Predictive Value of Amniotic Fluid Gram Stain in Postcesarean Endomyometritis

1992 ◽  
Vol 1 (4) ◽  
pp. 172-176 ◽  
Author(s):  
Alfred Z. Abuhamad ◽  
Christian L. Otrakji ◽  
Roberto Romero ◽  
Salih Y. Yasin ◽  
Mary Jo O'sullivan
Keyword(s):  
Amniotic Fluid ◽  
Predictive Value ◽  
Gram Stain

A Rapid Amniotic Fluid Interleukin-6 Assessment for the Identification of Intra-Amniotic Inflammation in Women with Preterm Labor and Intact Membranes

2021 ◽  
pp. 1-6
Author(s):  
Teresa Cobo ◽  
Victoria Aldecoa ◽  
Magdalena Holeckova ◽  
Ctirad Andrys ◽  
Xavier Filella ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Predictive Model ◽  
Predictive Value ◽  
Preterm Labor ◽  
Diagnostic Performance ◽  
Clinical Signs ◽  
Entire Study ◽  
Microbial Invasion ◽  
Automated Method ◽  
Spontaneous Delivery

<b><i>Objectives:</i></b> A multivariable predictive model has recently been developed with good accuracy to predict spontaneous preterm delivery within 7 days in women with preterm labor (PTL) and intact membranes. However, this model measures amniotic fluid (AF) interleukin (IL)-6 concentrations using the ELISA method, thereby limiting clinical implementation. The main objectives of this study were to validate the automated immunoassay as a quantitative method to measure AF IL-6 in women with PTL and to evaluate the diagnostic performance of AF IL-6 alone and as part of a multivariable predictive model to predict spontaneous delivery in 7 days with this automated method. <b><i>Study Design:</i></b> This is a retrospective observational study in women with PTL below 34 weeks who underwent amniocentesis to rule out microbial invasion of the amniotic cavity. Women with clinical signs of chorioamnionitis, cervical length measurement at admission &#x3e;5th centile, maternal age &#x3c;18 years, and no consent to perform amniocentesis for this indication were excluded. The local Institutional Review Boards approved the study (HCB/2019/0940). <b><i>Analysis of AF IL-6 Concentrations:</i></b> AF IL-6 concentrations were measured using an automated Cobas e602 electrochemiluminescence immunoanalyzer and Human IL-6 Quantikine ELISA kit. <b><i>Results:</i></b> Of the entire study group (<i>n</i> = 100), 38 women spontaneously delivered within 7 days after admission. Both laboratory methods showed good agreement (intraclass correlation coefficient: 0.937 (95% confidence interval [CI] 0.908–0.957); <i>p</i> &#x3c; 0.001). Diagnostic performance of AF IL-6 to predict spontaneous delivery within 7 days when it was included in the multivariable predictive model showed an area under the receiver operating characteristic curve of 0.894 (95% CI 0.799–0.955), sensitivity of 97%, specificity of 74%, positive predictive value of 73%, negative predictive value of 97%, positive likelihood ratio (LR) of 3.7, and negative LR of 0.045. <b><i>Conclusion:</i></b> While both analytical methods were comparable for measuring AF IL-6 concentrations in women with PTL, the Cobas immunoanalyzer provided rapid diagnosis of intra-amniotic inflammation within minutes. The predictive model showed a good diagnostic performance to target women at high risk of spontaneous delivery within 7 days.

scholarly journals Validation of the SavvyCheckTM Vaginal Yeast Test for Screening Pregnant Women for Vulvovaginal Candidosis: A Prospective, Cross-Sectional Study

2021 ◽  
Vol 7 (3) ◽  
pp. 233
Author(s):  
Philipp Foessleitner ◽  
Herbert Kiss ◽  
Julia Deinsberger ◽  
Julia Ott ◽  
Lorenz Zierhut ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Predictive Value ◽  
Point Of Care ◽  
Cross Sectional Study ◽  
Control Group ◽  
Gram Stain ◽  
Cross Sectional ◽  
Point Of Care Test ◽  
Increased Risk ◽  
Vulvovaginal Candidosis

Pregnant women have an increased risk of vulvovaginal candidosis. Recurrent candidosis is under debate as a contributor to preterm birth, and vertical transmission may cause diaper dermatitis and oral thrush in the newborn. Apart from cultural methods, the gold standard for diagnosing candidosis is Gram staining, which is time-consuming and requires laboratory facilities. The objective of this prospective study was to validate a point-of-care vaginal yeast detection assay (SavvyCheckÔ Vaginal Yeast Test) and to evaluate it in asymptomatic pregnant women. We enrolled 200 participants, 100 of whom had vulvovaginal candidosis according to Gram stain (study group) and 100 were healthy pregnant controls (control group). Of these, 22 participants (11%) had invalid test results. The point-of-care test of the remaining 85 and 93 study participants in the study and control groups, respectively, showed a sensitivity of 94.1%, specificity of 98.9%, positive predictive value of 90.3%, and negative predictive value of 99.4% when compared with Gram stain. In conclusion, we found a high correlation between the SavvyCheckÔ Vaginal Yeast Test and Gram-stained smears during pregnancy. This suggests a potential role of this point-of-care test as a screening tool for asymptomatic pregnant women in early gestation.

