COVID diagnostics by molecular methods: A systematic review of nucleic acid based testing systems.

BACKGROUND: The selection of appropriate kit and PCR equipment for the detection of SARS CoV-2 is critically important in view of many options available in the diagnostic market. Since last year many molecular products are available for COVID-19 diagnostics., some of these diagnostics have become commercially available for healthcare workers and clinical laboratories. However, the diagnostic technologies have specific limitations and reported several false-positive and false-negative cases, especially during the early stages of kit development and use. The current article addresses these and other relevant questions important to the medical microbiologists running or aspiring to run COVID diagnostic services using PCR and related technologies. METHODS: In this Systematic Review we follow Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA). A total of 258 citations retrieved, among those 77 peer reviewed articles was assessed for eligibility, and 181 studies were excluded. Based on inclusion criteria final data extraction was done. RESULTS: The question of diagnostic dilemma has also been addressed in view of discordant results between assays, inter-test variability, repeat testing requirements in specific settings and inconclusive or indeterminate results. Kit efficiency was satisfactory for all assays and the estimates varied within sample types and technology. Using clinical samples, we observed some variations in detection rate between kits. Importantly, none of the assays showed cross-reactivity with other respiratory (corona) viruses, except as expected for the SARS-CoV-1 E-gene. CONCLUSIONS: We conclude SARS CoV-2 related molecular assays differed considerably in performance. Hence we need to understand importance of molecular diagnostics test interpretation in light of the latest pandemic virus.

Colistin susceptibility testing of gram-negative bacilli: Better performance of vitek2 system than E-test compared to broth microdilution method as the gold standard test.

Introduction: Unavailability of optimal susceptibility testing (ST) challenges the clinical use of colistin. Broth microdilution (BMD), which is the reference for colistin ST, is inconvenient for diagnostics. Vitek2 and E-test although technically easier, are no longer recommended. Materials and Methods: For the evaluation of Vitek2 and E-test in reference with BMD, a total of 138 Gram-negative bacilli (GNB) especially carbapenem-resistant isolates from Tata Medical Center, Kolkata, India, were included during 2017-2018. The evaluation was performed only for Enterobacteriaceae (n = 102), but not for non-fermentative GNB (n = 36) due to lack of colistin-resistant (COLR) isolates. Results and Conclusion: Of 138 isolates, meropenem, colistin and dual resistance were detected in 110 (79.7%), 31 (22.5%) and 21 (15.2%) of isolates, respectively. Using the European Committee on Antimicrobial Susceptibility Testing guidelines (susceptible, ≤2 µg/ml), Vitek2 performed better than E-test (essential agreement, 92.2% vs. 63.7%; categorical agreement, 94.1% vs. 93.1%; very major error [VME], 10% vs. 23.3%). However, Vitek2 overcalled resistance than E-test (major error, 4.2% vs. 0%). Considering Chew et al. proposed breakpoints (susceptible, ≤1 µg/ml), VMEs declined for both test (6.7% vs. 10%), but still remained unacceptable. Of eight colistin-heteroresistant isolates, two VME were categorised by Vitek2, one VME was by E-test, and two were uninterpretable. Both Vitek2 and E-test are unreliable. Further studies correlating minimum inhibitory concentrations with clinical outcome are needed to determine the accurate breakpoints for better patient management.

Amelioration of mercurial toxicity by manganese. I. A case study in mung bean seedling.

Mercury, a non essential element renders inhibitory effect on many physiological activities of plants even at a low concentration. Plants absorb "Hg" from soil through root system. Manganese, an essential element has been found to counter the inhibitory effect of mercury mostly by preventing it's uptake from soil. Mung bean (Vigna radiata L. Wilczek) cv. Pusa Baisakhi grown in individual (1, 10, 100 and 1000 ppm) solution of Hg and Mn showed varied uptake of these heavy metals. However, in combined solutions (1 : 1, 10 : 1 and 1 : 10 ppm Hg : Mn), mercury uptake was mostly prevented in presence of 10 ppm Mn, indicating it's ameliorating effect.

Individual and combined effect of mercury and manganese on phenol and proline content in leaf and stem of mungbean seedlings.

Mungbean (Vigna radiata L. Wilczelk cv. Pusa Baisakhi seedlings were raised in individual (0, 1, 10, 100 and 1000 ppm) and combined solutions (1 : 1, 10: 1, 1: 0 ppm Hg : Mn) of mercury and manganese for 6 days. Phenol and proline were found to accumulate in leaves in response to treatment with heavy metals. The magnitude of accumulation correlated with concentration of metals. However, a reverse trend was noticed in stem for phenol. Accumulation of phenol in response to heavy metal treatment was organ specific and occurred at higher rate in plant parts, which faced the stress mostly. However, accumulation of proline helped the plant to survive stress situation. In combined solutions, amelioration of mercurial toxicity by manganese was recorded.