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Advances in the Diagnosis of Infectious Diseases and Microorganisms
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Advances in the Diagnosis of Infectious Diseases and Microorganisms

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Diagnostic Microbiology and Infectious Disease".

Deadline for manuscript submissions: 30 April 2024 | Viewed by 27673

Special Issue Editor

Prof. Dr. Philippe Colson

E-Mail Website
Guest Editor
IRD, AP-HM, MEPHI, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005 Marseille, France
Interests: mimivirus; metagenomics; virophages; megavirales; mobilome; emerging viruses; HIV; viral hepatitis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

There have recently been interesting advances in virological and microbiological diagnostic laboratories. These have notably consisted of the extended use of diagnostics through a syndromic approach, particularly using multiplex PCR, and also the introduction and increasing use of diagnosis through next-generation sequencing. These technologies can help improve the completeness and informativeness of infection diagnoses. They help, for example, to detect numerous viral, microbial or mixed co-infections, the epidemiological and clinical significance of which deserves careful analysis. Here, we describe examples of the implementation and optimization of virological diagnoses involving these approaches. Such diagnostic strategies can be combined with real-time monitoring of the numbers of clinical specimens sampled to search for infectious etiologies and of the numbers of positive diagnoses of infectious agents, in order to detect abnormal events which may correspond to emerging phenomena and epidemics.

Prof. Dr. Philippe Colson
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

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14 pages, 779 KiB  
Article
Urine Flow Cytometry and Dipstick Analysis in Diagnosing Bacteriuria and Urinary Tract Infections among Adults in the Emergency Department—A Diagnostic Accuracy Trial
by Mathias Amdi Hertz, Isik Somuncu Johansen, Flemming S. Rosenvinge, Claus Lohman Brasen, Eline Sandvig Andersen, Claus Østergaard, Thor Aage Skovsted, Eva Rabing Brix Petersen, Stig Lønberg Nielsen, Christian Backer Mogensen and Helene Skjøt-Arkil
Diagnostics 2024, 14(4), 412; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics14040412 - 13 Feb 2024
Viewed by 653
Abstract
Urinary tract infections (UTIs) are a leading infectious cause of emergency department admission. Early UTI diagnosis is challenging, and a faster, preferably point-of-care urine analysis is necessary. We aimed to evaluate the diagnostic accuracy of urine flow cytometry (UFC) and urine dipstick analysis [...] Read more.
Urinary tract infections (UTIs) are a leading infectious cause of emergency department admission. Early UTI diagnosis is challenging, and a faster, preferably point-of-care urine analysis is necessary. We aimed to evaluate the diagnostic accuracy of urine flow cytometry (UFC) and urine dipstick analysis (UDA) in identifying bacteriuria and UTIs. This study included adults suspected of an infection admitted to three Danish emergency departments. UFC and UDA were the index tests, and urine culture and an expert panel diagnosis were the reference tests. We used logistic regression and receiver operator characteristics curves to find each test’s optimal model and cut-off. We enrolled 966 patients and performed urine cultures on 786. Urine culture was positive in 337, and 200 patients were diagnosed with a UTI. The UFC model ruled out bacteriuria in 10.9% with a negative predictive value (NPV) of 94.6% and ruled out UTI in 38.6% with an NPV of 97.0%. UDA ruled out bacteriuria in 52.1% with an NPV of 79.2% and UTI in 52.8% with an NPV of 93.9%. Neither UFC nor UDA performed well in ruling out bacteriuria in our population. In contrast, both tests ruled out UTI safely and in clinically relevant numbers. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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11 pages, 2554 KiB  
Article
Assessment of Cross-Reactivity of Chimeric Trypanosoma cruzi Antigens with Crithidia sp. LVH-60A: Implications for Accurate Diagnostics
by Emily F. Santos, Ramona T. Daltro, Carlos G. Regis-Silva, Tycha B. S. Pavan, Fabrícia A. de Oliveira, Ângela M. da Silva, Roque P. Almeida, Noilson L. S. Gonçalves, Daniel D. Sampaio, Faber N. Santos, Fabricio K. Marchini, Paola A. F. Celedon, Nilson I. T. Zanchin and Fred L. N. Santos
Diagnostics 2023, 13(22), 3470; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13223470 - 17 Nov 2023
Viewed by 971
Abstract
This study focuses on developing accurate immunoassays for diagnosing Chagas disease (CD), a challenging task due to antigenic similarities between Trypanosoma cruzi and other parasites, leading to cross-reactivity. To address this challenge, chimeric recombinant T. cruzi antigens (IBMP-8.1, IBMP-8.2, IBMP-8.3, and IBMP-8.4) were [...] Read more.
This study focuses on developing accurate immunoassays for diagnosing Chagas disease (CD), a challenging task due to antigenic similarities between Trypanosoma cruzi and other parasites, leading to cross-reactivity. To address this challenge, chimeric recombinant T. cruzi antigens (IBMP-8.1, IBMP-8.2, IBMP-8.3, and IBMP-8.4) were synthesized to enhance specificity and reduce cross-reactivity in tests. While these antigens showed minimal cross-reactivity with leishmaniasis, their performance with other trypanosomatid infections was unclear. This study aimed to assess the diagnostic potential of these IBMP antigens for detecting CD in patients with Crithidia sp. LVH-60A, a parasite linked to visceral leishmaniasis-like symptoms in Brazil. This study involved seven Crithidia sp. LVH-60A patients and three Leishmania infantum patients. The results indicated that these IBMP antigens displayed 100% sensitivity, with specificity ranging from 87.5% to 100%, and accuracy values between 90% and 100%. No cross-reactivity was observed with Crithidia sp. LVH-60A, and only one L. infantum-positive sample showed limited cross-reactivity with IBMP-8.1. This study suggests that IBMP antigens offer promising diagnostic performance, with minimal cross-reactivity in regions where T. cruzi and other trypanosomatids are prevalent. However, further research with a larger number of Crithidia sp. LVH-60A-positive samples is needed to comprehensively evaluate antigen cross-reactivity. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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17 pages, 1160 KiB  
Article
A MicroRNA-Based Method for High-Viremia Detection—A New Approach on a Romanian Lot of Chronically Infected Patients with Hepatitis B Virus
by Marina Manea, Dimitri Apostol and Ileana Constantinescu
Diagnostics 2023, 13(22), 3425; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13223425 - 10 Nov 2023
Viewed by 868
Abstract
The HBV (hepatitis B virus) infection is intended for elimination, but evaluating patients is both costly and insufficiently applied in several countries. An expensive analysis in Romania is HBV-DNA quantification, with a limited prognostic potential. Our study intended to find new predictors for [...] Read more.