scholarly journals Evaluation of MRSASelect™Chromogenic Medium for the Early Detection of Methicillin-ResistantStaphylococcus aureusfrom Blood Cultures

2013 ◽  
Vol 24 (4) ◽  
pp. e113-e116 ◽  
Author(s):  
Kanchana Manickam ◽  
Andrew Walkty ◽  
Philippe RS Lagacé-Wiens ◽  
Heather Adam ◽  
Barbara Swan ◽  
...  
Keyword(s):  
Early Detection ◽  
Antimicrobial Therapy ◽  
Predictive Value ◽  
Turnaround Time ◽  
Blood Cultures ◽  
Gram Stain ◽  
Chromogenic Medium ◽  
Gram Positive ◽  
Microbiological Methods ◽  
Gram Positive Cocci

INTRODUCTION:Staphylococcus aureusbacteremia is associated with considerable morbidity and mortality. In theory, reducing the turnaround time in reporting of methicillin-resistantS aureus(MRSA) among patients with bactermia could assist with the rapid optimization of antimicrobial therapy.OBJECTIVE: To evaluate the sensitivity and specificity of MRSASelect(Bio-Rad Laboratories, USA), a chromogenic medium, in the early detection of MRSA from blood cultures growing Gram-positive cocci in clusters, and to confirm that routine use of this medium would, in fact, reduce turnaround time for MRSA identification.METHODS: The present study was conducted at three microbiology laboratories in Manitoba. Between April 2010 and May 2011, positive blood cultures with Gram-positive cocci in clusters visualized on Gram stain were subcultured to both MRSASelectand routine media. MRSA isolates were identified using conventional microbiological methods from routine media and using growth with the typical colony morphology (pink colony) on MRSASelectmedium.RESULTS: A total of 490 blood cultures demonstrating Gram-positive cocci in clusters on Gram stain were evaluated.S aureuswas recovered from 274 blood cultures, with 51S aureusisolates (51 of 274 [18.6%]) identified as MRSA. MRSASelectmedium had a sensitivity of 98%, a specificity of 100%, a positive predictive value of 100% and a negative predictive value of 99.8% for the recovery and identification of MRSA directly from positive blood culture bottles. In addition, use of MRSASelectmedium was found to improve turnaround time in the detection of MRSA by almost 24 h relative to conventional methods.DISCUSSION: These data support the utility of MRSASelectmedium for the rapid identification of MRSA from positive blood cultures. Further clinical studies are warranted to determine whether the improvement in turnaround time will result in a measurable reduction in suboptimal antimicrobial therapy and/or improvement in patient outcome.

scholarly journals Performance of a Semi-quantitative Multiplex Bacterial PCR Panel Compared with Standard Microbiological Laboratory Results: 396 Patients Studied with the BioFire® Pneumonia Panel

2020 ◽  
Author(s):  
Kenneth H Rand ◽  
Stacy G Beal ◽  
Kartikeya Cherabuddi ◽  
Brianne Couturier ◽  
Beth Lingenfelter ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Predictive Value ◽  
Copy Number ◽  
Clinical Laboratory ◽  
Bacterial Species ◽  
Turnaround Time ◽  
Gram Stain ◽  
Potential Pathogen ◽  
Microbiological Laboratory ◽  
Standard Culture

Abstract Background Microbiologic results are critical to optimal management of patients with lower respiratory tract infection, but standard methods may take several days. The multiplex PCR BioFire® Pneumonia (PN) panel detects 15 common bacterial species semi-quantitatively as copy number/mL, 8 viral species and 7 resistance genes in about an hour within the clinical laboratory. Methods We tested 396 unique endotracheal or bronchoalveolar lavage specimens with the BioFire® Pneumonia panel, and compared the bacterial detections to conventional gram stain and culture results. Results Of the 396 patients, 180 grew at least 1 bacteria that had a target on the PN panel and 177/180 (98.3%) were detected by the panel. A further 20% of patients had additional targets detected, but not found in standard culture (specificity 69%, positive predictive value 63%, and negative predictive value 98.9%). Copy number was strongly related to standard semi-quantitative growth on plates reported by the laboratory (e.g. 1+, 2+, 3+ growth), and was significantly higher in those specimens that grew a potential pathogen. Both higher copy number and bacterial detections found by the PN panel, but not found in culture, were strongly positively related to the level of WBC reported in the initial gram stain. Conclusions Higher copy number and bacterial detections per se by the PN panel are related to the host respiratory tract inflammatory response. If laboratories can achieve a rapid turnaround time, the PN panel should have a significant impact both to patient management and to antibiotic stewardship.

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