Evaluation of the eazyplex® EHEC complete (Amplex) assay for the differentiation of stx1 and stx2 positivity in stool samples.

The performance of the eazyplex® EHEC complete (Amplex) for the detection of Shiga toxin genes in stool samples was evaluated. The assay performed well in distinguishing between stx1 and stx2 but suboptimal sensitivity may limit its use to complementary testing rather than primary diagnosis of Shiga toxin-producing Escherichia coli infections.

Prevalence of Mycoplasma genitalium and Antibiotic Resistance-Associated Mutations in Patients at a Sexually Transmitted Infection Clinic in Iceland, and Comparison of the S-DiaMGTV and Aptima Mycoplasma genitalium Assays for Diagnosis.

Mycoplasma genitalium is prevalent among attendees in sexually transmitted infection (STI) clinics, and therapy is hampered by rapidly rising levels of resistance to azithromycin and moxifloxacin. In this study, we evaluated, for the first time in Iceland, the prevalence of M. genitalium and azithromycin and moxifloxacin resistance-associated mutations and assessed the diagnostic performance of the CE/in vitro diagnosis (IVD)-marked S-DiaMGTV (Diagenode Diagnostics) versus the U.S. FDA/CE/IVD-approved Aptima MG (AMG; Hologic) for M. genitalium detection. From October 2018 to January 2019, urine and vaginal swabs were provided by male and female attendees at Iceland's only STI clinic. Specimens were tested with S-DiaMGTV and AMG, and resistance-associated mutations were determined by 23S rRNA gene and parC sequencing. Demographic and clinical data were collected from patient records. M. genitalium prevalence was 9.3% overall; 7.7% (38/491) among male and 10.9% (53/487) among female participants. Azithromycin and moxifloxacin resistance-associated mutations were found in 57.0% (45/79) and 0.0% (0/80) of evaluable specimens, respectively. Sensitivity was 72.5% and 100%, and specificity was 99.9% and 100% for S-DiaMGTV and AMG, respectively. No association was found between M. genitalium and symptoms of urethritis in men. Prevalence rates for M. genitalium and azithromycin resistance-associated genes in Iceland are among the highest reported in Europe. The significantly higher sensitivity of AMG over that of S-DiaMGTV can have important clinical implications. More information is urgently needed to clarify the significance of false-negative results obtained with S-DiaMGTV and other similarly performing widely used real-time PCR methods for diagnosis and management of this sexually transmitted infection.

[Lyme disease in Iceland - Epidemiology from 2011 to 2015].

INTRODUCTION: Lyme disease is caused by an infection with Borrelia burgdorferi sensu latu (B. burgdorferi sl.) which is carried by Ixodes ticks. The disease has not been considered to be endemic in Iceland and no cases of Icelandic origin have been published. The epidemiology of Lyme disease in Iceland has never been studied. The objective of this study was to provide basic epidemiological information about Lyme disease in Iceland. MATERIAL AND METHODS: Included in the study were all pa--tients who had a measurement of serum antibodies against B. burgdorferi sl. or were diagnosed with Lyme disease (ICD-10, A69.2) at Landspítali University Hospital in Iceland from 2011-2015. Clinical data regarding these patients was retrospectively collected from medical records and the database of the Department of clinical microbiology at Landspítali University Hospital. RESULTS: 501 patient had a measurement of serum antibodies against B. burgdorferi sl. and 11 patients were clinically diag-nosed with Lyme disease during the study period. 33 patients fulfilled criteria for a confirmed diagnosis of Lyme disease. 32 (97%) patients had erythema migrans and one (3%) patient had neuroborreliosis. An average of 6.6 cases were diagnosed a year (two cases per 100,000 persons/year). All cases originated abroad. CONCLUSIONS: Lyme disease is rare in Iceland. On average around 6 to 7 cases are diagnosed every year, primarily localised infec-tions presenting as erythema migrans. None of the cases had a definitive Icelandic origin and the yearly number of cases has not been increasing.