Comparison of counterimmunoelectrophoresis, latex agglutination and bacterial culture for the diagnosis of bacterial meningitis using urine, serum and cerebrospinal fluid samples

Urine, serum and cerebrospinal fluid (CSF) samples from 98 children with clinical and laboratory diagnosis of bacterial meningitis were evaluated by counterimmunoelectrophoresis (CIE) and latex agglutination (LA) methods and the results compared to those obtained with bacterial cultures of the CSF samples. Antigens of Neisseria meningitidis groups A, B and C, Haemophilus influenzae type b and Streptococcus pneumoniae were determined by both immunological methods. Serum was diluted (1:4) with 0.1 M sodium EDTA pH 7.5, and held at 80 grade C for 10 min before assay. Polysaccharide of the urine samples was precipitated overnight using an equal volume of 1:1 ethanol-acetone followed by a heat-treatment with 0.1 M sodium EDTA, pH 7.5, at 80 grade C for 10 min. Sensitivity indices were 0.772 (CSF), 0.595 (urine) and 0.317 (serum) for CIE, and 0.914 (CSF), 0.930 (urine) and 0.683 (serum) for LA in relation to the 42 positive bacterial cultures. The optimal diagnostic efficacy reached 52% for CIE and 72% for LA when urine was concentrated 20-to 30-fold. These data show that immunological tests of urine samples were more effective than bacterial culture for diagnosing bacterial meningitis and may be indicated when negative results are obtained for tested by bacterial culture and immunoassay methods

Deteccao de antigenos bacterianos em pneumonia aguda: metodos de preparacao das amostras de urina, soro e liquido pleural para os testes de imunodiagnostico / Detection of bacterial antigens in acute pneumonia: methods of preparing the urine, serum and pleural fluid samples for immunodiagnostic assays

Foi desenvolvido um metodo de precipitacao de antigenos polissacaridicos de S. pneumoniae e H influenzae tipo b na urina, atraves do tratamento com uma solucao de etnol-acetona 1:1 seguido de um tratamento a quente com EDTA 0,1M. Foram empregadas as tecnicas de contra-imunoeletroforese e latex aglutinacao para a deteccao de antigenos polissacarideos em amostras pareadas de urina e soro e ainda de liquido pleural, de criancas com diagnostico clinico e radiologico de pneumonia aguda. Contra-imunoeletroforese e latex aglutinacao apresentaram melhores indices de sensibilidade em urina do que em soro e tiveram otimo desempenho tanto para urina de volume inicial relativamente pequeno como de grande volume, colhidas antes ou durante os primeiros dias de antibioticoterapia. Os resultados obtidos em contra-imunoeletroforese e latex aglutinacao mostraram que a solucao etanol-acetona 1:1 fornece melhor rendimento na precipitacao de antigeno polissacaridico enquanto que o aquecimento com EDTA diminui a probabilidade de ocorrencia de resultados falso-positivos e de reatividade cruzada entre S. pneumoniae e H. influenzae tipo b. A urina mostrou-se como importante meio de deteccao de antigenos bacterianos no diagnostico de pneumonia bacteriana aguda, principalmente se a antibioticoterapia previa obstrui o crescimento bacteriano nos meios de cultura.

Diffusion-in-gel enzyme-linked immunosorbent assay (DIG-ELISA) for Chagas'disease serodiagnosis

Diffusion-in-gel enzyme-linked immunosorbent assay (DIG-ELISA) was standardized and evaluated for the diagnosis of Chagas'disease in comparison with the conventional serological tests indirect immunofluorescence (IFI), passive hemagglutination (PHA) and complement fixation (CF). A total of 236 serum samples positive and negative for the serodiagnosis of Chagas'disease were studied. The group included 50 serum samples serologically positive for leishmaniasis and 36 positive for malaria. The best diagnostic performance of DIG-ELISA was observed when serum samples were diluted to 1:8 and a diameter of zero mm (no color) was taken as the cut-off. Under these conditions, the relative indices of sensitivity, specificity and agreement were 100%. High positive correlation coeficients were obtained between DIG-ELISA and IFI (r1=0.9010), PHA (r2=0.8943) and CF (r3=0.8269). We conclude that DIG-ELISA provides an alternative technique for screening chagasic infections, as well as for seroepidemiological surveys mainly because it is simple, easy to carry out and does not require expensive equipment