ABSTRACT
INTRODUCTION: The aim of the study was to compare the galactomannan antigen (GA) and molecular biology (PCRrt) tests with the culture in the diagnosis of invasive aspergillosis (IA). MATERIAL AND METHODS: Four hundred and seventy two samples were analyzed: 388 respiratory and 84 serum samples from 271 patients. Culture and GA were evaluated in the respiratory samples and GA in the serum samples. PCR was used when discrepancies were observed among culture and GA tests. RESULTS: The detection of GA in serum was positive in 22 (of 84), 21 had the test positive respiratory sample. Of the 62 sera with negative GA, 45 were also negative respiratory specimens. The culture was positive in 37 of which were positive for GA. Comparing culture with AG, it showed PPV=23%, NPV=100%, S=100% and E=52%. The PCR showed respect to culture: PPV=69%, NPV=89%, S=64% and E=82%. In sera were found in 60% discrepancies between PCRrt and GA. CONCLUSIONS: We consider useful the GA detection in serum combined with culture and GA in respiratory samples, for diagnosis of AI. PCR requires further studies for standardization and set breakpoints.
Subject(s)
Antigens, Fungal/analysis , Aspergillosis/diagnosis , Aspergillus/chemistry , Mannans/immunology , Real-Time Polymerase Chain Reaction/methods , Adolescent , Antigens, Fungal/immunology , Aspergillosis/microbiology , Aspergillus/immunology , Child , Child, Preschool , Female , Galactose/analogs & derivatives , Humans , Infant , Male , Sputum/chemistry , Sputum/immunologyABSTRACT
OBJETIVO.Conocer la seroprevalencia de brucelosis, los factores deriesgo y las patologías asociadas a la presencia de anticuerposespecíficos frente a Brucela sp en pacientes del área dependientedel Consorcio Hospital General de Valencia, destacandolos pertenecientes a poblaciones próximas a zonas endémicasde esta patología.MÉTODOS.En un año, se analizaron 580 muestras de suero de pacientesde los distintos servicios del Hospital General de Valencia yArea de Salud correspondiente. Todos presentaban síndromefebril a estudio y/o manifestaciones clínicas compatibles conbrucelosis. Se determinó la reactividad frente a Brucela spmediante las pruebas; Rosa de Bengala (RB), Seroaglutinación(SAT) y Test de Coombs. Obtuvimos resultados positivos en163 muestras (28,1 %) de 122 pacientes. Sólo tuvimos accesoa la historia clínica de 46, siendo las variables revisadas;sexo, edad, procedencia, manifestaciones clínicas y diagnóstico.RESULTADOS.La prueba Rosa de Bengala fue positiva en 35 muestras de8 pacientes con clínica de brucelosis. Títulos significativos deAglutininas y Ac bloqueantes se encontraron en 14 pacientes y a títulos bajos, en 32. Clinica y serológicamente se diagnosticaron,8 pacientes de brucelosis aguda, 3 de brucelosis crónicay 3 de complicaciones de brucelosis aguda no tratada.CONCLUSIONES.Nuestra seroprevalencia (28,1 %), fue superior a la descritapor otros autores. Encontramos discrepancia entre las pruebasRB, SAT y Test de Coombs, lo mismo que otros autores ypensamos que seria necesario, ante una sospecha clínica debrucelosis, realizar más determinaciones para ver seroconversiónevitando así problemas de diagnóstico, tratamiento y controlde esta patología
OBJECTIVE.Knowing the seroprevalencia of brucellosis, the risk factorsand the pathologies associated to the presence of specificantibodies opposite Brucella sp in patients of the area contingenton the Consortium Hospital General from Valencia, highlightingthe proximate populations to this pathologys endemiczones.METHODS.In a year, we examined 580 patientss serum from differentservices of the Hospital General from Valencia and correspondentHealts Area. They all presented feverish syndrome tostudy and or clinical compatible manifestations with brucellosis.The intervening spdetermined the reactivity in front of Brucellaitselftests; Bengali rose ( RB ), Seroaglutination ( SAT ) andCoombs Test. We obtained positive results in 163 sera sample(28.1 %) of 122 patients. Only we had access to