The HBV (hepatitis B virus) infection is intended for elimination, but evaluating patients is both costly and insufficiently applied in several countries. An expensive analysis in Romania is HBV-DNA quantification, with a limited prognostic potential. Our study intended to find new predictors for high viremia in HBV patients, using molecules involved in the multiple assessment of various HBV complications, such as microRNAs. A total of 61 subjects (48 patients with chronic HBV infection and 13 healthy subjects) were generally evaluated. Using a RT-PCR method, with a 2−ΔΔCT algorithm, we detected the expressions of miR-122 and miR-146a in 33 subjects. MiR-21 was the internal control. The results were analyzed with the R 4.2.2. software. Kruskal–Wallis’s comparisons, Spearman correlations, and several logistic regression methods were applied. The median age of the patients was over 40 years. Without microRNAs, we could not obtain a good prediction formula. The combination of miR-122 and age proved to be the best prediction method for high viremia, with an AUC of 0.827, and a sensitivity of 89.5%. This is the first study which included age and miR-122 as independent predictors for high viremia in Romanian HBV-positive patients. MiR-122 is a new potential biomarker in the evaluation of Romanian patients. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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9 pages, 641 KiB  
Article
Detection of Plasmodium falciparum in Saliva and Stool Samples from Children Living in Franceville, a Highly Endemic Region of Gabon
by Roméo Karl Imboumy-Limoukou, Jean-Claude Biteghe-Bi-Essone, Judicael Boris Lendongo Wombo, Sonia Etenna Lekana-Douki, Virginie Rougeron, Steede-Seinnat Ontoua, Lydie Sandrine Oyegue-Liabagui, Cherone Nancy Mbani Mpega Ntigui, Lady Charlène Kouna and Jean-Bernard Lekana-Douki
Diagnostics 2023, 13(20), 3271; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13203271 - 20 Oct 2023
Cited by 1 | Viewed by 895
Abstract
Due to the difficulty of obtaining blood samples, which is the invasive method that is currently used for the detection of Plasmodium spp., alternative diagnostic sampling methods that are effective and non-invasive are needed, particularly for long-term studies. Saliva and stool samples from [...] Read more.
Due to the difficulty of obtaining blood samples, which is the invasive method that is currently used for the detection of Plasmodium spp., alternative diagnostic sampling methods that are effective and non-invasive are needed, particularly for long-term studies. Saliva and stool samples from malaria-infected individuals contain trace amounts of Plasmodium DNA and therefore could be used as alternatives. Malaria was screened using rapid diagnosis tests and confirmed via microscopy. Nested PCR tests targeting the Plasmodium falciparum-specific STEVOR gene were performed for blood, saliva and stool samples that were positive for malaria. Three hundred sixty-seven (367) children were enrolled and eighty (22.22%) were confirmed to be positive for malaria. Matched blood, saliva and stool samples were available for 35 children. By using blood smears as the gold standard for the diagnosis of malaria, our study indicates that Plasmodium DNA was more detectable in blood (100%) than in saliva (22.86%) and stools (14.29%). Applying qPCR to the STEVOR gene to detect Plasmodium falciparum DNA in saliva and stool samples cannot be considered as an alternative to the current malaria detection processes using blood specimens. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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10 pages, 431 KiB  
Article
Procalcitonin and Risk Prediction for Diagnosing Bacteremia in Hospitalized Patients: A Retrospective, National Observational Study
by Tristan T. Timbrook, Cherilyn D. Garner, Kyle D. Hueth, Gerald A. Capraro, Louise Zimmer and Hari P. Dwivedi
Diagnostics 2023, 13(20), 3174; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13203174 - 11 Oct 2023
Cited by 1 | Viewed by 925
Abstract
Bacteremia is associated with significant morbidity and mortality. Timely, appropriate therapy may improve clinical outcomes, and therefore, determining which patients benefit from more comprehensive diagnostic strategies (i.e., direct specimen testing) could be of value. We performed an assessment of procalcitonin (PCT) and clinical [...] Read more.
Bacteremia is associated with significant morbidity and mortality. Timely, appropriate therapy may improve clinical outcomes, and therefore, determining which patients benefit from more comprehensive diagnostic strategies (i.e., direct specimen testing) could be of value. We performed an assessment of procalcitonin (PCT) and clinical characteristics in the discrimination of bacteremic hospitalizations. We analyzed 71,105 encounters and 14,846 visits of patients with bacteremia alongside 56,259 without an admission. The area under the receiver—operating characteristic (AUROC) curve for the prediction of bacteremia via procalcitonin was 0.782 (95% CI 0.779–0.787). The prediction modeling of clinical factors with or without PCT resulted in a similar performance to PCT alone. However, the clinically predicted risk of bacteremia stratified by PCT thresholds allowed the targeting of high-incidence bacteremia groups (e.g., ≥50% positivity). The combined use of PCT and clinical characteristics could be useful in diagnostic stewardship by targeting further advanced diagnostic testing in patients with a high predicted probability of bacteremia. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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14 pages, 2558 KiB  
Article
Exploiting the Potential of Magnetic Nanoparticles for Rapid Diagnosis Tests (RDTs): Nanoparticle-Antibody Conjugates and Color Development Strategies
by Yeonjeong Ha
Diagnostics 2023, 13(19), 3033; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13193033 - 23 Sep 2023
Cited by 1 | Viewed by 925
Abstract
Magnetic nanoparticles (MNPs) have emerged as a promising material in disease diagnostics due to their potential to enhance detection sensitivity, facilitate concentration and purification of target substances in diverse samples, and enable favorable color-based detection. In this study, antibody-conjugated MNPs were successfully synthesized [...] Read more.
