Comparación de los test Aptima MG y Cobas TV/MG para la detección de Mycoplasma genitalium en muestras urogenitales y extragenitales / Comparison of the Aptima MG and Cobas TV/MG tests for the detection of Mycoplasma genitalium in urogenital and extragenital samples

Introducción: Mycoplasma genitalium (M. genitalium) es un patógeno de transmisión sexual emergente de importancia creciente. El objetivo de este estudio fue comparar dos test para la detección de M. genitalium; el test de Aptima® MG (Hologic® Inc., San Diego, CA, EE. UU.) y el test Cobas® TV/MG (Roche® Diagnostics, Mannheim, Alemania). Métodos: Se trata de un estudio descriptivo prospectivo donde se analizaron en paralelo y en orden aleatorio por ambos sistemas un total de 489 muestras genitales y extragenitales de pacientes procedentes del Centro de Infecciones de Transmisión Sexual en Sevilla y de las Consultas de Enfermedades Infecciosas del Hospital Virgen de Valme. Resultados: La concordancia global entre ambos ensayos fue muy buena (k >0,91). La sensibilidad y la especificidad del test Aptima® MG fueron del 100 y el 98,7% respectivamente, y del 100 y del 99,8%, respectivamente, para el test Cobas® TV/MG. Conclusión: Ambos sistemas mostraron un rendimiento excelente para la detección de M. genitalium.(AU)

Background: Mycoplasma genitalium (M. genitalium) is an emerging sexually transmitted pathogen of increasing importance. The objective of this study was to compare twotests for the detection of M. genitalium; the Aptima® MG test (Hologic® Inc., San Diego, CA) and the Cobas® TV/MG test (Roche® Diagnostics, Mannheim, Germany). Methods: This is a prospective descriptive study where a total of 489 genital and extragenital samples were analyzed in parallel and in random order by both systems. The samples were collected from patients attending the Sexually Transmitted Infections Center in Seville and the Infectious Diseases consultation of the Virgen de Valme Hospital. Results: The overall agreement between both trials was very good (k>0.91). The sensitivity and specificity of the Aptima® MG test were 100% and 98.7% respectively for the Cobas® TV/MG test. Conclusion: Both systems showed excellent performance for the detection of M. genitalium.(AU)

Comparison of the Aptima MG and Cobas TV/MG tests for the detection of Mycoplasma genitalium in urogenital and extragenital samples.

BACKGROUND: Mycoplasma genitalium (M. genitalium) is an emerging sexually transmitted pathogen of increasing importance. The objective of this study was to compare two tests for the detection of M. genitalium; the Aptima® MG test (Hologic® Inc., San Diego, CA) and the Cobas® TV/MG test (Roche® Diagnostics, Mannheim, Germany). METHODS: This is a prospective descriptive study where a total of 489 genital and extragenital samples were analyzed in parallel and in random order by both systems. The samples were collected from patients attending the Sexually Transmitted Infections Center in Seville and the Infectious Diseases consultation of the Virgen de Valme Hospital. RESULTS: The overall agreement between both trials was very good (k > 0.91). The sensitivity and specificity of the Aptima® MG test were 100% and 98.7% respectively for the Cobas® TV/MG test. CONCLUSION: Both systems showed excellent performance for the detection of M. genitalium.

Atypical ocular Chlamydia trachomatis infections in two patients attending in a second-level hospital: a case report.

AIM: To report two atypical inclusion conjunctivitis cases due to Chlamydia trachomatis in young adults. METHOD: Transcription mediated amplification for C. trachomatis was performed using Aptima Combo 2 Assay (Hologic, Spain). RESULTS: The first patient was managed as an orbital disorder because he had unilateral location, and ptosis was observed. Orbital nuclear magnetic resonance revealed normal results, and conjunctival biopsy did not indicate significant results. For the second patient, thyroid eye disease was suspected, but the orbital nuclear magnetic resonance revealed normal results. Conjunctival exudate samples were collected and sent to the Microbiology Laboratory where C. trachomatis was confirmed. Both patients demonstrated a great improvement with oral azithromycin 1 g. CONCLUSION: Inclusion conjunctivitis could present as unspecified unilateral or bilateral chronic conjunctivitis. Thus, suspecting it would be important in order to prevent spread and wasting diagnostic resources.

