public health assistance for long-term, unrestricted access to Indigenous genomes that may disempower future tribal sovereignties over community members' data. Diagnostic testing, specimen collection, and vaccine research is ongoing; thus, our aim is to outline pathways to trust that center current and future equitable relationship-building between tribal entities and public-private interests. These pathways can be utilized to increase Indigenous communities' trust of external partners and share understanding of expectations for and execution of data protections. We discuss how to navigate genomic-based data use agreements in the context of pathogen genomics. While we focus on US tribal nations, Indigenous genomic data sovereignties relate to global Indigenous nations regardless of colonial government recognition.

scholarly journals HIV infection in England and Wales: a changing pattern

1989 ◽  
Vol 102 (2) ◽  
pp. 355-359 ◽  
Author(s):  
H. L. Taylor ◽  
P. P. Mortimer
Keyword(s):  
Diagnostic Testing ◽  
Clinical Information ◽  
Hiv Infections ◽  
Drug Abusers ◽  
Reference Laboratory ◽  
England And Wales ◽  
Free Data ◽  
Data Compromise ◽  
Anti Hiv ◽  
Positive Results

SUMMARYOf 32983 specimens from 307 sources in England and Wales tested in the Virus Reference Laboratory for anti-HIV between 1984 and 1987, 6491 (20%) were positive. Ninety-five per cent of the positive subjects were male and 44% of them were from three London genito-urinary medicine clinics. In 1987 the numbers of newly diagnosed HIV infections decreased in homosexual men and haemophiliacs and increased in injecting drug abusers; 148/119 (12%) of all the positive findings in 1987 were in females. Between 1984 and 1987 the proportion of anti-HIV positive individuals who were asymptomatic fell by nearly 10% and the proportion with AIDS/ARC rose by nearly 10%. Of the requests leading to positive results 1280 (20%) were recognized as duplicates of previous positive results, while for 34 % of the requests no clinical information was provided. These deficiencies in the data compromise HIV surveillance based on diagnostic testing, and supplementary bias-free data are needed.

scholarly journals Peer mobilisation and HIV partner notification services among gay, bisexual, other men who have sex with men and transgender women in coastal Kenya identified a high number of undiagnosed HIV infections

2021 ◽  
Author(s):  
Maartje Dijkstra ◽  
Khamisi Mohamed ◽  
Alex Kigoro ◽  
Teresia Mumba ◽  
Shally Mahmoud ◽  
...  
Keyword(s):  
Point Of Care ◽  
Partner Notification ◽  
Hiv Infections ◽  
Transgender Women ◽  
Newly Diagnosed ◽  
Antibody Testing ◽  
Self Testing ◽  
Undiagnosed Hiv ◽  
Sex With Men ◽  
Exposure Prophylaxis

Abstract Introduction HIV partner notification services (HPN), peer mobilisation with HIV self-testing and acute and early HIV infection (AEHI) screening among gay, bisexual, other men who have sex with men (GBMSM) and transgender women (TGW) were assessed for acceptability, feasibility and linkage to antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) services. Methods Between April-August 2019, peer mobilisers mobilised clients by offering HIV oral self-tests and immediate clinic referral for clients with AEHI symptoms. Mobilised participants received clinic-based rapid antibody testing and point-of-care HIV-RNA testing. Newly diagnosed participants including those derived from HIV testing services were offered immediate ART and HPN. Partners were recruited through HPN. . Results Of 772 mobilised clients, 452 (58.5%) enrolled in the study as mobilised participants. Of these, 16 (3.5%) were HIV newly diagnosed, including 2 (0.4%) with AEHI. All but two (14/16, 87.5%) initiated ART. 35 GBMSM and TGW were offered HPN and 27 (77.1%) accepted it. Provider referral identified a higher proportion of partners tested (39/64; 60.9% vs. 5/14; 35.7%) and partners with HIV (27/39; 69.2% vs. 2/5; 40.0%) than index referral. Of 44 enrolled partners, 10 (22.7%) were newly diagnosed, including 3 (6.8%) with AEHI. All 10 (100%) initiated ART. PrEP was initiated among 24.0% (103/429) mobilised participants and 28.6% (4/14) partners without HIV. Conclusions HPN, combined with a peer mobilisation-led self-testing strategy and AEHI screening for GBMSM and TGW, appears acceptable and feasible. These strategies, especially HPN provider referral, effectively identified undiagnosed HIV infections and linked individuals to ART and PrEP-services.

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