Magnetic nanoparticles (MNPs) have emerged as a promising material in disease diagnostics due to their potential to enhance detection sensitivity, facilitate concentration and purification of target substances in diverse samples, and enable favorable color-based detection. In this study, antibody-conjugated MNPs were successfully synthesized and validated through two appropriate methods: the measurement of MNPs’ size and the use of phosphatase methods. Additionally, three methods were suggested and implemented for developing color in MNPs-based immunoassay, including the formation of MNP aggregations, utilization of MNPs’ peroxidase-like activity, and synthesis of dually-conjugated MNPs with both enzyme and antibody. In particular, color development utilizing nanoparticle aggregations was demonstrated to result in a more yellowish color as virus concentration increased, while the peroxidase activity of MNPs exhibited a proportional increase in color intensity as the MNP concentration increased. This observation suggests the potential applicability of quantitative analysis using these methods. Furthermore, effective concentration and purification of target substances were demonstrated through the collection of MNPs using an external magnetic field, irrespective of factors such as antibody conjugation, dispersion medium, or virus binding. Finally, based on the key findings of this study, a design proposal for MNPs-based immunoassay is presented. Overall, MNPs-based immunoassays hold significant potential for advancing disease diagnostics. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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18 pages, 956 KiB  
Article
Particular Aspects Related to CD4+ Level in a Group of HIV-Infected Patients and Associated Acute Coronary Syndrome
by Mircea Bajdechi, Adriana Gurghean, Vlad Bataila, Alexandru Scafa-Udriște, Georgiana-Elena Bajdechi, Roxana Radoi, Anca Cristiana Oprea, Valentin Chioncel, Iuliana Mateescu, Lucia Zekra, Roxana Cernat, Irina Magdalena Dumitru and Sorin Rugina
Diagnostics 2023, 13(16), 2682; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13162682 - 15 Aug 2023
Cited by 1 | Viewed by 1048
Abstract
People living with HIV infection are at high risk for cardiovascular events due to inflammation and atherosclerosis. Also, some antiretroviral therapies may contribute to the risk of cardiovascular complications. Immune status is highly dependent on the level of lymphocyte T helper CD4+. There [...] Read more.
People living with HIV infection are at high risk for cardiovascular events due to inflammation and atherosclerosis. Also, some antiretroviral therapies may contribute to the risk of cardiovascular complications. Immune status is highly dependent on the level of lymphocyte T helper CD4+. There are data suggesting that immune status and CD4+ cell count may be involved in the development of cardiovascular complications in these patients. Our study is longitudinal and retrospective and included a total number of 50 patients with HIV infection associated with acute coronary syndrome, divided into two subgroups based on the nadir of CD4+ cells. This study analyzes the relationship between the immune status of HIV patients, assessed by the nadir of the CD4+ T-cell count, and the outcome of these patients. Also, secondary endpoints were the assessment of the magnitude of coronary lesions and of thrombotic and bleeding risk assessed by specific scores. Clinical and biological parameters and also the extension and complexity of coronary lesions were assessed. Although patients with poor immune status had more complex coronary lesions and increased operative risk and bleeding risk at one year, this was not associated with significant differences in major adverse cardiac and cerebrovascular events at the 30-day and 1-year outcomes. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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12 pages, 3732 KiB  
Article
Expanded PCR Panel Testing for Identification of Respiratory Pathogens and Coinfections in Influenza-like Illness
by Pallavi Upadhyay, Jairus Reddy, Teddie Proctor, Oceane Sorel, Harita Veereshlingam, Manoj Gandhi, Xuemei Wang and Vijay Singh
Diagnostics 2023, 13(12), 2014; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13122014 - 09 Jun 2023
Viewed by 1769
Abstract
While COVID-19 has dominated Influenza-like illness (ILI) over the past few years, there are many other pathogens responsible for ILI. It is not uncommon to have coinfections with multiple pathogens in patients with ILI. The goal of this study was to identify the [...] Read more.
While COVID-19 has dominated Influenza-like illness (ILI) over the past few years, there are many other pathogens responsible for ILI. It is not uncommon to have coinfections with multiple pathogens in patients with ILI. The goal of this study was to identify the different organisms in symptomatic patients presenting with ILI using two different high throughput multiplex real time PCR platforms. Specimens were collected from 381 subjects presenting with ILI symptoms. All samples (nasal and nasopharyngeal swabs) were simultaneously tested on two expanded panel PCR platforms: Applied Biosystems™ TrueMark™ Respiratory Panel 2.0, OpenArray™ plate (OA) (32 viral and bacterial targets); and Applied Biosystems™ TrueMark™ Respiratory Panel 2.0, TaqMan™ Array card (TAC) (41 viral, fungal, and bacterial targets). Results were analyzed for concordance between the platforms and for identification of organisms responsible for the clinical presentation including possible coinfections. Very good agreement was observed between the two PCR platforms with 100% agreement for 12 viral and 3 bacterial pathogens. Of 381 specimens, approximately 58% of the samples showed the presence of at least one organism with an important incidence of co-infections (~36–40% of positive samples tested positive for two and more organisms). S. aureus was the most prevalent detected pathogen (~30%) followed by SARS-CoV-2 (~25%), Rhinovirus (~15%) and HHV6 (~10%). Co-infections between viruses and bacteria were the most common (~69%), followed by viral-viral (~23%) and bacterial-bacterial (~7%) co-infections. These results showed that coinfections are common in RTIs suggesting that syndromic panel based multiplex PCR tests could enable the identification of pathogens contributing to coinfections, help guide patient management thereby improving clinical outcomes and supporting antimicrobial stewardship. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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12 pages, 339 KiB  
Article
Cardiovascular Risk Factors, Angiographical Features and Short-Term Prognosis of Acute Coronary Syndrome in People Living with Human Immunodeficiency Virus: Results of a Retrospective Observational Multicentric Romanian Study
by Mircea Bajdechi, Adriana Gurghean, Vlad Bataila, Alexandru Scafa-Udriste, Roxana Radoi, Anca Cristiana Oprea, Adrian Marinescu, Stefan Ion, Valentin Chioncel, Alina Nicula, Achilleas Anastasiou, Georgiana-Elena Bajdechi, Ilinca Savulescu-Fiedler, Irina Magdalena Dumitru and Sorin Rugina
Diagnostics 2023, 13(9), 1526; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13091526 - 24 Apr 2023
Cited by 1 | Viewed by 1036
Abstract
People living with human immunodeficiency virus have increased cardiovascular risk due to a higher prevalence of traditional and particular risk factors such as chronic inflammation, immune dysregulation, endothelial dysfunction, coagulation abnormalities and antiretroviral therapy. In developed countries, coronary artery disease has become the [...] Read more.