Microorganisms and Antibiotic Resistance of Bacterial Keratitis at a Rural County Hospital in Seville.

PURPOSE: To review the incidence, resistance patterns, and management of bacterial keratitis during the past 4 years. METHODS: We retrospectively reviewed the clinical records of microbiological isolates from patients with a clinical diagnosis of bacterial keratitis. RESULTS: A total of 159 patients were analyzed, and 102 microorganisms were isolated from 129 cultures. In these cultures, 23.7% of the microorganisms were gram positive, 60.8% were gram negative, and 15.5% were fungi. Pseudomonas aeruginosa was the most common bacteria (9.2%), followed by Serratia marcescens (4.4%) and Staphylococcus aureus (4%). Resistance to fluoroquinolones and aminoglycosides was found to be 23.1% and 53.1% in gram-positive and 2.8% and 13.9% in gram-negative bacteria, respectively. Resistance to ceftazidime against gram-negative bacteria was 13.9%. No resistance to vancomycin was observed. CONCLUSIONS: A high resistance rate to aminoglycosides and fluoroquinolones was observed in gram-positive bacteria. We concluded that fluoroquinolones or aminoglycosides may not be suitable for initial monotherapy in patients with severe bacterial keratitis.

Evaluation of 2 Commercial Assays for the Detection of Lymphogranuloma Venereum in Rectal Samples.

BACKGROUND: The early identification of the Chlamydia trachomatis variants that cause lymphogranuloma venereum (LGV) is very important to establish an adequate antibiotic treatment. This identification should be made with molecular techniques that are easy to perform and accessible to most microbiology laboratories. The objective of this study was to evaluate 2 real-time polymerase chain reaction (PCR)-based assay (VIASURE Haemophilus ducreyi + C. trachomatis (LGV) real-time PCR detection kit and the Allplex Genital ulcer Assay) for the detection of LGV in rectal samples. MATERIALS AND METHODS: Prospective study on positive rectal samples for C. trachomatis. All samples were processed in parallel by both tests. As a molecular reference method and to solve possible discrepancies between both assays, a PCR-based restriction fragment length polymorphism analysis of the major outer membrane protein gene (omp1) was used. RESULTS: In total, we detected 157 positive rectal samples for C. trachomatis, of which 36 were identified as LGV by PCR-based restriction fragment length polymorphism analysis. The positive percent agreement, negative percent agreement, and overall percent agreement were 88.9%, 100%, and 97.3%, respectively, for the Allplex Genital ulcer assay and 91.6%, 100%, and 97.1%, respectively, for the VIASURE assay. In the direct comparison between the Seegene assay and the VIASURE assay, we obtained a kappa concordance index of 0.98 between both tests. CONCLUSIONS: According to the results obtained, both tests could be used for the detection of LGV in rectal samples.

Updating of in vitro antifungal susceptibility tests. / Actualización de los métodos de estudio de sensibilidad in vitro a los antifúngicos.

Fungal diseases, including those caused by (multi)drug-resistant fungi, still represent a global public health concern. Information on the susceptibility of these microorganisms to antifungal agents must be quickly produced to help clinicians initiate appropriate antifungal therapies. Unfortunately, antifungal susceptibility tests are not as developed or widely implemented as antibacterial tests, being similar in design, accuracy and reproducibility, but also laborious and slow. In this article, we review the methods of in vitro susceptibility testing, both reference (CLSI and EUCAST), commercial and new methods based on proteomics (MALDI-TOF MS) and in the detection of resistance genes by nucleic acid amplification techniques. In addi-tion, we discuss the newly established clinical breakpoints, as well as the epidemiological cut-off points, which constitute a new category that can help in the early identification of isolates that have acquired resistance mechanisms. We also discuss the advantages and limitations of each of the methods studied. Therefore, we can conclude that, although there has been much progress in studies of in vitro susceptibility testing to antifungals, there are still limitations in its application in the daily routine of microbiology labo-ratories, although it seems that the future is promising with the new technologies based on proteomics and nucleic acid amplification. Supplement information: This article is part of a supplement entitled «SEIMC External Quality Control Programme. Year 2016¼, which is sponsored by Roche, Vircell Microbiologists, Abbott Molecular and Francisco Soria Melguizo, S.A. © 2019 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosasy Microbiología Clínica. All rights reserved.

