Molekulaarse kompleksdiagnostika olulisus suguteede infektsioonide diagnoosimisel

Taust. Molekulaarne kompleksdiagnostika võimaldab kliinilisest materjalist määrata palju erinevaid haigust tekitavaid mikroorganisme korraga. Eesmärk. Selgitada senist suguteede infektsioonide diagnoosimise praktikat, kompleksuuringu mõju selle kvaliteedile. Metoodika. Quattromed HTI laborisse ühe kuu jooksul saabunud suguteedest võetud proove (n = 4985) uuriti sõltumata arsti tellimusest Luminexi xMAP-paneeliga suguteede infektsioonide selliste võimalike tekitajate suhtes nagu N. gonorrhoeae, C. trachomatis, C. trachomatis LGV, T. vaginalis, M. genitalium, M. hominis, U. urealyticum, U. parvum. Tulemused. Enamasti tellis arst uuringu ühe (31%), kahe (22%) või kolme (20%) obligaatse või oportunistliku patogeeni suhtes. Enim telliti C. trachomatis’e uuringut (91% proovidest). Uuritud proovidest leiti N. gonorrhoeae 0,2%-l, C. trachomatis 3,5%-l, T. vaginalis 0,5%-l, M. genitalium 1,2%-l, M. hominis 7,9%-l, U. urealyticum 7,7%-l ja U. parvum 32%-l juhtudest. Kasutatud meetodiga tuvastasime uuritud materjalis ka teisi STLI tekitajaid, mille suhtes arst ei olnud uuringut tellinud (sagedamini mitmeid STLI-d tekitavaid mikroorganisme, nt N. gonorrhoeae ja M. genitalium). Analüüsides proove vaid arsti tellimuse järgi, oleks suguhaigusi põhjustavatest patogeenidest jäänud avastamata 40% N. gonorrhoeae, 0,6% C. trachomatis’e, 88% T. vaginalis’e ja 48% M. genitalium’i esinemisest. Järeldused. Kompleksdiagnostika kasutamine võimaldaks mitmete sugulisel teel levivate mikroorganismide (eelkoige N. gonorrhoeae ja T. vaginalis’e) paremat avastamist ning võiks seeläbi parandada suguhaiguste ravi ja diagnoosimise kvaliteeti.Eesti Arst 2014; 93(8):450–45

Respiratory Syncytial Virus Disease Burden in Community-Dwelling and Long-Term Care Facility Older Adults in Europe and the United States: A Prospective Study

Background. Data on respiratory syncytial virus (RSV) disease burden in adults remain scarce. We assessed the burden of confirmed RSV-acute respiratory infections (cRSV-ARIs) in community-dwelling (CD) adults and those in long-term care facilities (LTCFs).Methods. In this prospective cohort study covering 2 RSV seasons (October 2019-March 2020 and October 2020-June 2021), RSVARIs were identified through active surveillance, in medically stable CD-adults =50 years (Europe) or adults =65 years in LTCFs (Europe and the United States). RSV infection was confirmed by polymerase chain reaction from combined nasal and throat swabs.Results. Of 1981 adults enrolled, 1251 adults in CD and 664 LTCFs (season 1) and 1223 adults in CD and 494 LTCFs (season 2) were included in the analyses. During season 1, overall incidence rates ([IRs] cases/1000 person-years) and attack rates (ARs) for cRSVARIs were 37.25 (95% confidence interval [CI], 22.62-61.35) and 1.84% in adults in CD and 47.85 (CI, 22.58-101.4) and 2.26% in adults in LTCFs. Complications occurred for 17.4% (CD) and 13.3% (LTCFs) of cRSV-ARIs. One cRSV-ARI occurred in season 2 (IR = 2.91 [CI, 0.40-20.97]; AR = 0.20%), without complications. No cRSV-ARIs led to hospitalization or death. Viral pathogens were codetected in =17.4% of cRSV-ARIs.Conclusions. RSV is an important cause of disease burden in adults in CD and LTCFs. Despite the observed low severity of cRSVARI, our results support the need for RSV prevention strategies among adults =50 years old

Evaluation of ID-PaGIA syphilis antibody test

Background: Laboratory diagnosis of syphilis is usually accomplished by serology. There are currently a large number of different commercial treponemal tests available that vary in format, sensitivity and specificity. Aim: To evaluate the ID-PaGIA Syphilis Antibody Test as an alternative to other specific treponemal tests for primary screening or confirmation of diagnosis. Methods: Serum samples from healthy adults (n = 100) were used for detection of specificity of ID-PaGIA. To evaluate sensitivity of ID-PaGIA serum samples (n = 101) from patients with confirmed or suspected syphilis were tested for syphilis antibodies with FTA-Abs IgM, ID-PaGIA, ELISA IgM and TPHA tests. Results: No false-positive results were found with ID-PaGIA. Sensitivity of various treponemal tests was the following: FTA-Abs IgM: 95.5%, ID-PaGIA and ELISA IgM: 94%, and TPHA 75%. The positive and negative predictive values of ID-PaGIA were 100 and 89.5%, respectively. Conclusions: Compared with other treponemal tests ID-PaGIA has excellent sensitivity and specificity