People living with human immunodeficiency virus have increased cardiovascular risk due to a higher prevalence of traditional and particular risk factors such as chronic inflammation, immune dysregulation, endothelial dysfunction, coagulation abnormalities and antiretroviral therapy. In developed countries, coronary artery disease has become the most frequent cardiovascular disease and an important cause of mortality in these patients. The symptomatology of an acute coronary syndrome can be atypical, and the prevalence of each type of acute coronary syndrome is reported differently. Regarding coronary artery disease severity in people living with HIV, the literature data indicates that the presence of single-vessel disease is akin to that of HIV-negative patients, and their short-term prognosis is unclear. This study aims to assess the clinical characteristics, biological parameters, angiographical features and short-term prognosis of acute coronary syndrome in a cohort of Romanian people living with human immunodeficiency virus. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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13 pages, 550 KiB  
Article
Large-Scale Clinical Evaluation of Rapid Blood Culture Identification Panels for Bloodstream Infections at a Tertiary Hospital
by Min-Kyung So, Soo-Kyung Kim, Hae-Sun Chung, Ji-Yun Bae and Miae Lee
Diagnostics 2023, 13(6), 1177; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13061177 - 19 Mar 2023
Cited by 1 | Viewed by 1461
Abstract
The prompt implementation of optimal antibacterial therapy through the rapid identification of the causative organisms is essential for improving outcomes for critically ill patients with bloodstream infections. We evaluated the clinical performance of the FilmArray blood culture identification (BCID) panel for rapidly identifying [...] Read more.
The prompt implementation of optimal antibacterial therapy through the rapid identification of the causative organisms is essential for improving outcomes for critically ill patients with bloodstream infections. We evaluated the clinical performance of the FilmArray blood culture identification (BCID) panel for rapidly identifying causative pathogens in the bloodstream using large-scale clinical samples. We analyzed the results of identification using a BCID panel performed on 2005 positive blood culture bottles from September 2019 to June 2022. Pathogen detection efficiency and interval from Gram staining to identification using the BCID panel were compared to those of conventional identification systems—VITEK MS MALDI-TOF Mass Spectrometer and Vitek2—and antibiotic susceptibility testing—Vitek2. We detected 2167 isolates from 2005 positive blood culture bottles. In these isolates, the BCID panel showed 93% full agreement—both organisms and antimicrobial resistance genes were matched, and no off-target organisms were detected. Species-level discordance was found in 0.6% of tests. Sixty-five isolates (3.0%) were only detected by BCID, whereas 22 isolates (1.0%) from the on-target panel were not detected by BCID. This large-scale study demonstrated that the BCID panel was a reliable and rapid identification method for directly identifying bloodstream pathogens in a positive blood culture. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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20 pages, 1386 KiB  
Article
Platelet Abnormalities in Children with Laboratory-Confirmed Influenza
by August Wrotek, Oliwia Wrotek and Teresa Jackowska
Diagnostics 2023, 13(4), 634; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13040634 - 08 Feb 2023
Cited by 1 | Viewed by 1162
Abstract
Background: The role of platelets in the immune response against influenza has been raised, and a diagnostic or prognostic value of platelet parameter abnormalities, including platelet count (PLT), or mean platelet volume (MPV), has been suggested. The study aimed to analyze the prognostic [...] Read more.
Background: The role of platelets in the immune response against influenza has been raised, and a diagnostic or prognostic value of platelet parameter abnormalities, including platelet count (PLT), or mean platelet volume (MPV), has been suggested. The study aimed to analyze the prognostic value of platelet parameters in children hospitalized due to laboratory-confirmed influenza. Methods: We retrospectively verified the platelet parameters (PLT, MPV, MPV/PLT, and PLT/lymphocyte ratio regarding the influenza complications (acute otitis media, pneumonia, and lower respiratory tract infection—LRTI), and the clinical course (antibiotic treatment, tertiary care transfer, and death). Results: An abnormal PLT was observed in 84 out of 489 laboratory-confirmed cases (17.2%, 44 thrombocytopaenia cases, and 40 thrombocytoses). Patients’ age correlated negatively with PLT (rho = −0.46) and positively with MPV/PLT (rho = 0.44), while MPV was not age-dependent. The abnormal PLT correlated with increased odds of complications (OR = 1.67), including LRTI (OR = 1.89). Thrombocytosis was related to increased odds of LRTI (OR = 3.64), and radiologically/ultrasound-confirmed pneumonia (OR = 2.15), mostly in children aged under 1 year (OR = 4.22 and OR = 3.79, respectively). Thrombocytopaenia was related to antibiotic use (OR = 2.41) and longer hospital stays (OR = 3.03). A lowered MPV predicted a tertiary care transfer (AUC = 0.77), while MPV/PLT was the most versatile parameter in predicting LRTI (AUC = 0.7 in <1 yo), pneumonia (AUC = 0.68 in <1 yo), and antibiotic treatment (AUC = 0.66 in 1–2 yo and AUC = 0.6 in 2–5 yo). Conclusions: Platelet parameters, including PLT count abnormalities and MPV/PLT ratio, are related to the increased odds of complications and a more severe disease course, and may add important data in assessing pediatric influenza patients, but should be interpreted cautiously due to age-related specificities. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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15 pages, 611 KiB  
Article
Evaluation of InTray Cassettes Directly from Blood Cultures for the Diagnosis of Sepsis in Clinical Bacteriology Laboratories as an Alternative to Classic Culture Media
by Alessandra Natale, Saoussen Oueslati, Alice Rochard, Sien Ombelet, Daniel Lopez-Baez, Liselotte Hardy, Jane Cunningham, Céline Franquesa, Olivier Vandenberg, Jean-Baptiste Ronat and Thierry Naas
Diagnostics 2023, 13(3), 523; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13030523 - 31 Jan 2023
Viewed by 1667
Abstract
Culture media is fundamental in clinical bacteriology for the detection and isolation of bacterial pathogens. However, in-house media preparation could be challenging in low-resource settings. InTray® cassettes (Biomed Diagnostics) could be a valid alternative as they are compact, ready-to-use media preparations. In [...] Read more.