Actualización de los métodos de estudio de sensibilidad in vitro a los antifúngicos / Updating of in vitro antifungal susceptibility tests

Las infecciones fúngicas, incluyendo aquellas producidas por hongos que pueden ser resistentes o multirresistentes a los antifúngicos, representan un serio problema de salud pública. La información sobre la sensibilidad de estos microorganismos a los distintos antifúngicos debe ser analizada lo más rápidamente posible para ayudar a los profesionales clínicos a instaurar un tratamiento adecuado. Desafortunadamente, las pruebas de sensibilidad a los antifúngicos no están tan desarrolladas ni implementadas como las de los antibacterianos, que son similares tanto en su diseño como en su precisión y reproducibilidad, pero laboriosas y lentas. En este artículo realizamos una revisión de los métodos de estudio de sensibilidad in vitro, tanto los de referencia (CLSI y EUCAST) como los comerciales y los nuevos métodos basados en la proteómica (MALDI-TOF MS) y en la detección de genes de resistencia por técnicas de amplificación de ácidos nucleicos. Además, se comentan los nuevos puntos de corte clínicos establecidos recientemente, así como los puntos de corte epidemiológicos, que se trata de una nueva categoría que puede ayudar a identificar de manera precoz las cepas aisladas que han adquirido mecanismos de resistencia. También se comentan las ventajas y las limitaciones de cada uno de los métodos revisados. Por tanto, puede concluirse que, aunque se ha avanzado mucho en los estudios de sensibilidad in vitro a los antifúngicos, aún existen limitaciones en su aplicación en la práctica diaria de un laboratorio de microbiología aunque parece que el futuro es esperanzador con las nuevas tecnologías basadas en la proteómica y en la amplificación de los ácidos nucleicos. Información sobre el suplemento: este artículo forma parte del suplemento titulado "Programa de Control de Calidad Externo SEIMC. Año 2016", que ha sido patrocinado por Roche, Vircell Microbiologists, Abbott Molecular y Francisco Soria Melguizo, S.A

Fungal diseases, including those caused by (multi)drug-resistant fungi, still represent a global public health concern. Information on the susceptibility of these microorganisms to antifungal agents must be quickly produced to help clinicians initiate appropriate antifungal therapies. Unfortunately, antifungal susceptibility tests are not as developed or widely implemented as antibacterial tests, being similar in design, accuracy and reproducibility, but also laborious and slow. In this article, we review the methods of in vitro susceptibility testing, both reference (CLSI and EUCAST), commercial and new methods based on proteomics (MALDI-TOF MS) and in the detection of resistance genes by nucleic acid amplification techniques. In addition, we discuss the newly established clinical breakpoints, as well as the epidemiological cut-off points, which constitute a new category that can help in the early identification of isolates that have acquired resistance mechanisms. We also discuss the advantages and limitations of each of the methods studied. Therefore, we can conclude that, although there has been much progress in studies of in vitro susceptibility testing to antifungals, there are still limitations in its application in the daily routine of microbiology labo-ratories, although it seems that the future is promising with the new technologies based on proteomics and nucleic acid amplification. Supplement information: This article is part of a supplement entitled "SEIMC External Quality Control Programme. Year 2016", which is sponsored by Roche, Vircell Microbiologists, Abbott Molecular and Francisco Soria Melguizo, S.A