clinical historyof 46, being the revised variables; Sex, age, procedence,clinical manifestations and diagnosis.RESULTS.The RB test was positive in 35 samples of 8 patients withclinic of brucellosis. Significant levels of agglutinins and blockingantibodies, met in 14 patients and to low titles, in 32. Theclinical and serological diagnosed themselves, 8 patients ofacute brucellosis, 3 of chronic brucellosis and 3 with complicationsof acute brucellosis without treatment. CONCLUSIONS.Our seroprevalence ( 28.1 % ), was higher to the describedfor another authors. We found discrepancy among tests RB,SAT and Coombs Test, the same as another authors and wethought than it will be necessary, in front of a clinical suspicionof brucellosis, accomplishing more determinations to see seroconvertionavoiding thus problems of diagnosis, treatment andcontrol of this pathology
Subject(s)
Humans , Brucellosis/diagnosis , Brucellosis/epidemiology , Seroepidemiologic Studies , Rose Bengal , Coombs Test/statistics & numerical data , Agglutination TestsABSTRACT
Se pretende estudiar la seroprevalencia de infección porCoxiella burneti, y la incidencia de esta patología en nuestromedio. También destacamos la importancia del diagnósticoprecoz en su forma aguda para evitar las formas crónicas.MATERIAL Y METODOS.Analizamos 1259 sueros de 927 pacientes con clínica deinfección por Coxiella burneti, determinando anticuerpos IgG eIgM frente al antígeno en Fase II, resultando positivos 81. En19, determinamos anticuerpos IgG frente al antígeno en FaseI. Analizamos 102 sueros de donantes frente al antígeno enFase II . Se utilizaron los programas SPSS 6.0. y el test x2.RESULTADOS.Anticuerpos IgG positivos frente al antígeno en Fase II en132 pacientes (18,34%). De 132 pacientes, 78 tenían anticuerposIgG a título significativo, 3 anticuerpos IgM , seroconversiónen 34. De 81 pacientes, 19 presentaban clínica de FiebreQ crónica y anticuerpos frente al antígeno en Fase I, 8. Enlos donantes, 102, la seroprevalencia fue del 3,92 % al 11,69%. No se encontraron diferencias significativas respecto aedad, sexo ni procedencia, si en títulos menor o igual a 1/32. CONCLUSIONES.La Fiebre Q es un patología en la que hay que pensar paraevitar complicaciones graves sobre todo en su forma crónica.Su diagnóstico se incluirá en el protocolo de fiebres de origendesconocido
The objective of this work is to study the seroprevalence ofinfection for Coxiella burneti, in four years, evaluating the incidenceof this pathology in our means, in his sharp form and inchronic Q Fever. Also we highlighted the importance of the precociousdiagnosis in his sharp form to avoid the chronic forms.METHODS.Examined him 927 patientss 1259 serums with clinic ofinfection for Coxiella burneti. In wholes, we determined antibodiesIgG and IgM in front of the antigen in Phase II, clause positive81. In 19 we determined antibodies IgG in front of the antigenin Phase I. We examined 102 donorss serums in front ofthe antigen in Phase II. The SPSS utilized the programs themselves6,0 and the test x2.RESULTS.Antibodies IgG positive in front of the antigen in Fase II in132 patients, (18.34 %). Of 132 patients, 78 had antibodiesIgG to significant title, 3 antibodies IgM, seroconversion in 34.Of 81 patients, 19 presented clinical of Fever chronic Q andantibodies in front of the antigen in Phase I, 8. In donors, 102,the seroprevalence was from 3.92 % to 11.69 %. They did notfind significant differences in relation to age, sex neither precedence,but yes in younger titles or equal to 1/32. CONCLUSIONS.Fever the Q is one pathology that it is necessary to thinkabout to avoid grave complications most of all in his chronicform. His diagnosis will be included in the protocol of fevers ofunknown origin
Subject(s)
Humans , Q Fever/blood , Coxiella burnetii/isolation & purification , Coxiella burnetii/pathogenicity , Seroepidemiologic Studies , Q Fever/epidemiology , Chronic Disease/epidemiologyABSTRACT
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