Culture media is fundamental in clinical bacteriology for the detection and isolation of bacterial pathogens. However, in-house media preparation could be challenging in low-resource settings. InTray® cassettes (Biomed Diagnostics) could be a valid alternative as they are compact, ready-to-use media preparations. In this study, we evaluate the use of two InTray media as a subculture alternative for the diagnosis of bloodstream infections: the InTray® Müller-Hinton (MH) chocolate and the InTray® Colorex™ Screen. The InTray MH chocolate was evaluated in 2 steps: firstly, using simulated positive blood cultures (reference evaluation study), and secondly, using positive blood cultures from a routine clinical laboratory (clinical evaluation study). The Colorex Screen was tested using simulated poly-microbial blood cultures. The sensitivity and specificity of the InTray MH chocolate were respectively 99.2% and 90% in the reference evaluation study and 97.1% and 88.2% in the clinical evaluation study. The time to detection (TTD) was ≤20 h in most positive blood cultures (99.8% and 97% in the two studies, respectively). The InTray® MH Chocolate agar showed good performance when used directly from clinical blood cultures for single bacterial infections. However, mixed flora is more challenging to interpret on this media than on Colorex™ Screen, even for an experienced microbiologist. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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11 pages, 1956 KiB  
Article
Formalin Inactivation of Virus for Safe Downstream Processing of Routine Stool Parasite Examination during the COVID-19 Pandemic
by Pisith Chinabut, Nuntiya Sawangkla, Suphaluck Wattano, Techit Thavorasak, Weluga Bootsongkorn, Anchalee Tungtrongchitr and Pichet Ruenchit
Diagnostics 2023, 13(3), 466; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13030466 - 27 Jan 2023
Viewed by 1643
Abstract
During the COVID-19 pandemic, the parasitology laboratories dealing with fecal samples for the diagnosis of gastrointestinal parasitic infections are confronting the unsaved virus-containing samples. To allow for safe downstream processing of the fecal samples, a protocol for preparing a fecal smear is urgently [...] Read more.
During the COVID-19 pandemic, the parasitology laboratories dealing with fecal samples for the diagnosis of gastrointestinal parasitic infections are confronting the unsaved virus-containing samples. To allow for safe downstream processing of the fecal samples, a protocol for preparing a fecal smear is urgently needed. Formalin was tested with or without isotonic forms for virus inactivation using porcine epidemic diarrhea virus (PEDV) as a representative, as it belongs to the Coronaviridae family. The results revealed complete inactivation activity of 10% formalin and 10% isotonic formalin on coronavirus after 5 min of treatment at room temperature. Both also inhibited Naegleria fowleri growth after 5 min of treatment at 37 °C without disruption of the structure. In addition to these key findings, it was also found that isotonic formalin could stabilize both red and white blood cells when used as a solution to prepare fecal smears comparable to the standard method, highlighting its value for use instead of 0.9% normal saline solution for the quantification of blood cells without active virus. The 10% isotonic formalin is useful to safely prepare a fecal smear for the diagnosis of parasites and other infections of the gastrointestinal tract during the COVID-19 pandemic. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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9 pages, 804 KiB  
Article
Efficacy of Lavage by Tube under Local Anesthesia versus Arthroscopic Treatment of Acute Septic Arthritis of Native Knee
by Byung Hak Oh, Youn Moo Heo, In UK Yeo, Woo Jin Shin and Hyun Jin Yoo
Diagnostics 2023, 13(3), 371; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13030371 - 19 Jan 2023
Cited by 1 | Viewed by 2246
Abstract
Although arthroscopic treatment is a minimally invasive surgery that effectively treats septic arthritis of the knee joint, it requires general or regional anesthesia. This study aimed to compare the clinical results of lavage after tube insertion versus arthroscopic treatment. Patients treated with arthroscopic [...] Read more.
