[Assessment of 4 commercial immunoenzymatic assays for the serologic diagnosis of Helicobacter pylori infection]. / Evaluación de cuatro enzimoinmunoanálisis comerciales para el diagnóstico serológico de la infección por Helicobacter pylori.

BACKGROUND: The aim of this study was to evaluate four commercial tests for the serologic diagnosis of infection by Helicobacter pylori based on the detection of IgG class antibodies versus this microorganism. METHODS: Four commercial kits were analyzed based on the ELISA method in serum samples of 48 patients admitted for digestive endoscopy. The data of the serologic tests were compared with those provided by the culture, the histologic observation and the urease test of gastric biopsy specimens. The calculation of seroprevalence of anti-H. pylori antibodies in serum of 60 asymptomatic subjects was carried out. RESULTS: The seroprevalence of infection by H. pylori in an asymptomatic population of between 18 to 78 years of age was 58.33%. A sensitivity of 94.3% and a specificity of 88.9% were observed with the Pyloriset EIA-G test. The positive predictive value (PPV) was 92.2% and the negative predictive value (NPV) 91.5%. With the Chemifarma commercial kit the sensitivity was 78.8% and the specificity 100% with a PPV of 100% and NPV of 76.7%. Plate showed a sensitivity of 85.3% and a specificity of 87.5% with a PPV of 90% and a NPV of 80.76%. Milenia had a sensitivity of 80% and a specificity of 66.7% and a PPV of 77% and a NPV of 70.7%. CONCLUSIONS: The usefulness of the serologic tests for the diagnosis of Helicobacter pylori infection is herein confirmed with the test evaluated showing a high sensitivity and specificity as well as high predictive values.

[Clinical and epidemiologic study of meningococcal meningitis in the health region of Santiago de Compostela (1990-1997)]. / Estudio clínico y epidemiológico de las meningitis meningocócicas en el área sanitaria de Santiago de Compostela (1990-1997).

BACKGROUND: The aim of this study was to determine the clinico-epidemiologic characteristics of meningitis caused by Neisseria meningitidis. METHODS: A retrospective study was performed of the bacterial meningitis with LCR positive cultures for Neisseria meningitidis from January 1990 to 31 March, 1997. To calculate the rate of incidence data from the 1990 population census were used corresponding to a population of 465,786 inhabitants per year attended in our hospital. RESULTS: A growth was observed in the strains of N. meningitidis in 61 LCR, representing 30% of all positive LCRs. Thirty-three strains belonged to serogroup B (54%) and 28 of serogroup C (46%). Ninety-one point nine percent of the cases were found in patients under the age of 20. The annual rates of incidence ranged from 2.3 cases/100,000 inhabitants in 1990 to 3.4 cases/100,000 inhabitants in 1996 with a slight decrease between these two dates. In patients under the age of 15 years, the rates of incidence ranged from 12.3/100,000 in 1990 to 13.4 per 100,000 inhabitants in 1996. In the remaining years the rates decreased with a minimum of 2.2 cases/100,000 inhabitants. The incidence for N. meningitis serogroup C ranged from 0 to 0.9 cases/100,000 inhabitants between 1990 and 1995. In 1996 the rate increased up to 2.6 cases/100,000 inhabitants. The rate of mortality was 6.6% and sequelae 8.7%. Since 1995 strains with decreased sensitivity to penicillin have been isolated, with percentages ranging from 20% to 56.25%. All strains remained sensitive to third generation cephalosporins and rifampicin. CONCLUSIONS: Neisseria meningitidis remains the most frequent etiologic agent of acute bacterial meningitis. The increase in serogroup C strains and the ever more frequent appearance of strains with decreased resistance to penicillin are confirmed, as is the persistence of high levels of endemia in our medium.