Although arthroscopic treatment is a minimally invasive surgery that effectively treats septic arthritis of the knee joint, it requires general or regional anesthesia. This study aimed to compare the clinical results of lavage after tube insertion versus arthroscopic treatment. Patients treated with arthroscopic treatment were included in group I (n = 76), while those treated with lavage by tube were included in group II (n = 34). We investigated the following in all patients: demographics, underlying disorders, initial serum white blood cell (WBC) count, C-reactive protein (CRP) level, synovial fluid WBC and polymorphonuclear cell counts, causative organism, initial Kellgren–Lawrence grade, lavage number, interventional delay, hospitalization days, CRP normalization time, and Western Ontario McMaster Universities Osteoarthritis index scores for clinical outcomes at 3 months postoperative. The mean interventional delay was significantly greater in group I (23.6 ± 15.6 h vs. 8.7 ± 9.3 h, p < 0.001). The lavage by tube featured a significantly shorter interventional delay time than arthroscopy, while the CRP decrease rate did not differ between groups. Moreover, lavage by tube showed no significant differences in outcomes, including laboratory results and functional outcomes at 3 months postoperative. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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Review

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16 pages, 1048 KiB  
Review
Diagnosis of Human Cytomegalovirus Drug Resistance Mutations in Solid Organ Transplant Recipients—A Review
by Madain S. Alsanea, Ahmed A. Al-Qahtani, Reem S. Almaghrabi, Maha A. AlAbdulkareem, Basma M. Alahideb, Dalia Obeid, Feda A. Alsuwairi and Fatimah S. Alhamlan
Diagnostics 2024, 14(2), 203; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics14020203 - 18 Jan 2024
Viewed by 1137
Abstract
Human cytomegalovirus (HCMV) infection may be asymptomatic in healthy individuals but can cause severe complications in immunocompromised patients, including transplant recipients. Breakthrough and drug-resistant HCMV infections in such patients are major concerns. Clinicians are first challenged to accurately diagnose HCMV infection and then [...] Read more.
Human cytomegalovirus (HCMV) infection may be asymptomatic in healthy individuals but can cause severe complications in immunocompromised patients, including transplant recipients. Breakthrough and drug-resistant HCMV infections in such patients are major concerns. Clinicians are first challenged to accurately diagnose HCMV infection and then to identify the most effective antiviral drug and determine when to initiate therapy, alter drug dosage, or switch medication. This review critically examines HCMV diagnostics approaches, particularly for immunocompromised patients, and the development of genotypic techniques to rapidly diagnose drug resistance mutations. The current standard method to identify prevalent and well-known resistance mutations involves polymerase chain reaction amplification of UL97, UL54, and UL56 gene regions, followed by Sanger sequencing. This method can confirm clinical suspicion of drug resistance as well as determine the level of drug resistance and range of cross-resistance with other drugs. Despite the effectiveness of this approach, there remains an urgent need for more rapid and point-of-care HCMV diagnosis, allowing for timely lifesaving intervention. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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25 pages, 992 KiB  
Review
Alternate Antimicrobial Therapies and Their Companion Tests
by Sriram Kalpana, Wan-Ying Lin, Yu-Chiang Wang, Yiwen Fu and Hsin-Yao Wang
Diagnostics 2023, 13(15), 2490; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13152490 - 26 Jul 2023
Viewed by 1323
Abstract
New antimicrobial approaches are essential to counter antimicrobial resistance. The drug development pipeline is exhausted with the emergence of resistance, resulting in unsuccessful trials. The lack of an effective drug developed from the conventional drug portfolio has mandated the introspection into the list [...] Read more.
New antimicrobial approaches are essential to counter antimicrobial resistance. The drug development pipeline is exhausted with the emergence of resistance, resulting in unsuccessful trials. The lack of an effective drug developed from the conventional drug portfolio has mandated the introspection into the list of potentially effective unconventional alternate antimicrobial molecules. Alternate therapies with clinically explicable forms include monoclonal antibodies, antimicrobial peptides, aptamers, and phages. Clinical diagnostics optimize the drug delivery. In the era of diagnostic-based applications, it is logical to draw diagnostic-based treatment for infectious diseases. Selection criteria of alternate therapeutics in infectious diseases include detection, monitoring of response, and resistance mechanism identification. Integrating these diagnostic applications is disruptive to the traditional therapeutic development. The challenges and mitigation methods need to be noted. Applying the goals of clinical pharmacokinetics that include enhancing efficacy and decreasing toxicity of drug therapy, this review analyses the strong correlation of alternate antimicrobial therapeutics in infectious diseases. The relationship between drug concentration and the resulting effect defined by the pharmacodynamic parameters are also analyzed. This review analyzes the perspectives of aligning diagnostic initiatives with the use of alternate therapeutics, with a particular focus on companion diagnostic applications in infectious diseases. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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Other

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10 pages, 3114 KiB  
Brief Report
A Multivariant Surrogate Virus Neutralization Test Demonstrates Distinct SARS-CoV-2-Specific Antibody Responses in People Living with HIV after a Fourth Monovalent mRNA Vaccination or an Omicron Breakthrough Infection
by David Niklas Springer, Simon Daller, Michael Knappik, Katja Prüger, Sylvia Hartl, Robab Breyer-Kohansal, Elisabeth Puchhammer-Stöckl, Judith Helene Aberle, Lukas Weseslindtner and Marie Kathrin Breyer
Diagnostics 2024, 14(8), 822; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics14080822 - 16 Apr 2024
Viewed by 415
Abstract
While neutralizing antibodies (nAbs) induced by monovalent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations are primarily directed against the wildtype (WT), subsequent exposure to the Omicron variants may increase the breadth of the antibodies’ cross-neutralizing activity. Here, we analyzed the impact of [...] Read more.
While neutralizing antibodies (nAbs) induced by monovalent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations are primarily directed against the wildtype (WT), subsequent exposure to the Omicron variants may increase the breadth of the antibodies’ cross-neutralizing activity. Here, we analyzed the impact of an Omicron breakthrough infection (BTI) or a fourth monovalent mRNA vaccination on nAb profiles in people living with human immunodeficiency virus (PLWH). Using a multivariant surrogate virus neutralization test (sVNT), we quantified nAbs in 36 three-times vaccinated PLWH, of whom 9 acquired a serologically confirmed Omicron BTI, 8 received a fourth vaccine dose, and 19 were neither infected nor additionally vaccinated. While nAbs against WT and Delta increased after the BTI and a fourth vaccination, a significant increase against BA.1, BA.2, and BA.5 was only observed after the BTI. However, there was no significant difference in nAb concentrations between the samples obtained after the BTI and fourth vaccination. In contrast, nAb levels were significantly lower in PLWH, who were neither infected nor additionally vaccinated after three vaccinations. Thus, our study demonstrates the suitability of a multivariant sVNT to assess hybrid humoral immunity after Omicron BTIs in PLWH vaccinated against SARS-CoV-2. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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12 pages, 4239 KiB  
Case Report
A Rare Case of Dirofilariasis in the Genian Region
by Andrei Nicolau, Florin Petrică Sava, Florentina Severin, Mihai Liviu Ciofu, Dan Ferariu, Daniela Dodu and Victor Vlad Costan
Diagnostics 2024, 14(6), 628; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics14060628 - 15 Mar 2024
Viewed by 571
Abstract
Dirofilariasis is an infectious disease caused by species of the Dirofilaria genus. It is manifested by the appearance of a subcutaneous swelling, especially in the eye region. We present the case of a 29-year-old patient who presented with facial asymmetry in the right [...] Read more.
Dirofilariasis is an infectious disease caused by species of the Dirofilaria genus. It is manifested by the appearance of a subcutaneous swelling, especially in the eye region. We present the case of a 29-year-old patient who presented with facial asymmetry in the right genian region. Following clinical and paraclinical evaluations, the diagnosis of a parasitic cyst was established in the context of dirofilariasis with Dirofilaria repens (D. repens). Treatment consisted of surgical excision of the formation associated with prophylactic antibiotic medication. Macroscopic analysis of the excision piece revealed a structure that contained a cystic cavity and a filamentous form with a length of approximately 10 mm and a diameter of 1 mm. This is the first case of dirofilariasis located in the genian region reported in Romania. The overview of this pathology is important to raise awareness among physicians about its presence and clinical variations. Understanding such cases helps healthcare professionals enhance diagnostic skills, refine treatment strategies, and provide valuable insights into the prevalence and clinical presentation, fostering early detection and timely intervention. Detailed case reports contribute to the understanding of the disease’s epidemiology, including risk factors and transmission patterns, which is essential for effective public health strategies. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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9 pages, 1224 KiB  
Brief Report
Generation of JC Polyoma Pseudovirus for High-Throughput Measurement of Neutralizing Antibodies
by Mami Matsuda, Tian-Cheng Li, Akira Nakanishi, Kazuo Nakamichi, Makoto Saito, Tadaki Suzuki, Tomokazu Matsuura, Masamichi Muramatsu, Tetsuro Suzuki, Yoshiharu Miura and Ryosuke Suzuki
Diagnostics 2024, 14(3), 311; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics14030311 - 31 Jan 2024
Viewed by 908
Abstract
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system (CNS) caused by reactivation of dormant JC polyomavirus (JCPyV). PML was mainly observed in immunocompromised individuals, such as HIV-positive patients, autoimmune disease patients, and cancer patients. Given that the presence [...] Read more.
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system (CNS) caused by reactivation of dormant JC polyomavirus (JCPyV). PML was mainly observed in immunocompromised individuals, such as HIV-positive patients, autoimmune disease patients, and cancer patients. Given that the presence of anti-JCPyV antibodies in serum is a risk indicator for PML development, it is essential to monitor anti-JCPyV antibody levels. In the present study, we established reporter-based single-infection neutralization assays for JCPyV and the genetically similar BK polyoma virus (BKPyV). We then confirmed the lack of cross-reactivity between the two viruses using test sera obtained from mice immunized with plasmids encoding the JCPyV or BKPyV capsid. Next, we compared neutralization antibody titers in sera from healthy donors, patients with multiple sclerosis (MS), and HIV-positive patients using an in-house enzyme-linked immunosorbent assay (ELISA) with JCPyV-like particles (virus-like particles; VLPs). A positive correlation was demonstrated between the neutralization titer (75% infectious concentration; IC75) against JCPyV and the antibody titer obtained by VLP-based JCPyV ELISA. This assay system may be applied to detect antibodies against other PyVs by generation of pseudoviruses using the respective capsid expression plasmids, and is expected to contribute to the surveillance of PyV as well as basic research on these viruses. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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9 pages, 1674 KiB  
Brief Report
Comparative Evaluation of a Standard M10 Assay with Xpert Xpress for the Rapid Molecular Diagnosis of SARS-CoV-2, Influenza A/B Virus, and Respiratory Syncytial Virus
by Azwani Abdullah, I-Ching Sam, Yin Jie Ong, Chun Hao Theo, Muhammad Harith Pukhari and Yoke Fun Chan
Diagnostics 2023, 13(23), 3507; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13233507 - 22 Nov 2023
Cited by 2 | Viewed by 935
Abstract
SARS-CoV-2, influenza A/B virus (IAV/IBV), and respiratory syncytial virus (RSV) are among the common viruses causing acute respiratory infections. Clinical diagnosis to differentiate these viruses is challenging due to similar clinical presentations; thus, laboratory-based real-time RT PCR is the gold standard for diagnosis. [...] Read more.
SARS-CoV-2, influenza A/B virus (IAV/IBV), and respiratory syncytial virus (RSV) are among the common viruses causing acute respiratory infections. Clinical diagnosis to differentiate these viruses is challenging due to similar clinical presentations; thus, laboratory-based real-time RT PCR is the gold standard for diagnosis. This retrospective study aimed to evaluate the diagnostic performance of STANDARD M10 Flu/RSV/SARS-CoV-2 (SD Biosensor Inc., Seoul, Korea) using archived positive and negative respiratory samples for SARS-CoV-2, IAV, IBV, and RSV. A total of 322 respiratory samples were tested, comprising 215 positive samples (49 SARS-CoV-2, 48 IAV, 53 IBV, 65 RSV) and 107 negative samples. All samples were tested with both STANDARD M10 and compared to either Xpert Xpress SARS-CoV-2 or Xpert Xpress Flu/RSV (Cepheid, Sunnyvale, CA, USA). The sensitivity, specificity, positive predictive value, and negative predictive value rates of STANDARD M10 were very similar to Xpert Xpress SARS-CoV-2 or Xpert Xpress Flu/RSV ranges for each virus (98–100%). The duration of testing and workflows were similar. The overall agreement was 99.4%, including 99.1% agreement for positive samples and 100% agreement for negative samples. In conclusion, the STANDARD M10 point-of-care test is suitable for rapid simultaneous detection of SARS-CoV-2, IAV, IBV, and RSV. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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9 pages, 1234 KiB  
Case Report
Refractory Bilateral Tubo-Ovarian Abscesses in a Patient with Iatrogenic Hypogammaglobulinemia
by Elizabeth J. Klein, Nouf K. Almaghlouth, Gabriela Weigel, Dimitrios Farmakiotis and Erica Hardy
Diagnostics 2023, 13(22), 3478; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13223478 - 19 Nov 2023
Viewed by 1130
Abstract
Genital mycoplasmas are sexually transmitted Mollicutes with a high prevalence of urogenital tract colonization among females of reproductive age. Current guidelines recommend against routine screening for these organisms, since their role in the pathogenesis of pelvic inflammatory disease and tubo-ovarian abscesses (TOAs) remains [...] Read more.
Genital mycoplasmas are sexually transmitted Mollicutes with a high prevalence of urogenital tract colonization among females of reproductive age. Current guidelines recommend against routine screening for these organisms, since their role in the pathogenesis of pelvic inflammatory disease and tubo-ovarian abscesses (TOAs) remains unclear. However, genital mycoplasmas harbor pathogenic potential in immunocompromised hosts, especially patients with hypogammaglobulinemia. It is important to identify such infections early, given their potential for invasive spread and the availability of easily accessible treatments. We present a young adult female with multiple sclerosis and iatrogenic hypogammaglobulinemia, with refractory, bilateral pelvic inflammatory disease and TOAs due to Ureaplasma urealyticum, identified as a single pathogen via three distinct molecular tests. To our knowledge, this is the second case of TOAs caused by U. urealyticum in the literature, and the first diagnosed by pathogen cell-free DNA metagenomic next-generation sequencing in plasma. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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8 pages, 1660 KiB  
Brief Report
A Single-Tube Colorimetric Loop-Mediated Isothermal Amplification for Rapid Detection of SARS-CoV-2 RNA
by Sayamon Hongjaisee, Nang Kham-Kjing, Piyagorn Musikul, Wannaporn Daengkaokhew, Nuntita Kongson, Ratchadakorn Guntala, Nitipoom Jaiyapan, Enos Kline, Nuttada Panpradist, Nicole Ngo-Giang-Huong and Woottichai Khamduang
Diagnostics 2023, 13(19), 3040; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics13193040 - 25 Sep 2023
Cited by 1 | Viewed by 1186
Abstract
Since SARS-CoV-2 is a highly transmissible virus, a rapid and accurate diagnostic method is necessary to prevent virus spread. We aimed to develop and evaluate a new rapid colorimetric reverse transcription loop--mediated isothermal amplification (RT-LAMP) assay for SARS-CoV-2 detection in a single closed [...] Read more.
Since SARS-CoV-2 is a highly transmissible virus, a rapid and accurate diagnostic method is necessary to prevent virus spread. We aimed to develop and evaluate a new rapid colorimetric reverse transcription loop--mediated isothermal amplification (RT-LAMP) assay for SARS-CoV-2 detection in a single closed tube. Nasopharyngeal and throat swabs collected from at-risk individuals testing for SARS-CoV-2 were used to assess the sensitivity and specificity of a new RT-LAMP assay against a commercial qRT-PCR assay. Total RNA extracts were submitted to the RT-LAMP reaction under optimal conditions and amplified at 65 °C for 30 min using three sets of specific primers targeting the nucleocapsid gene. The reaction was detected using two different indicator dyes, hydroxynaphthol blue (HNB) and cresol red. A total of 82 samples were used for detection with HNB and 94 samples with cresol red, and results were compared with the qRT-PCR assay. The sensitivity of the RT-LAMP-based HNB assay was 92.1% and the specificity was 93.2%. The sensitivity of the RT-LAMP-based cresol red assay was 80.3%, and the specificity was 97%. This colorimetric feature makes this assay highly accessible, low-cost, and user-friendly, which can be deployed for massive scale-up and rapid diagnosis of SARS-CoV-2 infection, particularly in low-resource settings. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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6 pages, 616 KiB  
Case Report
Fatal Fulminant Hepatitis E in a Diabetic Patient on Metformin
by Erika Peroni, Pierre Mora, Anne Motte, René Gerolami, Sarah Aherfi and Philippe Colson
Diagnostics 2022, 12(10), 2385; https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics12102385 - 30 Sep 2022
Cited by 1 | Viewed by 1258
Abstract
Hepatitis E is mostly autochthonous in Western developed countries, eating pig-derived products being the most frequently documented source. Hepatitis E virus (HEV) infection is usually asymptomatic or self-limiting, but it can cause acute liver failure. HEV serological testing was performed using EUROIMMUN immunoenzymatic [...] Read more.
Hepatitis E is mostly autochthonous in Western developed countries, eating pig-derived products being the most frequently documented source. Hepatitis E virus (HEV) infection is usually asymptomatic or self-limiting, but it can cause acute liver failure. HEV serological testing was performed using EUROIMMUN immunoenzymatic assays. HEV RNA in the serum was determined using an in-house real-time reverse transcriptase PCR procedure. The HEV genotype was determined through phylogenetic analysis after Sanger sequencing was performed using an in-house procedure. The case patient, an immunocompetent patient in his 60s with type 2 diabetes and no documented chronic liver disease, was hospitalized in February 2021 in an intensive care unit due to an initially unexplained coma. He presented metformin overdose and fulminant hepatitis E (HEV RNA in the serum was 4,140,000 copies/mL) that evolved toward death. The HEV genotype was 3f. We identified eight previous hepatitis E in diabetic patients, but with no metformin excessive plasma concentration, in the literature. Three patients were liver transplant recipients and three died. HEV infection can be severe and life-threatening in diabetic patients, which warrants HEV testing in this special population in the case of an altered general condition and/or liver cytolysis. Full article
(This article belongs to the Special Issue Advances in the Diagnosis of Infectious Diseases and Microorganisms)
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